PTH 646_Hip Interventions

Prime movers for hip flexion?

Iliopsoas, rectus femoris, tensor fasciae latae, sartorius

Prime movers for hip extension?

Gluteus maximus and hamstrings

Prime movers for abduction?

Gluteus medius, gluteus minimus, and tensor fasciae latae

Prime movers for hip adduction?

Adductor magnus, adductor longus, adductor brevis, gracilis, and pectineus

Prime movers for external rotation?

Obturator internus and externus, gemellus superior and inferior, quadratus femoris, piriformis, and gluteus maximus

Prime movers for internal rotation?

None

If TFL is weakened, how does this affect force?

Decreased abduction force by 15% in 30 degrees of flexion

If glute max is weakened, how does this affect force?

Decreased by 56% in flexion, 46% in neutral, and 43% in extension

If glute med-min were weakened, how would this affect force?

Decreased by 62% in flexion, 61.5% in neutral, and 63% in extension

What muscle can act as an internal rotator?

Piriformis

When can the piriformis act as an internal rotator?

More than 90 degrees hip flexion

When the angle of inclination is >125, what does this cause?

Coxa valgus

When the angle of inclination is <125, what does this cause?

Coxa vara

What is the normal angle of torsion?

15 degrees

What is uncompensated anteversion?

Toed-in position

What is compensated anteversion?

Femoral medial rotation with lateral tibial torsion

Uncompensated retroversion?

Out-toed

Is foam rolling a valid intervention?

“Represents an adequate method to acutely induce strong improvements in joint ROM, being non-inferior to stretching”

What are the muscles included with PSOIQ?

Piriformis, superior gemellus, obturator internus, inferior gemellus, and quadratus femoris

Phase I - Muscle Strain?

Protection phase

Interventions for phase I muscle strain?

Control pain and inflammation (POLICE), taping/bracing, patient education, active rest

Phase II - Muscle Strain?

Stretching/ROM

Phase III - Muscle Strain?

Preinjury muscle balance; focus on flexibility and strength and tissue loading

How long does Phase I typically last?

0-4 weeks

How long does phase II typically last?

2-8 weeks

How long does phase III typically last?

4-8 weeks

What causes internal snapping hip?

Iliopsoas

What causes external snapping hip?

ITB

What is the common culprit of sciatric neural restrictions?

Piriformis

What causes femoral neural restrictions?

Fractures, obstetric pressure, reduction of congenital dislocation of the hip

What is meralgia paresthetica?

Lateral femoral cutaneous nerve restriction

Another name for meralgia paresthetica?

Skinny pant syndrome

What are acute hip fractures usually treated with?

ORIF

When is hemiarthroplasty indicated with an acute hip fracture?

Instability inherent

Clinical prediction rules for diagnosing hip OA?

Squatting aggravates symptoms, active hip flexion causes lateral hip pain, scour test with adduction causes lateral hip or groin pain, active hip extension causes pain, and passive IR is <25 degrees

What is the best non-exercise therapeutic intervention recommended for people with hip or knee OA?

TENS

When is a cemented fixation common?

Elderly and inactive younger populations

What is incised during a posterior THA approach?

TFL and ITB

What is incised with a lateral THA approach?

TFL

How long do THA surgical approaches typically last?

About 6 weeks

Precautions to anterior THA?

No hip flexion > 90 degrees, no hip extension, adduction, or external rotation past neutral, no figure 4, no anti-gravity hip abduction

When are assistive devices discontinued?

The patient can ambulate without pain, balance difficulties, or a passive Trendelenburg test