Weight-Bearing Restrictions Following Total Hip Arthroplasty in a Patient with Upper Limb Amputation - a Care Compliant Case Report and Review of The Literature

Abstract

We present the case of a 71 year male patient with right upper limb amputation who presented to an orthopaedic clinical hospital for increased pain in the hip area associated with decreased range of motion which interfered with most of his daily activities. Patient was evaluated in an interdisciplinary team by rehabilitation and orthopaedic specialists and was scheduled for surgery after a pre rehabilitation period. Acute phase included the first week post-surgery in which early mobilization was initiated with transfer training and verticalization. Weight-bearing as tolerated was indicated on the operated limb from postoperative day 1 and the use of an axillary crutch on the functional upper limb. Walking was supervised by a physical-therapist in the first days post-surgery. Neuromuscular electrical stimulation was associated in order to promote muscle strength and static cryotherapy was applied every 4 hours on the operated limb. At day 7 the patient was discharged with a functional autonomy sufficient for his home activities. The patient was given a precise protocol to follow until control a reevaluation at 6 weeks postsurgery. By the end of the 8 week post-surgery the patient was able to demonstrate reliable gait patterns and was permitted to wean assistive devices. At 6 month follow up the patient was able to restore all functional activities with satisfying results regarding functional scores. Our case report suggests that THA can be indicated for a broader spectrum of patients without posing a major risk regarding the rehabilitation program if supervised properly in an interdisciplinary team.