A Case of Postoperative Physiotherapy Management after Uncemented Total Hip Arthroplasty in an Individual with Bilateral Avascular Necrosis: A Study of Functional Recovery using Harris Hip Score

Mayank Shukla* and Utshab Rai

Background: Avascular necrosis (AVN) of the femoral head is a progressive condition that often leads to severe functional limitation and necessitates Total Hip Arthroplasty (THA). While surgical techniques continue to advance in bilateral involvement of young patients, postoperative physiotherapy remains the cornerstone of optimal functional recovery. This case report evaluates the effectiveness of an intensive, structured four-week physiotherapy program following bilateral uncemented THA in a young adult with advanced bilateral AVN.

Case presentation: A 31-year-old male chef with a 14-year history of bilateral hip pain underwent bilateral uncemented THA via a bikini incision. Postoperative physiotherapy commenced on day 7 and continued for four weeks, focusing on progressive mobility training, strengthening, gait retraining, balance restoration, and functional task practice. Baseline assessments revealed antalgic gait, limited range of motion, tenderness, and reduced Harris Hip Score (HHS = 37).

Results: The patient demonstrated significant clinical and functional improvements over four weeks. Clinically important differences were seen in - Pain decreased from 7/10 to 4/10, and hip range of motion (ROM) increased appreciably across all planes. Muscle strength, balance, and gait mechanics improved substantially, reflected by a rise in the Harris Hip Score from 37 to 77. The patient achieved near-independent ambulation and improved performance of activities of daily living.

Conclusion: Early, structured physiotherapy significantly accelerates recovery after uncemented THA, improving mobility, pain, gait, and functional independence. Continued rehabilitation is recommended to achieve full functional recovery.

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Published on: Dec 19, 2025 Pages: 13-18

Full Text PDF Full Text HTML DOI: 10.17352/2455-5487.000109
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