Instructional Use Statement
The following information is used for instructional purposes for students enrolled in the Physical Therapist Assistant Program at Lane Community College. It is not intended for commercial use or distribution or commercial purposes. It is not intended to serve as medical advice or treatment.
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Introduction Screen-cast (Approximately 10 min)
Objectives
- Describe non-surgical management principles for hyper mobility disorders in the hip.
- Describe the varied surgical approaches for THA and hemiarthroplasties and report their precautions.
- Describe post-operative management of THA and hemiarthroplasties and relate how the surgical approach will affect exercise selection for the client.
- Integrate principles of exercise to create a post-operative program for management of a patient with hip fracture.
- Describe non-surgical management of overuse injuries of the hip.
Guided Learning
You should be glad to know that you can apply your knowledge and skills as it relates to arthritis management, fracture repair, hypomobile and hypermobile syndromes, and symptoms and soft tissue healing will continue to help guide clinical decision-making. As we cover the hip, the new focus is:
- recognizing specific SAFETY parameters specific to certain hip conditions (fracture, surgical approaches, and joint replacements)
- applying knowledge of open and closed chain activities as it relates to hip function
- expanding knowledge of therapeutic exercises; connecting exercises to improving function
PTA Scope of Practice
Our text is very detailed in providing an overview of surgical interventions for the hip. Here are some scope of practice guidelines which can help you focus on the most important components:
In general, a PTA is not expected to make clinical decision about patient progressions as it relates to indications for surgery, prosthetic type and design, benefit of cement versus cementless prosthesis placement procedures, or implantation of components.
A PTA is expected to recall and recognize signs and symptoms of a post-operative medical emergency, these include:
- Signs and symptoms of a Deep Vein Thrombosis (DVT); a clot in the vasculature can block circulation to the operative limb, create pain and swelling, and increase risk for the clot breaking and traveling to vessel in the lungs, heart and brain.
- Signs and symptoms of infection, particularly on or around the incision site
A PTA is expected to effectively instruct the patient, family, caregivers, and staff in weight-bearing and post-surgical precautions (and assess the effectiveness of this instruction). The goal is continuous patient, family, and staff adherence to post-surgical status to optimize recovery and minimize risk for reinjury, including post-operative dislocation.
A PTA is expected to interpret the rehabilitation phase based on the initial evaluation, plan of care, patient subjective and tests and measures during treatment. Never forget the powers of observation and rapport.
Protocols provide a framework; however, a PTA must apply clinical reasoning and assess the patient response to interventions and make informed decision to progress to higher level activities. Close coordination with the patient, physician, and PT is essential in ensuring safe and timely progression toward goals.
Video Resources
Videos are included to support your understanding of testing and movement interventions
There are approximately 42 minutes of videos included as part of this lecture.