All-Care Physical Therapy Center LLC

Total Hip Arthroplasty Anterior Approach vs. Posterior Approach

David Walinger, PTA

Total hip arthroplasty (THA) is used worldwide as one of the most effective procedures for relieving pain, restoring function, and improving quality of life in patients with painful or deformed hip joints. Improvements in hip arthroplasty procedures have led to faster recovery, shorter hospitalization, and higher patient satisfaction.

In the United States, more than 300,000 patients between 50-80 years of age undergo total hip replacement. The most common cause for requiring a THA is due to osteoarthritis or injury. Symptoms of osteoarthritis include pain, joint stiffness, and decreased range of motion. THA has the ability to relieve pain and improve quality of life. Among all the joints in the human body, the hip joint has a faster, more durable and successful recovery following replacement. The hip joint is a ball-and-socket joint. The prosthetic (artificial) portion of the hip joint consists of two parts, a cup-like component that is attached to the acetabulum (portion of the pelvic bone), and a shaft with a round top that attaches to the femur (thigh bone of the leg). The damaged parts of the hip bone are removed, contoured and replaced with the prosthetic. These material combinations can include metal-on-polyethylene ,metal-on-metal, and ceramic-on-ceramic.

Total hip replacements can be performed with two techniques which include an anterior approach or posterior approach. The anterior approach is considered less invasive in comparison to the posterior approach. During a posterior approach, while lying on your side, your orthopedic surgeon will create a 4-7 inch incision behind the hip along the outer buttock area. The gluteus maximus muscle is split but will not require repair. Two hip external rotator muscles are detached and then reattached to bone and will heal within 4-6 weeks. The anterior approach is usually performed creating an incision along the front upper thigh separating but not detaching muscle to avoid nerve damage. Following surgery, your physician will discuss your hip precautions to ensure a successful recovery.

Hip Precautions

Posterior Approach: What to avoid:

• Sitting on low chair/toilets • Bringing you knee past you hip ( >90 degrees of hip flexion) • Bending at the waist to pick up objects off the floor • Standing “pigeon toed” (inward rotation of feet) • Crossing of legs

Anterior Approach: What to avoid:

• Stepping backwards on your surgical leg • Crossing of legs • Lying on your stomach • Standing with your feet rotated outward *Please consult with your physician regarding hip precautions

Your safety and health are our first priority

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Physical Therapy

Early postoperative therapeutic exercises are necessary for preventing blood clots and increasing blood circulation to your lower extremities. Early exercises are also important to strengthen muscles and maintain joint integrity. Following surgery, you will meet your supervising physical therapist in the recovery room to begin exercises implemented in your personal treatment plan. It may feel uncomfortable at first, but these exercises will speed your recovery and reduce your postoperative pain.

Outpatient physical therapy sessions will help restore range of motion and increase your proximal hip stability. Weight-bearing activities will help restore strength to optimal levels as well. This level of physical therapy focuses on activity-specific rehabilitation for your personal goals, such as a return to work or other activity. Your physical therapist will incorporate exercises that simulate those activities. These may include lifting techniques, pushing, pulling carts, climbing ladders, agility exercises, or light jogging depending on your recovery and activity level.

Today, 80% of all hip replacements last for up to 20 years. Some are not always successful, leaving various factors which increase the chances of failure including an individual’s weight, compliance of hip precautions as well as level of activity and overall health status. Performing strengthening exercises is essential for stabilizing the hip during recovery. Excessively high impact exercises can cause too much force and can increase the likelihood of complications. Skilled manual therapy and rehabilitation is very important in order to regain full potential and proper recovery. For more information on the importance of physical rehabilitation following a total joint replacement surgery, please call (609) 660-1900 to schedule an appointment at our Barnegat location.

David Walinger, PTA David graduated from Union County College where he earned his Associates Degree in Applied Science with successful completion of the Physical Therapist Assistant Program. Prior to this, he attended Bloomsburg University where he studied exercise science. During his clinical rotations he has treated many patients with a variety of pathologies including musculoskeletal injuries, Parkinson’s disease, cerebrovascular accidents, traumatic brain injuries, and more. David is an active member of the American Physical Therapy Association and is delighted to be a part of the All-Care team.

