Rehabilitation of patients after hip disarticulation

We review rehabilitation of patients after hip disarticulation operated on over the past 5 years. Sixty-two patients underwent 63 hip disarticulations: 24 had malignancies, 23 arteriosclerosis, 11 Buerger's disease, 3 diabetes and 1 uncontrollable infections. The mean age of tumour patients was 39 years (range 6-69 years), that of the vascular patients was 55 years (range 33-78 years). The postoperative mortality rate of the vascular patients was 16/37, and 0/24 of those with malignancies. There was one bilaterally operated patient with bilateral purulent coxitis from decubitus ulcers, who died on the 32nd postoperative day. Complicated wound healing was observed in 5 of the 24 tumour patients, and in 24 of the 37 vascular patients. The strategy of prostheses fitting has a two-stage concept: temporary prostheses in the 1st or 2nd month, permanent prostheses in the 6th month. All 24 tumour patients were fitted and could walk, while only 2 of 37 vascular patients were able to walk with prostheses. In our experience the outcome is significantly dependent upon the primary illness: in vascular cases it is poor, while in malignancies it is fairly good.