600 Section - Multimodal rehabilitation approach in a patient without a coxofemoral joint for the dynamic phase of gait.

Tuesday, May 19, 2026

6:00 PM - 7:30 PM PT

Presenting Author/Autor expositor(s)

CK

Cristian Raul R. Kelemen, MD

Medical Director of the Rehabilitation and Functional Recovery Unit
Italia Hospital S.p.A. Ospedale Generale di Zona Moriggia Pelascini Gravedona ed Uniti
Gravedona ed Uniti, Lombardia, Italy

Co-Author(s)

FC

Fabio Colonna, MD

Director of the Specialized Rehabilitation Operational Unit
Italia Hospital S.p.A. Ospedale Generale di Zona Moriggia Pelascini Gravedona ed Uniti
Gravedona ed Uniti, Lombardia, Italy

Case Diagnosis: Impaired walking and balance in a patient previously undergoing a total hip replacement, which was removed and an antibiotic spacer implanted in the right hip due to a complex intercurrent infection multidrug-resistant opportunistic bacteria.

Case Description: This clinical case describes a complex disability characterized by clinical and functional peculiarities, all of which prompted us to explore a multimodal approach, incorporating, as an innovation, to the traditional-conventional approach, robotic-assisted engagement using the Lokomat exoskeleton. With this paradigm shift in mind, we explored the possibility of ensuring that functional fragility does not become a barrier, but rather a successful challenge to overcome this obstacle, previously considered insurmountable. Utmost dedication, appropriate skills, and an inclusive and personalized multidisciplinary approach have allowed us to achieve dynamic functionality without orthoses.

Discussions: The multimodal rehabilitation approach, combining conventional and robotic-assisted (Lokomat exoskeleton), achieved the following results: improved standing and dynamics with symmetrical foot support, greater balance and safety, reduction in excessive external rotation and lower limb abduction, as well as a more effective stance phase, as well gait alternation and static-dynamic balance. The patient was able to walk independently with a walker. This clinical and biomechanical work was stimulating and expanded our professional knowledge, opening up recovery options with a focus on dynamic functioning for residual activities of daily living.

Conclusions: The multimodal applicability in the rehabilitation program for this clinical case is promising and may stimulate further interest in works/studies on biomechanical compensatory readjustment in the absence of a coxofemoral joint to ensure dynamic movement with gait kinetics and kinematics at the highest possible standards of expression and safety.