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no abduction pillow w/ THR

Posted
by mommynmaddie mommynmaddie (New) New

One of our orthopedic doctors does not use abduction pillows with his post op total hip replacement patients. He uses a knee immobilizer on the affected leg. Have any of you experienced this? What are your thoughts on this?

I work on the orthopedic floor and I have never seen a THR with no abductor pillow... Only hip pinnings and arthoplastys and what not but not total hip replacements. What would the knee immobilizer do?? They can still use their knee, its just the hip that had the surgery! Does this doctor always do this? I find this very strange...

Sounds weird huh? The doctor stated that he thinks the abd pillow is uncomfortable to his patients and that the knee immob serves his purpose without increased discomfort. I am guessing that since they are unable to bend that knee then it is harder to have >90degree angle at hip, but I would still believe that they could cross the surgical leg over the midline causing adduction and possibly hip dislocation.

unknown99, BSN, RN

Specializes in Inpatient Acute Rehab.

We have 4 ortho's on the ortho floor where I work, and not one of them uses an abduction pillow. They use braces on some, CPM's on others, and sometimes alternating both. It seems to work just fine.

P_RN, ADN, RN

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89. Has 30 years experience.

Not strange at all here. I think it was around the time press fit /no cement hips came out, maybe 1990 or so. Try this: Hold your knee stiff then try to flex your hip over 90 deg. Pretty difficult, no? Imagine you are 70 years old and just had surgery. Impossible. I only know of one doc around here who still used the abd wedge and I believe he's retired now.

edited to add:

Re dislocation. Depending on the type of incision and the way the hip was disarticulated, there may or may not be the potential there with the knee immobilizer. Nonetheless most patients will not be able to SLR enough to get the operative leg/hip past midline.

VivaLasViejas, ASN, RN

Specializes in LTC, assisted living, med-surg, psych. Has 20 years experience.

I haven't seen an abduction pillow used in 2-3 years. Our surgeons stopped ordering them a while back---I don't really know the reason why they're no longer used, but we haven't had any increase in the number of dislocations, and I for one am glad we don't have to deal with them anymore. Most patients hated them, especially females who were brought up in an era when a lady was supposed to keep her legs together! They were hot, awkward, bulky, and confining, and I didn't blame patients for wanting to be rid of them. :)

If I remember my ortho correctly, there are 2 approaches to a THR, anterior and posterior. And I think with the pos. you typically use an abduction pillow, but with ant. you are not suppose to. But I recall seeing some pts with them and some without who had the pos. aproach...But I think P_RN's response is right on...they decrease mobility.

what is an abduction pillow? we just use an ordinary pillow to lay between the patients legs while in bed and while swivelling around i.e. to get out of bed.... was wondering if this is what you mean when talking bout the abduction pillow, tho it almost sounds as if it's some special device that's strapped on or something!?

interesting all the same, it probably means that in a few more years (when we catch up) we'll probably be using knee immobilisers too

P_RN, ADN, RN

Specializes in ORTHOPAEDICS-CERTIFIED SINCE 89. Has 30 years experience.

Ours were pink, but this is the general idea. Mind you it's been years since we used them. Always on when in the bed,& removed to ambulate.

I dont see abductor pillows being used as often.

UM Review RN, ASN, RN

Specializes in Utilization Management.

I kinda miss those things. They kept the leg in proper position when we needed to logroll the patient to change positions and provide skin care.

renerian, BSN, RN

Specializes in MS Home Health.

There is hope... I was hoping that pillow would leave soon..........I hate that pillow and would not like it as a patient at all.

renerian

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