Physical Therapy Management for a Patient Over 100 Years Old Status Post Total Hip Arthroplasty: A Case Report

Background: The research on the outcomes following a total hip replacement in someone over the age of 100 is currently very limited. The research does not confidently state whether the benefits outweigh the risks when doing this surgery on a patient over 100 years old. Along with the lack of research on if the procedure is safe or not, there also is a lack of research on what the most effective physical therapy treatment interventions are with these patients. Thus, the purpose of this case report is to demonstrate how functional mobility can be considered as the primary intervention when treating a patient over 100 years old after a total hip replacement. Case Description: The patient is a 105-year-old female that was seen in the hospital status post right total hip arthroscopy following a fall that caused a femoral neck fracture. The patient had many complications throughout her length of stay, but also had many positive environmental factors as well. Intervention: Physical therapy with this patient focused on functional movements that would be necessary in her daily life, such as bed mobility, transfers, and ambulation. Outcome: In physical therapy, the patient was able to progress from requiring moderate assistance of 2 for bed mobility to ambulating with contact guard assistance for 16ft in room using a front wheeled rolling walker. Following an 18-day length of stay, the patient was discharged to a skilled nursing facility. Discussion: There is a need for more research on how to best treat a patient over 100 years old status post total hip arthroplasty. However, this case demonstrated functional mobility can be a successful intervention.