Clinical Profile of Patients with Hip Hemi-arthroplasty Managed at the Physiotherapy Department of a Nigerian Tertiary Health Institution between 2008 and 2013

Abstract

This study was a review of individuals who had hip hemi-arthroplasty and were managed at the physiotherapy department of a Nigerian tertiary health institution. Information on age, sex, causes of fracture, types of referral, outcomes assessed, treatment provided and discharge pattern were obtained from physiotherapy patients’ register, case files and nursing registers. Data was summarized using descriptive statistics of range, mean, standard deviation, and percentages. A total of 57 cases (26 males; 31 females) aged 76.77±11.59 years (32-92 years) was reviewed. The majority (98.2%) had hip hemi-arthroplasty secondary to femoral neck fracture. Only one case was due to femoral head damage secondary to sickle cell disease. The cause of fracture was documented in 21 cases with 76% of the fractures resulting after falls. Forty-one patients (71%) were referred for ambulation only post-surgery while sixteen (29%) were referred for full physiotherapy. Pain and muscle strength were the only impairment variables assessed in those referred for physiotherapy. Fifty-five (91%) were discharged home with walking aids while three (6%) were deceased. Fourteen (25%) continued physiotherapy on out-patient basis and 12 completed physiotherapy. It was observed that more women had hemi-arthroplasty compared to men. The majority of the patients who had hemi-arthroplasty were aged seventy years and above and were not referred for full physiotherapy. There was poor documentation of the cause of fracture in the files of most of the cases reviewed, though a fall was the cause of fracture in the few that were documented. Outcome measures were underutilized with no record of reported patient-centred outcome measures for all the reviewed cases.

KEY WORDS: hemi-arthroplasty, full physiotherapy, ambulation