text:  He is 5 feet   9 inches   225 pounds . He walks with a limp related to his right hip . His right hip is irritable with a 10-degree fixed flexion contracture . He is able to flex his right hip to 100 degrees . He has 10 degrees of internal and external rotation . He has intact distal pulses and 5  5 muscle strength in all major muscle groups . His X-rays show advanced osteoarthritis of his right hip . IMPRESSION AND PLAN  This is a 62-year-old male with severe osteoarthritis of the right hip who after discussion   including the nature   risks   benefits and alternative treatment plans   signed informed consent for a right total hip replacement .