What precautions should be taken to minimize dislocation risk following a Total Hip Arthroplasty with a posterior approach?

• A. Limit active extension and internal rotation
• B. Avoid hip flexion past 90 degrees and adduction
• C. Encourage full weight-bearing immediately
• D. Perform abductor strengthening exercises

Answer: (B)

Following a Total Hip Arthroplasty (THA) with a posterior approach, a critical aspect of rehabilitation is minimizing the risk of dislocation. The correct measure in this context involves avoiding hip flexion past 90 degrees and adduction.

This is essential because during the posterior approach surgery, the posterior capsule and the external rotators are often cut, which increases the risk of dislocation if the hip is positioned in ways that compromise the stability of the joint. Specifically, bringing the knee above the hip level (hip flexion greater than 90 degrees) or crossing the legs (adduction) can lead to a situation where the femoral head can dislocate from the acetabulum. Therefore, guiding patients to maintain their hip in a safer position helps protect the integrity of the joint and ensures a successful recovery.

The other strategies mentioned do not adequately address the specific risk factors associated with the posterior surgical approach. For example, limiting active extension and internal rotation, while important, does not directly tackle the most critical ranges of motion that lead to dislocation. Encouraging full weight-bearing immediately may also pose risks depending on the individual’s stability and healing processes, as premature stress on the joint can lead to complications. Lastly, while abductor