ALGORITHM FOR EARLY AMBULATION IN INDIVIDUALS UNDERGOING NON-CONVENTIONAL HIP ENDOPROSTHESIS

ALGORITMO PARA MARCHA PRECOCE EM INDIVÍDUOS SUBMETIDOS A ENDOPRÓTESE NÃO CONVENCIONAL DE QUADRIL

ABSTRACT

Introduction:  The incidence of bone metastases has increased in recent years, driven by population aging and the efficacy of treatments for visceral-origin cancers. Bone metastasis ranks as the third most common type, with approximately one-third located in the proximal femur. Prosthetic hip replacement is a key treatment option, enabling immediate weight-bearing and resumption of patients’ normal activities.

Objective:  This study aims to develop an algorithm to encourage early ambulation in patients undergoing hip arthroplasty with non-conventional endoprostheses, targeting improved recovery and minimized complications.

Method:  The algorithm was designed by the multidisciplinary team of the Orthopedic Oncology Service at Irmandade da Santa Casa de São Paulo. It focuses on promoting early ambulation for hospital discharge, incorporating specific patient-guided milestones to ensure safe mobility progression while respecting clinical conditions.

Results:  The mean time to sitting position was 1.64 ± 0.66 days, while ambulation was initiated at 3 ± 0.42 days.

Conclusion:  The implementation of the algorithm demonstrated its efficacy in inpatient rehabilitation through personalized milestones. This approach promotes early ambulation and enhances patient confidence in mobility. Level of Evidence VI; Case series.

Keywords:
Arthroplasty; Arthroplasty, Replacement, Hip; Neoplasm Metastasis; Pathologic Fracture