Total Hip Replacement THR Total Knee
Replacement TKR
Total hip replacement THR or THA - Answer- Surgical procedure to replace a hip joint damaged
by a degenerative disease such as osteoarthritis arthritis.
A surgical replacement of the head of the femur (long bone of the leg) and the socket it fits into
where it joins the hip with artificial materials
Osteoarthritis (OA) - Answer- Osteoarthritis (known as wear-and-tear arthritis) is a condition in
which the natural cushioning between joints -- cartilage -- wears away.
Causes the bones of the joints to rub more against one another with less of the shock-absorbing
benefits of cartilage.
-The rubbing results in pain, swelling, stiffness, decreased ability to move and, sometimes, the
formation of bone spurs.
Posterior hip replacement - Answer- Posterior hip replacement is a minimally invasive hip surgery
performed to replace the hip joint. It is also referred to as muscle sparing surgery because no
muscles are cut to access the hip joint, enabling a quicker return to normal activity.
Posterior Hip Replacement Precautions - Answer- 1. No bending at the hip past 90 degrees.
2. No femoral Adduction past midline of body (ie: Don't cross your legs or sleep on unaffected
side.)
3. Don't turn foot inward.
Anterior hip replacement - Answer- Anterior hip replacement (AHR) is surgery to replace a hip joint
damaged by wear, injury, or disease.
The hip joint is where the top of your femur (thigh bone) sits in the socket of your pelvic bone. The
joint is held together by ligaments and muscles.
Anterior Hip Replacement Precautions - Answer- 1. No stepping backwards with surgical leg.
2. No femoral Adduction past midline of body (ie: Don't cross your legs or sleep on unaffected
side.)
3. Don't turn foot outward
Hemiarthroplasty of the hip - Answer- Hemiarthroplasty of the hip:
-generally used to treat a fractured hip.
- replaces only the head and neck of femur, correspond to the size of the original head
- usually indicated for fractures of the neck biologically older patients
- we perform in young patients with good quality of the acetabulum
-hemiarthroplasty is a surgical procedure that involves replacing half of the hip joint. Hemi means
"half" and arthroplasty refers to "joint replacement."
Hemiarthroplasty Precautions - Answer- 1)Usually no weight bearing precautions
2)Sometimes hip precautions.
Open Reduction Internal Fixation (ORIF) - Answer- ORIF Open Reduction Internal Fixation
Least invasive form of surgery; involves surgical pinning of a traumatic fracture.
, Type of surgery used to fix broken bones.
Two part surgery, the bone is put back into ...place then an internal fixation tool is inserted to put
the bone back together with screws or plates.
1. Displacement is minimal to moderate and blood supply is intact
2. Limited out of bed activities initiated one day post-op on physician's orders- can move
immediately (but it is not mature bone yet)
3. WB precautions may be necess for 6-8 wks with crutches or walker
4. NO HIP PRECAUTIONS (did not go through capsule)
THR and TKR Bed Mobility ( No ROLLING) - Answer- Getting into bed
•Back up until you feel the bed against the back of your legs.
•Place your surgical leg forward.
•Reach back for the bed surface, lowering yourself slowly to the edge.
•Scoot back on the bed in a diagonal direction until your knees feel supported.
•As you turn your body to get into bed, you may need to use a leg lifter or someone to help lift your
surgical leg.
When getting out of bed, come to a sitting position on the bed.
•As you turn your body to get out of bed, you may need to use a leg lifter or someone to help move
your surgical leg.
•Lean back as you push with your hands to help move your body forward until you are sitting at the
edge of the bed.
•Place your surgical leg forward.
•Push up from the bed and stand up.
•Do not reach for a walking device until your balance is secure.
THR Bed Positioning - Answer- Sleep Patterns:
•Lying on back- keep a wedge or pillow while in bed to avoid crossing legs. Legs should be at least
6" apart
•Lying on non-operative side, a large pillow should between legs w/bottom (non-operated side) leg
bent at the hip and knee. The top (operated side) may also be slightly bent at the hip and knee.
Total Hip Replacement Transfers - Answer- •Transfers toward their 'stronger', unoperated side.
- Keep their affected leg straight for the transfer.-
Brace unoperated leg w/your knees for greater stability. DO NOT force both knees together, as
this violates internal rotation precaution.-
Occupational Therapy Goals for THR, HA and ORIF - Answer- -ADLs:Dressing/Bathing/Toileting -
- Balance - consider both time & quality of standing
- Endurance
- take into acct the functional activity & address endurance appropriately
- Independent Living Skills
- work from simple interaction w/the environment to completion of actual, relevant homemaking
skills.
-Balance:Reaching for items, table top activities while standing, bean bag toss, balloon tap and
bounce, standing act on mat, UE bike, ball catch or bounce.
