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663 - Implementation of Visual Aids for Patient with Strict Posterior Hip Precautions

Thursday, February 27, 2025

5:00 PM - 6:30 PM MST

Presenting Author(s)

SR

Sparsh Ray, MD

Resident Physician
NM Marianjoy Rehabilitation Hospital
Oak Park, Illinois, United States

Co-Author(s)

ND

Noelia Donamaria, MD

Attending Physician
NM Marianjoy Rehabilitation Hospital
Wheaton, Illinois, United States
TM

Timothy Mason, MD

Resident Physician
NM Marianjoy Rehabilitation Hospital
Wheaton, Illinois, United States

Case Diagnosis: A 75-year-old female with a past medical history of chronic obstructive pulmonary disease, type 2 diabetes, peripheral neuropathy, depression, recurrent C. difficile colitis, hypertension, alcoholic cirrhosis, hypothyroidism, and osteoporosis presented to acute inpatient rehabilitation (AIR) following a right total hip arthroplasty (THA) complicated by recurrent dislocations and a prosthetic hip infection.

Case Description: The patient returned to AIR for the third time within a year due to multiple dislocations (six total) and underwent two right THAs. Despite prior education, the patient struggled to adhere to posterior hip precautions, especially during activities of daily living (ADLs). During a recent stay at the rehabilitation hospital, the patient experienced a sudden dislocation while partially wearing a hip brace and was briefly transferred to acute care before being readmitted. Recognizing the need for enhanced education, the rehabilitation team implemented a strategy using visual aids: detailed images of a therapist acting out posterior hip precautions were displayed in her room. These visual aids were placed on the cabinets in her room during the last stay in AIR. This intervention reinforced precaution adherence, enabling a two-and-a-half-week safe stay, after which she was safely discharged to a subacute facility.

Discussions:

Patients with a history of hip surgery face up to five times the risk of recurrent dislocations compared to those without. Visual cues for hip precautions can reinforce patient education and improve compliance, potentially reducing recurrence.

Conclusions: This case highlights the significant risk of recurrent hip dislocations in patients with prior hip surgeries and suggests that visual aids in a rehabilitation setting may effectively enhance patient adherence to strict posterior hip precautions. This approach could serve as a model for improving safety and self-care techniques for patients transitioning back to home environments.