Hip arthroplasty: Effective rehabilitation protocols

Luan Dos Santos Mendes Costa ,Raiana Maria Alves Lima,José Carlos Tatmatsu-Rocha,Francisco Douglas Da Silva Freires Barros,Paloma Almeida Pereira,Vanessa Garcia De Lima ,Ana Karoline Almeida Da Silva

doi:10.33448/rsd-v10i4.14370

Luan Dos Santos Mendes Costa , Raiana Maria Alves Lima + Show 5 more

Open Access

https://doi.org/10.33448/rsd-v10i4.14370

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Abstract

Purpose: To identify the effectiveness of protocols in the functional rehabilitation process in the postoperative treatment of the hip. Methods: This is a systematic review study, composed of 4 blind and independent evaluators divided into three schematic phases. For the construction of this manuscript, the Recommendation Preferred Reporting Items for Systematic Reviews and Meta-Analyzes was applied. The descriptors used were: "rehabilitation", "physical therapy", "arthroplasty" and "hip" using the Boolean operator “AND” between each of them in the indexing bases. Results: Initially, 136 studies were found in LILACS, MEDLINE, MEDCARIB, PAHO-IRIS and WHOLIS, 99 studies in MEDLINE and 08 articles in PEDro. After reading the abstracts, 13 studies were selected, which were carefully analyzed. Discussion: Among the thirteen selected articles, the main clinical effects observed in the evaluated protocols were: improved functionality, quality of life, reduced pain, increased muscle strength. Conclusion: The functional rehabilitation of postoperative hip arthroplasty was significant in protocols that adopted early physical therapy intervention. These protocols resulted in rapid improvement in functionality, reduction of pain and quality of life. These improvements were also seen in protocols applied at home.

Highlights

The coxofemoral joint is an enarthrosis that has great freedom of movement, which is provided by the concave spherical shape of the femoral head and the convex hemispherical fossa of the acetabulum
The phases described below sought for studies that would elucidate the answer to the question PICO: What behaviors adopted by physiotherapists in the postsurgical rehabilitation programs for hip arthroplasty were effective?
Phase I: Searches were performed for the keywords Rehabilitation AND physical therapy AND arthroplasty AND hip, on the following bases: Virtual Health Library (VHL), Medical Literature Analysis and Retrieval System Online (PubMed/Medline) Physiotherapy Evidence Database (PEDro), between October and November 2019

Summary

Introduction

The coxofemoral joint is an enarthrosis that has great freedom of movement, which is provided by the concave spherical shape of the femoral head and the convex hemispherical fossa of the acetabulum. Total Hip Arthroplasty (THA) is indicated when the conservative treatment fails and is understood as an effective procedure that provides better quality of life for patients, as it reduces pain and improves the functional capacity of the hip joint. It is important to consider the increase in life expectancy of the population in relation to this increase in THA indications, and, with this, the inherent problems of this age group, such as fractures of the proximal femur, among which we highlight the Neck of Femur (NOF) fractures, revealing a greater weight of chronic degenerative diseases, including joint pathologies (Ferreira et al, 2018). Postoperative care is needed, among which, physiotherapy stands out This therapeutic approach acts directly on the first motor activities of this patient, such as: sitting, walking around the bed, indicating auxiliary devices such as the walker, for example. In view of the scenario of different individuals who underwent hip arthroplasty, we sought to list which physiotherapy procedures were most effective in the rehabilitation programs adopted by professionals and directed to their patients

Methodology

Results and Discussion

Results

Final Considerations