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Use of Joint Mobilization in a Patient With Severely Restricted Hip Motion Following Bilateral Hip Resurfacing Arthroplasty

JB Crow, PT, DPT, CSCS, is Staff Physical Therapist, Sports Therapy and Rehabilitation, 160 E 56th St, New York, NY 10022 (USA)
B Gelfand, PT, SCS, is Co-owner, Sports Therapy and Rehabilitation
EP Su, MD, is Assistant Attending Orthopaedic Surgeon, Hospital for Special Surgery, and Assistant Professor of Orthopedic Surgery, Weill Medical College of Cornell University, New York, New York

Address all correspondence to Dr Crow at: jcrow77{at}aol.com

Background and Purpose: Hip resurfacing arthroplasty (HRA) is an alternative for management of end-stage osteoarthritis (OA) in young patients with high activity demands and offers several advantages over total hip arthroplasty. Severely restricted hip motion is a rare complication of the surgery. The purpose of this case report is to describe the treatment for a patient who developed severely restricted hip motion following bilateral HRA.

Case Description: A 43-year-old, athletic man underwent bilateral HRA and developed severely restricted hip motion. At 3 months postoperatively, the patient had approximately 90 degrees of hip flexion and 10 degrees of lateral rotation bilaterally. A multimodal treatment approach with an emphasis on joint mobilization was incorporated to improve hip joint mobility by restoring accessory motion.

Outcomes: The patient's passive range of motion (PROM) and Harris Hip Score (HHS) at the time of discharge showed clinically significant improvements. Total disability, as measured by the HHS, improved by 13 points, and total PROM increased 82 degrees in the right hip and 101 degrees in the left hip. The patient became independent and had full return to all activities and sports.

Discussion: The patient showed clinically meaningful improvements in PROM measurements and functional activities during a course of care using a multimodal treatment approach with an emphasis on joint mobilization. This is the first case report to describe the treatment for a patient who developed severely restricted hip motion following bilateral HRA.

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