Il trattamento riabilitativo nella rimozione dell'artroprotesi d'anca infetta

Background. Although rare, deep infection in hip arthroplasty represents with no doubt a difficult and serious complication that suggests to orthopedist and physiatrist great caution in its treatment. Methods. Between January 1994 and May 1996, 7 patients were admitted at the Division of Physical Therapy and Rehabilitation of the 'G. Pini' Orthopedic Institute in Milan for a rehabilitation period after surgical removal of septic hip arthroplasty. Due to extreme care in the treatment of these inpatients, immobility syndrome, in its various expressions (such as muscle atrophies, tendon retractions, pulmonary-circulatory-urinary complications), is a problem directly connected. Clinical evaluation at admission in our Division and three months later the operation considered hip pain, length difference of lower limbs and deambulation. Functional Independence Measure scale was used at admission and discharge from our Division to evaluate improvements in executing specific activities of daily living (ADL). Results. Regression of hip pain, walking recovery and functional recovery in FIM's ADL required longer times for patients undergone to definitive removal by Girdlestone method, than for those with planned reimplantation of the hip arthroplasty. Conclusions. Associated pathologies played an important role.