Best Practice for Total Hip Arthroplasty in a 24-year-old Woman with a Hemipelvectomy: A Case Report

Abstract

Background & Purpose: This case report is being completed as a requirement for PTP 761. There is a wealth of protocols for rehabilitating patients after a THA; there is an assumption made within the protocols that the person undergoing the protocol has a contralateral limb to assist in the rehabilitation process. The purpose of this case report is to examine the modifications to the existing Brigham and Women's protocol for total hip arthroplasty in a young adult patient with a contralateral hemipelvectomy. Case Description: The subject of the report is a 24-year-old woman undergoing physical therapy starting status post 3 weeks of a left total hip arthroplasty (THA), who previously underwent a right hemipelvectomy for treatment of rhabdomyosarcoma at the age of 7. Outcomes: Outcome measures used during the course of this case study included gait quality, lateral reach, manual muscle testing (MMT), range of motion (ROM), and pain. Additionally, the patient completed the Short Form-36 (SF-36) quality of life questionnaire, which was compared to age and gender matched norms for this patient. Discussion: Intervention strategies needed to be modified for this patient due to lack of a contralateral limb. The patient was unable to follow protocol progression of interventions. The plan of care required more emphasis on trunk control in sitting and standing. The patient's quality of life was significantly decreased as compared to age norms and her previously reported level of function.