Femoroplasty
This protocol should be used as a guideline for progression and should be tailored to the needs of the individual patient.
- Allowed full weight bearing, but use crutches for four weeks
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- Avoids risk of fracture through area of recontoured head/neck junction.
- Protects against unexpected inordinate torsional or twisting forces, while muscle strength and response are regained.
- Bony strength mostly unchanged at four weeks, but muscular function can protect the joint.
- Vigorous impact loading avoided for 12 weeks.
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- Allows for bone remodeling/healing.
- Aggressive functional progression delayed until 12 weeks.
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- Then progressed to tolerance
- Resumption of full activities anticipated at 4-6 months.
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- Variable as dictated by hip symptoms.
- Always use pharmacologic prophylaxis against heterotopic ossification (unless contraindicated.)
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- Quiz patient
- Must initiate and maintain immediately postop
Week 1Phase 1
Initial Exercises (Weeks 1-3)
Other Exercises Week 1
- Standard stationary bike without resistance at 3 days post-op (10 min. if tolerated)
- Upper body ergometer, upper body strengthening
Week 2Phase 1
In Addition to Previous Exercises (Weeks 1-3)
Other Exercises Week 2
- Pool exercises (water walking, range of motion, march steps, lateral steps, backward walking, mini-squats, heel raises, hamstring and hip flexor stretches)
Week 3Phase 1
In Addition to Previous Exercises (Weeks 1-3)
Goals of Phase 1
Criteria for progression to Phase 2
Other Exercises Week 3
- Wall mini-squats
- Physioball mini-squats with cocontraction
- Leg raise - Adduction
- Kneeling hip flexor stretch (short of pain)
- Active range of motion with gradual end range stretch within tolerance
Weeks 4-5Phase 2
Intermediate Exercises (Weeks 4-6)
Other Exercises Week 4-5
- Wean off crutches after 4 weeks
- Gradually increase resistance with stationary bike
- Single leg sports cord leg press (long sitting) limiting hip flexion
- Pool water exercises - flutterkick swimming, 4 way hip with water weights, step-ups
- Initiate elliptical machine
Weeks 6Phase 2
Intermediate Exercises (Weeks 4-6)
Other Exercises Week 6
- Single leg balance - firm to soft surface with external perturbation (ball catch, sports specific/simulated ex.)
- Knee extensions, hamstring curls
Goals of Phase 2
Criteria for progression to Phase 2
Weeks 7-8Phase 3
Advanced Exercises (Weeks 7-8)
Other Exercises Week 7-8
- Full squats
- Single stability ball bridges
Goals of Phase 3
Criteria for Progression to Phase 4
Week 9-11Phase 4
Sports specific training rehab clinic based progression
Other Exercises Week 9-11
- All phase 3 exercises
- Pool running (progress from chest deep to waist deep), treadmill jogging
- Step drills, quick feet step-ups (4-6 inch box) forward, lateral, carioca
- Plyometrics, double leg and single leg shuttle jumps
- Theraband walking patterns 1 rep of six exercises x 50yds, progress to band at knee height and ankle height
Week 12 and BeyondPhase 4
Sports specific training on field or court
Other Exercises Week 12 and Beyond
- Running progression
- Sport specific drills
- Traditional weight training