We present the case of a 71 year male patient with right upper limb amputation who presented to an orthopaedic clinical hospital for increased pain in the hip area associated with decreased range of motion which interfered with most of his daily activities. Patient was evaluated in an interdisciplinary team by rehabilitation and orthopaedic specialists and was scheduled for surgery after a pre rehabilitation period. Acute phase included the first week post-surgery in which early mobilization was initiated with transfer training and verticalization. Weight-bearing as tolerated was indicated on the operated limb from postoperative day 1 and the use of an axillary crutch on the functional upper limb. Walking was supervised by a physical-therapist in the first days post-surgery. Neuromuscular electrical stimulation was associated in order to promote muscle strength and static cryotherapy was applied every 4 hours on the operated limb. At day 7 the patient was discharged with a functional autonomy sufficient for his home activities. The patient was given a precise protocol to follow until control a reevaluation at 6 weeks postsurgery. By the end of the 8 week post-surgery the patient was able to demonstrate reliable gait patterns and was permitted to wean assistive devices. At 6 month follow up the patient was able to restore all functional activities with satisfying results regarding functional scores. Our case report suggests that THA can be indicated for a broader spectrum of patients without posing a major risk regarding the rehabilitation program if supervised properly in an interdisciplinary team.

Multiple knee ligament injuries represent a significant traumatic event with an important functional prejudice which involves the injury of at least two of the four major ligaments of the knee. Management of such injury requires a thorough assessment and an interdisciplinary approach.The rehabilitation program will be constructed in accordance to the severity of the lesion and the patients expectations. The higher the goals and a more pronounced injury will results in a higher degree of involvement from the rehabilitation team. In case of cruciate ligament injury associated with a collateral ligament injury the rehabilitation program is based mostly on the same principles as for a cruciate ligament intervention, with the first phase of the rehabilitation protocol being governed by an early protection phase due to the fact that early weight-bearing is considered a risk for later instability of the knee and influence over the healing tissue, while the second phase of protocol is characterised by gait restoration and maintaning balance and coordination. Multiple ligament injuries often necessitate longer rehabilitation periods, regaining full activity level being estimated at around 1 year post surgery. The purpose of the paper is to analyse the optimal modality of constructing a rehabilitation program for multiple ligament injuries and whether a consensus regarding protocol and procedures can be obtained.