Pre-operative physiotherapy impact in early post -operative recovery in a case of bilateral avascular necrosis secondary to sickle cell disease in rural India - Case report

Abstract

An inherited disorder of red blood cell, Sickle cell disease is characterized by inadequate amount of healthy red blood cells in the blood to therefore reducing the body's oxygen carrying capacity. In sickle cell disease RBC are crescent shaped so while passing through the blood vessel they block the blood flow and reduce the oxygen supply to the tissues. Normally the average lifespan of RBC is about 120 days but in sickle cell anemia it is reduced to only 10 to 20 days. So leading to various complications, out of all of them Avascular necrosis of femoral head is the most common due to precarious blood supply to that region. Presenting a case of 45 year old elderly male, who visited our hospital with the major complaints of pain in both hips since I month along with difficulty in walking and after investigations was diagnosed with bilateral Stage 4 avascular necrosis of femoral head. Pre-operative Physiotherapy was started. Due to low economic status patient underwent only unilateral total hip replacement. Post-Operative physiotherapy was started on the same day of operation and rehabilitation was progressed into 3 phase that is immediate post-surgical phase, motion phase and advanced strengthening and higher level function stage. The outcomes were satisfactory and pre-operative physiotherapy was found to be highly beneficial in post-operative period in gaining early recovery. Multidisciplinary approach and patients positive attitude was the key to get the favorable outcomes.