両側セメントレス大腿骨人工骨頭置換術に対する理学療法の経験 : 荷重訓練を中心に

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The purpose of this paper is to report two cases who had bilateral cementless bipolar hip arthroplasty and present some problems on physical therapy arising from differences between bilateral and unilateral cases. Case 1 was a 29-year-old man. His diagnosis was bilateral necrosis of the femoral head. He could walk on the walker or crutches from eight weeks after the surgery because he could partial weight bearing by himself. Case 2 was a 59-year-old woman. Her diagnosis was bilateral fracture of the femoral neck. Partial weight bearing exercise started after the surgery of both hips. She could control partial weight bearing by use of the partial weight bearing trainer device (ANIMA, MP-100), and could transfer from the bed to the weelchair by herself. In the case of cementless bipolar hip arthroplasty, partial weight bearing -exercise is generally contraindicated soon after the operation. On our program, partial weight bearing exercise starts after eight weeks postoperatively, and full weight bearing exercise starts after twelve weeks as a rule. Although unilateral case has a supporting leg, bilateral case does not have any. Therefore it is difficult to walk at the early stage for bilateral case. Our experience of physical therapy for two cases with bilateral cementless bipolar hip arthroplasty showed not only a difficulty and an importance of learning locomotion but also a necessity of much trals for different conditions.
神戸大学の論文