Acute Care PT Management After Two-Stage Revision THA

Document Type

Poster

Start Date

28-4-2026 12:00 PM

End Date

28-4-2026 2:00 PM

Description

Background: Periprosthetic joint infection (PJI) occurs in approximately 1–2% of total hip arthroplasties (THA) and is more prevalent in patients with diabetes mellitus. Delayed infections are often managed with two-stage revision THA and antibiotic spacer placement, resulting in significant mobility restrictions. While early mobilization after primary THA is supported, limited evidence guides acute care rehabilitation following two-stage revision procedures.

Purpose: To describe acute care physical therapy management and early functional outcomes of a patient with diabetes mellitus type II following two-stage revision THA due to methicillin-susceptible Staphylococcus aureus infection.

Case Description: A 64-year-old female with comorbidities underwent two-stage revision THA with antibiotic spacer placement. She was toe-touch weight-bearing with posterior hip precautions. On postoperative day (POD) 1, she required maximal assistance of two people for bed mobility and was restricted to sitting at the edge of the bed. Examination revealed high pain levels (NPRS), intact distal sensation, decreased left lower extremity strength, and left upper extremity weakness due to prior rotator cuff pathology. Interventions from POD 1–6 emphasized bed mobility, transfer training, task-specific strengthening, and motor learning strategies while maintaining precautions.

Outcomes: By POD 6, the patient progressed from inability to stand to performing sit-to-stand and step-pivot transfers with maximal assistance of 2–3 clinicians. She demonstrated improved movement sequencing, precaution adherence, and activity tolerance, though assistance level remained maximal.

Discussion: Early, task-specific mobilization following two-stage revision THA is feasible in the acute setting despite medical complexity. This case highlights the need for evidence-based rehabilitation protocols and further research to guide physical therapy management after two-stage revision THA for periprosthetic joint infection.

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Apr 28th, 12:00 PM Apr 28th, 2:00 PM

Acute Care PT Management After Two-Stage Revision THA

Background: Periprosthetic joint infection (PJI) occurs in approximately 1–2% of total hip arthroplasties (THA) and is more prevalent in patients with diabetes mellitus. Delayed infections are often managed with two-stage revision THA and antibiotic spacer placement, resulting in significant mobility restrictions. While early mobilization after primary THA is supported, limited evidence guides acute care rehabilitation following two-stage revision procedures.

Purpose: To describe acute care physical therapy management and early functional outcomes of a patient with diabetes mellitus type II following two-stage revision THA due to methicillin-susceptible Staphylococcus aureus infection.

Case Description: A 64-year-old female with comorbidities underwent two-stage revision THA with antibiotic spacer placement. She was toe-touch weight-bearing with posterior hip precautions. On postoperative day (POD) 1, she required maximal assistance of two people for bed mobility and was restricted to sitting at the edge of the bed. Examination revealed high pain levels (NPRS), intact distal sensation, decreased left lower extremity strength, and left upper extremity weakness due to prior rotator cuff pathology. Interventions from POD 1–6 emphasized bed mobility, transfer training, task-specific strengthening, and motor learning strategies while maintaining precautions.

Outcomes: By POD 6, the patient progressed from inability to stand to performing sit-to-stand and step-pivot transfers with maximal assistance of 2–3 clinicians. She demonstrated improved movement sequencing, precaution adherence, and activity tolerance, though assistance level remained maximal.

Discussion: Early, task-specific mobilization following two-stage revision THA is feasible in the acute setting despite medical complexity. This case highlights the need for evidence-based rehabilitation protocols and further research to guide physical therapy management after two-stage revision THA for periprosthetic joint infection.