Academy of Orthopaedic Physical Therapy

American Physical Therapy Association (APTA)

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Special Collection - Hip
Table of Contents

JOINT ARTHROPLASTY: ADVANCES IN SURGICAL MANAGEMENT AND REHABILITATION
HIP ARTHROPLASTY

Abstract:

CONTENT: In the monograph, Dr. Heislein first reviews the anatomy and biomechanics of the hip as an introduction to indications and prevalence for hip joint arthroplasty. Physical examination considerations and the role of imaging in hip osteoarthritis follow. Conservative intervention strategies are then reviewed along with prognostic indicators for hip arthroplasty. Common surgical procedures and approaches are then explained in the context of advantages and disadvantages of each procedure and their implications on rehabilitation. Dr. Heislein also informs the reader of potential complications following arthroplasty procedures. Preoperative and postoperative rehabilitation strategies and guidelines on exercise and functional progression are then discussed. The remaining portion of the monograph addresses common outcome measures for hip arthroplasty and also the author's opinion on future directions in this area. The content of this work will enable readers to update their current level of knowledge concerning factors that guide rehabilitation and provide an appreciation for the role of effective communication and teamwork among health care providers, the patient, and their family. Despite the assumption that all postoperative arthroplasty rehabilitation is protocol driven, the unique needs and individual characteristics of each patient will ultimately influence the success of the specific rehabilitation program that is developed. CASE ANALYSES: Three case studies assist in applying the information presented in the monograph. The first case presents a patient who has undergone a total hip arthroplasty. The second case discusses hemiarthroplasty following hip fracture, and the third case illustrates the impact of complications for a revision total hip arthroplasty.

Keywords:​

joint replacement, arthritis, surgery

References:

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INJURIES TO THE HIP
FUNCTIONAL PERFORMANCE TESTING OF THE HIP

Abstract:

This monograph discusses functional performance tests and their reliability and validity for patients with hip dysfunction. The assessments cover the categories of movement, balance and postural control, hop/jump, and field agility tests. Selection and interpretation of each functional performance test support the detection of hip dysfunction and aid in determining treatment progression. The monograph also addresses the use of cutting edge functional performance tests to assist in differential diagnosis of hip-related pathology. CASE ANALYSES: Three intriguing case studies are presented. Each case highlights strong clinical reasoning and proper care. The first case involves a 19-year-old female Broadway dancer complaining of pain and a sense of instability in her right hip. The second case describes a 44-year-old female who is referred to physical therapy for ongoing complaints of posterior-lateral hip pain that radiates into the buttock. The third case clearly details a pre-participation screening exam of a 22-year-old male collegiate hockey player.

Keywords:​

reliability, validity, dysfunction

References:

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INJURIES TO THE HIP
THERAPEUTIC EXERCISE FOR HIP REHABILITATION: AN EVIDENCE-BASED APPROACH

Abstract:

CONTENT: This monograph first reviews the functional anatomy and kinesiology of the hip. This knowledge then forms the basis for enhancing the reader's understanding of normal hip function during ambulation and how to prescribe therapeutic exercises. Referenced electromyographic studies of the hip provide evidence for the approach advocated in the monograph. The authors include a supplemental booklet containing photos of several exercises for hip rehabilitation. The majority of these exercises also appear as video clips online. This approach provides the reader with a unique learning resource. CASE ANALYSES: Three cases studies are provided. The first case describes a 55-year-old female who underwent right total knee arthroplasty 4 weeks prior to beginning physical therapy. The second case details a 44-year-old hockey coach who presents with a history of right hip pain along with a recent injury caused when one of his players collided with him on the ice. The third case describes a 21-year-old college female who suffers from right anterior hip pain for 2 months, but also desires to run in an upcoming triathlon. This case is accompanied by a pre- and posttreatment online video showing the patient's running gait.

Keywords:​

kinesiology, anatomy, ambulation

References:

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BIOMECHANICS OF GAIT:
THE HIP

Abstract:

CONTENT: The latest research on gait is readily applied to the evaluation and treatment of patients with hip pathology. Examination of the hip joint during gait is the entire focus of this monograph. The authors first review common terms used in gait analysis and then discuss spatiotemporal factors that lead into planar kinematics and kinetics of the hip during the gait cycle. Graphs and figures assist in clarifying important concepts. A major section focuses on application of normal gait to clinical pathomechanics. Acute, chronic, and pathological adaptations that accompany select pathologies are included. Discussion focuses specifically on adaptations following total hip replacement, iliotibial band syndrome, and hip flexion contracture. Gait deviations commonly observed for each orthopaedic condition are described and evidence for interventions suggested to improve aberrant gait for orthopaedic injuries is also presented. CASE ANALYSES: Two cases studies are presented. The first case describes a 25-year-old female triathlete referred to physical therapy with a diagnosis of Iliotibial Band Syndrome. The second case involves a 74-year-old male, 11 months status post left total hip replacement with continued complaints of pain and stiffness in the left hip.

Keywords:​

walking, hip injuries, kinetics, kinematics

References:

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CURRENT CONCEPTS OF ORTHOPAEDIC PHYSICAL THERAPY, 4TH ED. 
PHYSICAL THERAPY PATIENT MANAGEMENT USING CURRENT EVIDENCE

Abstract:

This monograph discusses the clinical diagnosis and physical management of conditions affecting the hip including pathoanatomy, biomechanics, clinical examination, and manual therapy. The monograph also addresses differential diagnosis from a medical perspective and updates in surgical management. Eleven intriguing case studies are presented. These cases highlight the condition most commonly seen by physical therapists in the clinical. Multiple-choice questions with answers and detailed explanations are used to aid learning.

Keywords:​

biomechanics, mobilization, lumbopelvic

References:

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POSTOPERATIVE MANAGEMENT OF ORTHOPAEDIC SURGERIES
HIP

Abstract:

The range of surgical options available for individuals with hip pathology has continued to expand. Although total hip arthroplasty is a well-established technique for late-stage degenerative joint disease, arthroscopy and periacetabular osteotomy procedures are becoming more popular in the treatment of non-arthritic hip pain when conservative treatment is not successful. As surgical procedures for hip pathology advance, related rehabilitation protocols must evolve in parallel. This monograph will review pathological conditions of the hip joint, corresponding surgical options, and related postoperative rehabilitation concepts. Case studies will be provided to demonstrate application of postoperative rehabilitation protocols in specific clinical situations.

Keywords:​

acetabular labrum, femoral acetabular impingement, rehabilitation

References:

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