Rehabilitation after Hip Surgery: Efficiency and Management Plans

Running head: GERONTOLOGOCAL NURSING
GERONTOLOGOCAL NURSING
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GERONTOLOGOCAL NURSING
Introduction and background:
Elderly people are seen to use a bigger part of the health as well as social services mainly
in the developed countries. One of the very common health injury like the hip fracture is seen to
be considered to be one of the major issue that old people face because of its high incidence.
High level of mortality and morbidity are also seen to be intricately associated with hip fracture.
Hip fracture is also found to be intricately associated with decrease in the quality of life with
reduction in the physical movement and increased cost of the healthcare required for the
treatment after the surgery and meeting their needs. The most commonly utilized intervention
after hip fracture is surgery that helps people to come back into their normal life and become
independent. Studies are of the opinion that hip replacement surgeries are also a treatment
intervention mainly for people with abrasion of hip joints for the reduction of the pain as well as
for increase in mobility. It has been stated by researchers that establishment of the rehabilitation
programs after that of hip surgery help by improving the quality of life of elderly people. It has
been found that patients who seek for the services of the outpatient rehabilitation had improved
strength and even better functional performance like that of better mobility and self-care abilities
after 1 year and 3 months respectively (Ling et al, 2017). This assignment would mainly include
a literature search that would try to find out the efficiency of rehabilitation as well as the
different associated aspects of rehabilitation after hip surgery. Different important databases like
Pubmed, Cochrane, Medline and others would be searched to find out important articles that
suffice the topic that needs to be researched on.

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GERONTOLOGOCAL NURSING
Pathophysiology of hip replacement:
During the time of hip replacement, a surgeon mainly causes removal the damaged
sections of the hip joint and then replacing them with different parts that are mainly constructed
from metal as well as ceramic and very hard plastic. Studies have found that these artificial joints
also called prosthesis have the ability in reducing the pain as well as improvement in the
functions. Hansen et al. (2018) are of the opinion that hip replacement surgery is mainly an
useful option for those individuals where their hip pain interferes with that of the daily activities
and when more conservative treatment have not been able to help the patients or have proved to
be ineffective. During the time of hip replacement doctors are seen to make incisions over the
front side of the hip through different layers of the tissue (Tuncel et al., 2015). This is then
followed by the professionals removing the diseased as well as the damaged bone and cartilage
leaving all the healthy bone intact. The surgeon then implants the prosthetic socket in the pelvic
bones thereby replacing the damaged socket. They then replace the round ball like structure on
the top region of the femur with the prosthetic ball that is attached to the stem fitting into the
thigh bone (Esposito et al., 2018). Hutchinson et al. (2018) are of the opinion that different
techniques for hip replacement are always evolving and as the professionals are continuing to
develop less invasive surgical techniques, these techniques might cause reduction of the recovery
time and the pain.
Management plans:
After hip replacement surgeries, patients often start physical therapies. On the first days,
patients can be seen to perform minor physical therapies sitting on the chair. In course of time,

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GERONTOLOGOCAL NURSING
the rehabilitation process is mainly seen to include stepping, walking, and climbing. Some of the
supportive devices like that of walkers or crutches are used in the initial phases. Pain is
monitored by the nurses when exercises are done by the patients. Many of the professionals are
of the opinion that some forms of discomfort are normal (Haas et al., 2018). Physical therapy is
found to be excessively important in the overall outcomes of any joint replacement surgery.
Coulter et al. (2017) are of the opinion that most of the goals of the physical therapy are to
prevent contractures, improvement in patient education, as well as in the strengthening of the
muscles around the hip joint through the interventions of controlled exercises.
Scarring of the tissues, surrounding the joint, results in contractures which can cause
limitation on the joint motion. Such contractures do not allow full range of motion and therefore,
they are seen to impede mobility of the replaced joint. Nurses should instruct patients not to
cause any form of strains to their hip joints with any activities like heavy lifting as well as other
activities at homes (Zhu et al., 2016). Patients are advised in not crossing the operated lower
extremity across the midline of the body and this might be because of the risk of dislocating the
replaced joint. Professionals should discourage them from bending at the regions mainly the
waist. They are also instructed to using of pillows between the legs when lying on the non-
operated sides form preventing the lower operated lower extremity from crossing over the
midline (Erlenwein et al., 2016). Patients at this time are given home exercise programs for
strengthening the muscles around the buttocks as well as the thigh. Most of the patients are also
seen to attend outpatient physical therapies for a period of time and at the same time,
incorporating home exercises into their daily living.
Evaluation of the management plans along with critical analysis of the knowledge: