American Journal of Clinical Medicine Research. 2013, 1(1), 9-14
DOI: 10.12691/AJCMR-1-1-4
Original Research

The Effect of Femoral Stem Length on Inpatient Rehabilitation Outcomes

Serkan BAKIRHAN1, Bayram UNVER2, and Vasfi KARATOSUN3

1Department of Physiotherapy and Rehabilitation, School of Health, Izmir University, Izmir, Turkey

2School of Physiotherapy, Dokuz Eylül University, Izmir, Turkey

3Department of Orthopaedics, School of Medicine, Dokuz Eylül University, Izmir, Turkey

Pub. Date: February 16, 2013

Cite this paper

Serkan BAKIRHAN, Bayram UNVER and Vasfi KARATOSUN. The Effect of Femoral Stem Length on Inpatient Rehabilitation Outcomes. American Journal of Clinical Medicine Research. 2013; 1(1):9-14. doi: 10.12691/AJCMR-1-1-4

Abstract

Thrust plate prosthesis (TPP) has load-transferring characteristics different from those of conventional intramedullary stemmed prostheses (ISP). We investigate whether prosthesis type (intramedullary or extramedullary application) can improve early functional activities in hospital patients with hip arthroplasty. Early postoperative functional activities of 30 patients with TPP were compared with 31 patients treated by ISP. Each group received same rehabilitation programmes: TPP patients with early full weight bearing and ISP patients with early full weight bearing. Patients were evaluated postoperatively (on the second, sixth and discharge days). Their functional activities were assessed with Iowa Level of Assistance Scale (ILAS), walking speed with Iowa Ambulation Velocity Scale (IAVS), hip functions with Harris Hip Scoring System, and hip motions with goniometer. TPP patients achieved higher scores for total functional activities on the second and sixth postoperative days and during discharge than did ISP patients (p<0.05). Comparison of the walking speed of the patients on the second and sixth postoperative days and during discharge showed that TPP patients walked faster than did ISP patients (p<0.05). TPP patients had higher Harris hip scores and a higher hip motion degree than did ISP patients during discharge (p<0.05). We conclude that patients with TPP gain their independence in functional activities earlier than do patients with ISP.

Keywords

Thrust plate prosthesis, Intramedullary stemmed prostheses, Hip, Joint, Osteoarthritis, Replacement, Rehabilitation

Copyright

Creative CommonsThis work is licensed under a Creative Commons Attribution 4.0 International License. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/

References

[1]  Unver B, Karatosun V, Gunal I, Angin S (2004). Comparison of two different rehabilitation programmes for thrust plate prosthesis: a randomized controlled study. Clin Rehabil 18:84-91.
 
[2]  Unver B, Karatosun V, Bakirhan S (2008). Effects of obesity on inpatient rehabilitation outcomes following total knee arthroplasty. Physiotherapy 94:198-203.
 
[3]  Ganz SB, Wilson PD Jr, Cioppa-Mosca J, Peterson MGE (2003). The day of discharge after total hip arthroplasty and the achievement of rehabilitation functional milestones. J Arthroplasty 8:453-457.
 
[4]  Karatosun V, Unver B, Gunal I (2008). Hip arthroplasty with the thrust plate prosthesis in patients of 65 years of age or older: 67 patients followed 2-7 years. Arch Orthop Trauma Surg 128:377-381.
 
[5]  Aarons H, Hall G, Hughes S, Salmon P (1996). Short-term recovery from hip and knee arthroplasty. J Bone Joint Surg Br 78:555-558.
 
[6]  Bakirhan S, Unver B, Karatosun V (2009). Comparison of early postoperative functional activity levels of patients undergoing unilateral and bilateral total knee arthroplasty. Acta Orthop Traumatol Turc 43:478-483.
 
[7]  Clark CR (1994). Cost containment: total joint implants. J Bone Joint Surg Am 76:799-800.
 
[8]  Gocen Z, Sen A, Unver B, Karatosun V, Gunal I (2004). The effect of preoperative physiotherapy and education on the outcome of total hip replacement: a prospective randomized controlled trial. Clin Rehabil 18:353-358.
 
[9]  Tahim AS, Stokes OM, Vedi V (2012). The effect of femoral stem length on duration of hospital stay. Hip Int 22:56-61.
 
[10]  Berger RA, Sanders SA, Thill ES, Sporer SM, Della Valle C (2009). Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop Relat Res 467:1424-1430.
 
[11]  Rao RR, Sharkey PF, Hozack WJ, Eng K, Rothman RH (1998). Immediate weight bearing after cementless total hip arthroplasty. Clin Orthop 349:156-162.
 
[12]  Karatosun V, Unver B, Gultekin A, Gunal I (2010). Thrust plate prosthesis for proximal femoral deformity: a series of 15 patients. Acta Orthop Traumatol Turc 44:437-442.
 
[13]  Corner JA, Rawoot A, Parmar HV (2008). The thrust plate prosthesis in the treatment of osteoarthritis of the hip. Clinical and radiological outcome with minimum 5-year follow-up. Hip Int 18:88-94.
 