# Community Community 7

♥Heart Disease: It Can Happen at Any Age

Heart disease doesn’t happen just to older adults. It is happening to younger adults more and more often. This is partly because the conditions that lead to heart disease are happening at

February is Heart Month

Other conditions and behaviors that affect your risk for heart disease include: • Obesity. Carrying extra weight puts stress on the heart. More than 1 in 3 Americans—and nearly 1 in 6 children ages 2 to 19— has obesity. • Diabetes. Diabetes causes sugar to build up in the blood. This can damage blood vessels and nerves that help control the heart muscle. Nearly 1 in 10 people in the United States has diabetes. • Physical inactivity. Staying physically active helps keep the heart younger ages. February is Heart Month, the perfect time to learn about your risk for heart disease and the steps you need to take now to help your heart.

Heart disease—and the conditions that lead to it—can happen at any age. High rates of obesity and high blood pressure among younger people (ages 35-64) are putting them at risk for heart disease earlier in life. Half of all Americans have at least one of the top three risk factors for heart disease (high blood pressure, high cholesterol, and smoking).

You Could Be at Risk

Many of the conditions and behaviors that put people at risk for heart disease are appearing at younger ages: • High blood pressure. Millions of

Americans of all ages have high blood pressure, including millions of people in their 40s and 50s. About half of people with high blood pressure don’t have it under control. Having uncontrolled high blood pressure is one of the biggest risks for heart disease and other harmful conditions, such as stroke. • High blood cholesterol. High cholesterol can increase the risk for heart disease. Having diabetes and obesity, smoking, eating unhealthy foods, and not getting enough physical activity can all contribute to unhealthy cholesterol levels. • Smoking. More than 37 million U.S. adults are current smokers, and thousands of young people start smoking each day. Smoking damages the blood vessels and can cause heart disease.

On average, U.S. adults have hearts that are 7 years than they should be. Watch this video, and figure out your own “heart age” by taking this quiz. and blood vessels healthy. Only 1 in 5 adults meets the physical activity guidelines of getting 150 minutes a week of moderate-intensity activity. • Unhealthy eating patterns. Most Americans, including children, eat too much sodium (salt), which increases blood pressure. Replacing foods high in sodium with fresh fruits and vegetables can help lower blood pressure. But only 1 in 10 adults is getting enough fruits and vegetables each day. Diet high in trans-fat, saturated fat, and added sugar increases the risk factor for heart disease.

4 Ways to Take Control of Your Heart Health

You’re in the driver’s seat when it comes to your heart. Learn how to be heart healthy at any age. Don’t smoke. Smoking is the leading cause of preventable death in the United States. If you don’t smoke, don’t start. If you do smoke, learn how to quit. Manage conditions. Work with your health care team to manage conditions such as high blood pressure and high cholesterol. This includes taking any medicines you have been prescribed. Learn more about preventing and managing high blood pressure and high cholesterol. Make heart-healthy eating changes. Eat food low in trans-fat, saturated fat, added sugar and sodium. Try to fill at least half your plate with vegetables and fruits, and aim for low sodium options. Learn more about how to reduce sodium. Stay active. Get moving for at least 150 minutes per week. You ♥♥ can even break up the 30 minutes into 10-minute blocks. Learn more about how to get enough physical activity. Reference: Centers for Disease Control and Prevention (CDC)

Meet the Production Manager, Lauren Shover

This will be Lauren Shover’s 10th year as the Production Manager for County Woman Publications. Considered to be the true “backbone” of the publication by those who work with her, she began her career right before graduating from Rowan University with a Bachelors degree in Public Relations. She later decided to continue her education, earning a Master’s Degree in Communications from Southern New Hampshire University. Her educational background has prepared her well for this role, as the job is not one for the faint of heart.

Generally speaking, a magazine production manager oversees the production of a magazine, from initial meetings that decide editorial and advertising, to the final stages of production, design, printing, and circulation. Luckily, one of Lauren’s strongest qualities is organization, which happens to be critical for this role. The job also demands excellent time management skills and the ability to manage competing deadlines. While chaotic days still exist, Lauren admits to being the type of person that relishes in challenges and actually views them as opportunities.

Lauren is excited to reach for some of her goals for the magazine this year. One of them is continuing to explore new opportunities for the magazines and to advertise the publication more on the digital side. She adds, “It is imperative that we remain current and up to date with new advances in technology.”