A case study on Total Hip Arthroplasty- A breakdown on Rehabilitation process part 1

Before you think about diving into this, be informed that this a going to be a long post on a rehabiltatory process which will most like be broken down into several part such as a part 1,2,3 and so on and will definitely involve more than a single post as all to be broken down cant be cramped into a single draft. If you hate long post, especially ones that have more than one part, this is not for you. You have been informed, if you have chosen to stay, I promise this will be worth your time.

Ok lets go

The subject of our case study:

Age: 46

Sex: Male

Now looks at this 👇👇👇

This is a case study of a 46yrs old man who had proximal femoral replacement done which in simple terms is a replacement for damaged hip bone (of course I believe you know the meaning of bone) , its also known as an hip arthroplasty (you can google that for more details, highly recommended) which was done on account of proximal femoral bone loss following left subtrochanteric femoral fracture (open) from a gunshot wound last year. So basically, in summary, he had a gun shot wound that severely destroyed the bone of his hip


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A brief history of how the whole incident went down👇

He was in his usual state of health until some months back when he was attacked by robbers while coming home from work.

He was attacked with machetes and a barrel gun, after which he sustained a supracondylar humeral fracture at his left arm (dont stress, this is basically a broken elbow bone at the elbow) and an open left subtrochanteric femoral fracture (also this is basically a broken hip bone which is actually complicated).

The fracture was actually from him trying to defend his wife from the robbers which he successfully did, talk about being brave as Man but at the cost of his bones.

Personal comment: You see in a situation like this, some men would run like dogs with their tails in between their leg, thus leaving the wife and avoiding trouble 😵‍💫, I am not judging, but just saying

Back on track

Now following this unfortunate and really life threatening incident he was brought to the hopsital, yes he was brought in soaked in blood. Surgical intervention was done with immobilization of the areas where he sustained fracture (broken bones). A proximal femoral replacement was recommended which was just done this year due to unavailability last year

On account of the above stated, he is undergoing physiotherapy management.

Now the purpose of this post is to highlight the role of Physiotherapy in the rehabilitatory management of this man, from zero level to hero level . From the above it is made clear that he underwent a femoral replacement which is clearly a hip replacement

First lets state what a hip replacement is

A Hip replacement, also known as Hip arthroplasty is basically a artificial replacement for a damaged hip (a severe damage to the bone of the hip). It is usually more of a matallic implant which is shaped like the bone of the hip to serve as a replacement in an event where there is a severe damage to a persons hip bone.

Now before any form of physiotherapy management there are things we need to know about him, nothing should be regarded as irrelevant and nothing should be overlooked you know, it goes thus :

Past Medical history - This is to identify if he has any disease or ailment apart from the one which he was admitted for. It usually state if he is hypertensive, diabetic, epileptic, sickle celled, or asthmatic. It also states if he has had any course to be admitted in the hopsital, have a blood transfusion done and the likes.

In his case, he didnt have any underlying disease or ailment but he did have a blood transfusion done some times ago while on admission

Past surgical history - This is to tell if he has ever been operated before and the answer is yes, he had a surgery to, in simple terms align the broken bones last year (dont forget that I mentioned that the replacement was done this year instead of last year due to unavailability of the replacement, but while waiting for the replacement the broken bone were aligned through surgery).

Surgrical history - Basically the sugery for which he was currently admitted for which hip replacement surgery

Past Drug history- This refers to the drugs he was on due to one reason or the other before he was recently admitted in the hospital. This only included some analgesics and some blood thinners. In case you are wondering what blood thinner are, they basically help to reduce the thickness of the blood in really simple terms, this help to prevent some blood complications which I don't think I am ready to go into now may be in some other post.

Drug history- This refers to the drug he is on at the hospital, yeah they are just drug he is being placed on, on admission. They included antibiotics to prevent infection, analgesics to help with the pain , blood thinner which I explained earlier .

Family and social History- This just give details about he as a person, his family (married or single) , where he lives, how he lives, what he does regularly like his occupation and also what he doesn't do and so on. So in this case, he is a known driver by occupation, he definitely smokes and drink alcohol which we had to educate him on (it called patient education)

Now what you see in the above is a just a history of the him as a person in the hospital, which gives you a general idea about who he is, what he has been through and why the hell he is on admission. But it not over, there is still a lot to be done and we have not even gotten to the heart of the matter. All you see is a step out of many to his successful rehabilitation.

We have not even scratch the surface

This is a good point to draw the curtain, rehabilitatory process continues in subsequent parts where we talk about examination and assesement, treatment and rehabilitation goals and the likes, you made it this far...

Stay tuned for part 2 tomorrow...

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