Equipment for THR - Answer- -Hip Kit
-Tub transfer benches (TTB)
-Raised toilet seat (RTS)/3 in 1 commode
-WC
Replacement TKR
Total hip replacement THR or THA - Answer- Surgical procedure to replace a hip joint damaged
by a degenerative disease such as osteoarthritis arthritis.
A surgical replacement of the head of the femur (long bone of the leg) and the socket it fits into
where it joins the hip with artificial materials
Osteoarthritis (OA) - Answer- Osteoarthritis (known as wear-and-tear arthritis) is a condition in
which the natural cushioning between joints -- cartilage -- wears away.
Causes the bones of the joints to rub more against one another with less of the shock-absorbing
benefits of cartilage.
-The rubbing results in pain, swelling, stiffness, decreased ability to move and, sometimes, the
formation of bone spurs.
Posterior hip replacement - Answer- Posterior hip replacement is a minimally invasive hip surgery
performed to replace the hip joint. It is also referred to as muscle sparing surgery because no
muscles are cut to access the hip joint, enabling a quicker return to normal activity.
Posterior Hip Replacement Precautions - Answer- 1. No bending at the hip past 90 degrees.
2. No femoral Adduction past midline of body (ie: Don't cross your legs or sleep on unaffected
side.)
3. Don't turn foot inward.
Anterior hip replacement - Answer- Anterior hip replacement (AHR) is surgery to replace a hip joint
damaged by wear, injury, or disease.
The hip joint is where the top of your femur (thigh bone) sits in the socket of your pelvic bone. The
joint is held together by ligaments and muscles.
Anterior Hip Replacement Precautions - Answer- 1. No stepping backwards with surgical leg.
2. No femoral Adduction past midline of body (ie: Don't cross your legs or sleep on unaffected
side.)
3. Don't turn foot outward
Hemiarthroplasty of the hip - Answer- Hemiarthroplasty of the hip:
-generally used to treat a fractured hip.
- replaces only the head and neck of femur, correspond to the size of the original head
- usually indicated for fractures of the neck biologically older patients
- we perform in young patients with good quality of the acetabulum
-hemiarthroplasty is a surgical procedure that involves replacing half of the hip joint. Hemi means
"half" and arthroplasty refers to "joint replacement."
Hemiarthroplasty Precautions - Answer- 1)Usually no weight bearing precautions
2)Sometimes hip precautions.
Open Reduction Internal Fixation (ORIF) - Answer- ORIF Open Reduction Internal Fixation
Least invasive form of surgery; involves surgical pinning of a traumatic fracture.
, Type of surgery used to fix broken bones.
Two part surgery, the bone is put back into ...place then an internal fixation tool is inserted to put
the bone back together with screws or plates.
1. Displacement is minimal to moderate and blood supply is intact
2. Limited out of bed activities initiated one day post-op on physician's orders- can move
immediately (but it is not mature bone yet)
3. WB precautions may be necess for 6-8 wks with crutches or walker
4. NO HIP PRECAUTIONS (did not go through capsule)
THR and TKR Bed Mobility ( No ROLLING) - Answer- Getting into bed
•Back up until you feel the bed against the back of your legs.
•Place your surgical leg forward.
•Reach back for the bed surface, lowering yourself slowly to the edge.
•Scoot back on the bed in a diagonal direction until your knees feel supported.
•As you turn your body to get into bed, you may need to use a leg lifter or someone to help lift your
surgical leg.
When getting out of bed, come to a sitting position on the bed.
•As you turn your body to get out of bed, you may need to use a leg lifter or someone to help move
your surgical leg.
•Lean back as you push with your hands to help move your body forward until you are sitting at the
edge of the bed.
•Place your surgical leg forward.
•Push up from the bed and stand up.
•Do not reach for a walking device until your balance is secure.
THR Bed Positioning - Answer- Sleep Patterns:
•Lying on back- keep a wedge or pillow while in bed to avoid crossing legs. Legs should be at least
6" apart
•Lying on non-operative side, a large pillow should between legs w/bottom (non-operated side) leg
bent at the hip and knee. The top (operated side) may also be slightly bent at the hip and knee.
Total Hip Replacement Transfers - Answer- •Transfers toward their 'stronger', unoperated side.
- Keep their affected leg straight for the transfer.-
Brace unoperated leg w/your knees for greater stability. DO NOT force both knees together, as
this violates internal rotation precaution.-
Occupational Therapy Goals for THR, HA and ORIF - Answer- -ADLs:Dressing/Bathing/Toileting -
- Balance - consider both time & quality of standing
- Endurance
- take into acct the functional activity & address endurance appropriately
- Independent Living Skills
- work from simple interaction w/the environment to completion of actual, relevant homemaking
skills.
-Balance:Reaching for items, table top activities while standing, bean bag toss, balloon tap and
bounce, standing act on mat, UE bike, ball catch or bounce.
Equipment for THR - Answer- -Hip Kit
-Tub transfer benches (TTB)
-Raised toilet seat (RTS)/3 in 1 commode
-WC