[14]  Unver B, Karatosun V, Gunal I (2005). Assessing the results of thrust plate prosthesis: a comparison of four different rating systems. Clin Rehabil 19:654-658.
 
[15]  Huddleston JI, Wang Y, Uquillas C, Herndon JH, Maloney WJ (2012). Age and Obesity Are Risk Factors for Adverse Events After Total Hip Arthroplasty. Clin Orthop Relat Res 470:490-496.
 
[16]  Kinkel S, Wollmerstedt N, Kleinhans JA, Hendrich C, Heisel C (2009). Patient activity after total hip arthroplasty declines with advancing age. Clin Orthop Relat Res 467:2053-2058.
 
[17]  Johanson MA, Cohen BA, Snyder KH, McKinley AJ, Scott ML (2009). Outcomes for aging adults following total hip arthroplasty in an acute rehabilitation facility versus a subacute rehabilitation facility: a pilot study. J Geriatr Phys Ther 32:73-78.
 
[18]  Mallinson TR, Bateman J, Tseng HY, Manheim L, Almagor O, Deutsch A, Heinemann AW (2011). A comparison of discharge functional status after rehabilitation in skilled nursing, home health, and medical rehabilitation settings for patients after lower-extremity joint replacement surgery. Arch Phys Med Rehabil 92:712-720.
 
[19]  Dejong G, Horn SD, Smout RJ, Tian W, Putman K, Gassaway J (2009). Joint replacement rehabilitation outcomes on discharge from skilled nursing facilities and inpatient rehabilitation facilities. Arch Phys Med Rehabil 90:1284-1296.
 
[20]  Zavadak KH, Gibson KR, Whitley DM, Britz P, Kwoh CK (1995). Variability in the attainment of functional milestones during the acute care admission after total joint replacement. J Rheumatol 22:482-487.
 
[21]  Shields RK, Enloe LJ, Evans RE, Smith KB, Steckel SD (1995). Reliability, validity, and responsiveness of functional tests in patients with total joint replacement. Phys Ther 75:169-179.
 
[22]  Jesudason C, Stiller K (2002). Are bed exercises necessary following hip arthroplasty ? Aust J Physiother 48:73-81.
 
[23]  Stockton KA, Mengersen KA (2009). Effect of multiple physiotherapy sessions on functional outcomes in the initial postoperative period after primary total hip replacement: a randomized controlled trial. Arch Phys Med Rehabil 90:1652-1657.
 
[24]  McCrory JL, White SC, Lifeso RM (2001). Vertical ground reaction forces: objective measures of gait following hip arthroplasty. Gait Posture 14:104-109.
 
[25]  Perron M, Malouin F, MoVet H, McFadyen BJ (2000). Three-dimensional gait analysis in women with a total hip arthroplasty. Clin Biomech (Bristol, Avon) 15:504-515.
 
[26]  Loizeau J, Allard P, Duhaime M, Landjerit B (1995). Bilateral gait patterns in subjects fitted with a total hip prosthesis. Arch Phys Med Rehabil 76:552-557.
 
[27]  Karatosun V, Unver B, Gultekin A, Gunal I (2011). A biomechanical comparison of the thrust plate prosthesis and a stemmed prosthesis. Hip Int 21:565-570.
 
[28]  Munin MC, Hockenberry PS, Flynn PG, Toplak W (1998). Rehabilitation. In: Callaghan JJ, Rosenberg AG, Rubash HE, editors. The adult hip. Philadelphia: Lippincott-Raven 1571-1579.
 
[29]  Yoshii T, Jinno T, Morita S, Koga D, Matsubara M, Okawa A, Sninomiyak A (2009). Postoperative hip motion and functional recovery after simultaneous bilateral total hip arthroplasty for bilateral osteoarthritis. J Orthop Sci 14:161-166.
 
[30]  Nankaku M, Tsuboyama T, Kakinoki R, Akiyama H, Nakamura T (2011). Prediction of ambulation ability following total hip arthroplasty. J Orthop Sci 16:359-363.
 
[31]  Efthekhar NS (1993). Total Hip Arthroplasty. Missouri: Mosby.
 
[32]  Ferrara PE, Rabini A, Maggi L, Piazzini DB, Logroscino G, Magliocchetti G, Amabile E, Tancredi G, Aulisa AG, Padua L, Aprile I, Bertolini C (2008). Effect of pre-operative physiotherapy in patients with end-stage osteoarthritis undergoing hip arthroplasty. Clin Rehabil 22:977-986.
 
[33]  Angin S, Karatosun V, Unver B, Gunal I (2007). Gait assessment in patients with thrust plate prosthesis and intramedullary stemmed prosthesis implanted to each hip. Arch Orthop Trauma Surg 2:91-96.
 
[34]  Fink B, Siegmüller C, Schneider T, Conrad S, Schmielau G, Rüther W (2000). Short-and medium-term results of the thrust plate prosthesis in patients with polyarthritis. Arch Orthop Trauma Surg 120:294-298.