Multimodal Physiotherapy Management Following Total Hip Arthroplasty in Seronegative Rheumatoid Arthritis: A Case Report

Syahdina Putri Arsyad; Irianto; Aulia Masita

doi:10.24843/

Authors

Syahdina Putri Arsyad Professional Physiotherapy Study Program, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia Author
Irianto Professional Physiotherapy Study Program, Faculty of Nursing, Hasanuddin University, Makassar, South Sulawesi, Indonesia Author
Aulia Masita Emphysio Clinic Makassar, Makassar, South Sulawesi, Indonesia Author

DOI:

https://doi.org/10.24843/

Keywords:

Arthroplasty, Replacement, Hip, Pain, Physical Therapy Modalities, Range of Motion, Articular, Rheumatoid Arthritis

Abstract

Background: Seronegative rheumatoid arthritis (SRA) is characterized by the absence of serological biomarkers, making diagnosis and treatment challenging. Delayed diagnosis may lead to progressive joint destruction, functional impairment, and the need for total hip arthroplasty (THA), particularly in young adults.
Objective: To describe the clinical characteristics, multimodal physiotherapy management, and short-term clinical outcomes of a patient with SRA following THA.
Methods: This single-patient case report was prepared in accordance with the CARE guidelines. A 27-year-old man with SRA following THA presented with multiple musculoskeletal pain, restricted joint range of motion (ROM), muscle weakness, and functional limitations. Clinical outcomes included pain intensity measured using the Visual Analogue Scale (VAS), ROM assessed with a universal goniometer, muscle strength evaluated by Manual Muscle Testing (MMT), and leg length measurement. The patient underwent two outpatient physiotherapy sessions comprising infrared radiation, transcutaneous electrical nerve stimulation, manual therapy, stretching, active-assisted and active ROM exercises, muscle strengthening, and low-intensity aerobic exercise based on the Frequency, Intensity, Time, and Type (FITT) principle.
Results: Following the intervention, pain intensity decreased under all assessment conditions, while ROM improved in the cervical spine, left shoulder, right hip, and both knees. Muscle strength and leg length remained unchanged, and no adverse events were observed.
Conclusion: Multimodal physiotherapy contributed to early pain reduction and improved joint mobility in this patient with SRA following THA. Longer rehabilitation and studies with larger sample sizes are needed to confirm these findings.