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697 - Rehabilitation of Hip Disarticulation Secondary to Chronic Peri-prosthetic Joint Infections: A Case Report

Thursday, February 27, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

IR

Isha Rao, DO

PGY3, Resident Physician
SUNY - - Brooklyn, NY
Brooklyn, New York, United States

Co-Author(s)

ND

Nikita Desai, DO

Resident Physician
SUNY Downstate Medical Center
Brooklyn, New York, United States
RT

Rebecca Takele, DO

PM&R Resident Physician
SUNY Downstate Health Science University
Brooklyn, New York, United States
HC

Haris Choudry, MD

Residency program director
Burke Rehabilitation Hospital
White Plains, New York, United States
Sanjeev Agarwal, MD

Program Director
SUNY Downstate Health Science University
Brooklyn, New York, United States

Case Diagnosis: Right Hip Disarticulation

Case Description: A 70-year-old female with HIV on HAART and a history of chronic periprosthetic joint infections (PJIs) following a right total hip arthroplasty presented with recurrent PJI. Despite multiple revision surgeries and eight weeks of parenteral antibiotics, she underwent right hip disarticulation (HD). Postoperatively, the patient developed ESBL bacteremia and required acute rehabilitation. Initially at admission to acute rehab, she needed maximal assistance for bed mobility, transfers, dressing, and was unable to ambulate. An intensive 20-day rehabilitation program focused on bed mobility, transfers, gait training, and patient/family education was implemented. Midway through, she improved to needing moderate assistance for bed mobility and transfers and ambulate 20 feet with a rolling walker. By discharge, she achieved modified independence with bed mobility, transfer setup, and dressing. She ambulated 100 feet with a standard walker and climbed 12 steps with moderate assistance and was discharged home with plans for prosthetic fitting upon medical clearance.

Discussions: The patient’s rehabilitation program targeted mobility, physical conditioning including aerobic training, core strengthening, balance training, and dynamic and isometric exercises for the residual limb. The approach aimed to enhance gait and overall function, addressing pain management and mobility challenges post amputation. Upon discharge, the patient demonstrated improved mobility and independence in activities of daily living.

Conclusions: Effective, focused rehabilitation is crucial in managing hip disarticulation post-PJIs. Addressing challenges such as pain and dysfunction through targeted therapy contributes to improvement of function and quality of life and enhances overall patient outcomes following PJIs and hip disarticulation.