Who needs hip replacement - rehabilitation after operation
The formation of the hip joint( TS), which is related to simple synovial joints, occurs with the participation of two jointed bones - iliac and femoral.
The bowl-shaped recess from the outside of the pelvic bone( acetabulum) and the ball-shaped bone of the femoral head together form a hip joint, which is a kind of hinge structure.
The head of the thigh is connected to the femur neck, which in the common people is called the "femoral neck" .The inside of the acetabulum and the head of the femur are covered with a layer of special articular cartilage( hyaline).
Cartilage is an elastic and, at the same time, strong and smooth interlayer in the joint. Provides slip during joint operation, releasing articular fluid, distributes load during movement and necessary cushioning.
Around the head of the joint is a capsule, consisting of a very dense and strong fiber-fibrous tissue.
Joint fixing occurs with using:
- Bundle. The outer ones are attached at one end to the femur, the others to the pelvic bone. And the inner ligament of the head of the hip bone connects the head itself with the acetabulum of the pelvic bone.
- Muscle. They surround the hip joint - the buttocks behind and the femur in front. The more developed the muscular frame of the joint, the less traumatic loads on it during running, unsuccessful jumps and movements of weights. Another important thing is that a good amount of strong working muscles delivers with blood sufficient amount of nutrients to the joint.
With the help of the hip joint, the person is simultaneously provided with such functional capabilities:
- body stability( support, balance);
- variety of movements.
We advise you to refresh your knowledge about how to treat gonarthrosis of the knee joint and what complications can cause this most serious illness.
Why the joint
is affected The obvious causes of injury include injuries. Examples are a fracture of the neck of the thigh, a dislocation of the TS or its subluxation.
To non-obvious - diseases( infectious and there are no arthritis, osteoarthrosis, inflammatory processes in the joint and periarticular tissues).In this case, over time, various complications develop which are expressed in injuries to the components of the pelvic joint - cartilaginous tissue, capsular, bone.
- pelvic inflammation - usually caused by arthritis of various etiologies, bursitis, synovitis, etc.;
- pathology of joint deflection - dysplasia;
- necrosis in the head of the TC of some parts of the bone marrow - non-infectious necrosis( avascular).
When and who needs hip replacement
The appearance of pain in the hip joint is a signal that one should turn to a professional to establish its causes. For this, an X-ray examination of the TC should be performed at the initial stage of the.
A solution to the problem for a worn or permanently injured joint may be endoprosthetics, which can be shown in such cases:
- is not a growing fracture of the TC head;
- fractures of the femoral neck or acetabulum in patients with advanced age;
- aseptic necrosis;
- is a tumor-like disease of the TS;
- deforming arthrosis of the third stage;
- congenital hip dislocation, etc.
What kinds of operations are offered by medicine
In the conditions of modern medicine, according to the type of prosthesis, patients are offered three types of operations:
- Replacement of TC surfaces - removal of cartilaginous interlayers from the acetabulum, with replacement of a special artificial material and turning of the head of the femur with a metal cap on it. Slip, due to this replacement of articular surfaces, is achieved close to the natural.
- Partial prosthetics - replacement, for example, of the pelvic joint head with a portion of the femoral neck, articular bed.
- Complete prosthesis - removal of the entire hip joint and its replacement by EP( endoprosthesis).
Types of endoprostheses
In modern day medicine there are more than six dozen modifications of endoprostheses. They are subdivided by the fixation method and the material. Methods of fixation today proposed three:
- cementless - fixation occurs due to the fact that the bone of the joint grows into the surface of the EP;
- cement - the endoprosthesis is fixed using a special bone cement;
- mixed( hybrid) - the cup is attached without bone cement, and the foot - with cement.
Modern combinations of materials, from which prostheses are made, are selected depending on the patient's illness, age and lifestyle. They can be as follows:
- metal - metal;
- metal - plastic of very high quality;
- ceramics - ceramics;
- ceramics - plastic.
Preparing for operation
All the necessary information on the preparation for the operation will be presented to you by the attending physician.
However, there are moments that the patient will have to prepare in advance( especially those who are lonely).
Since rehabilitation after joint replacement is continued at home, it is worthwhile to prepare your home for the post-operation period recovery:
- purchase special equipment in the form of walkers or crutches, special toilet seat and so on;
- stop taking certain drugs( aspirin-containing, anti-inflammatory);
- if necessary, reduce your weight;
- to do physical training;
- visit the dentist;
- to abandon bad habits( smoking).
Before the operation of , the patient is obliged to issue the necessary documents to ( carrying out an operation for cash, under a contract under medical insurance or under quotas of the federal program for providing free high-tech medical care);talk with an anesthesiologist about the most favorable variant of anesthesia for you;at least 12 hours before the operation to stop eating.
Joint replacement operationModern advances in medicine make it possible to perform both open surgeries on endoprosthetics of the TC, and minimally invasive and minimally invasive.
Today, minimally invasive operations( MO) are most common because of their minimal impact on the body.
To carry out ,
- requires high qualification and professionalism of the surgeon and the entire medical staff;
- availability of technical capabilities( endoscopic equipment, high-tech materials).
Depending on the complexity of the operation( partial or complete prosthetics), its time can last from one to three to four hours:
- installation of a catheter into the urethra( to prevent involuntary urination and control the amount of fluid secreted by the body);
- incision from the outer thigh( or two small - on the thigh and in the groin area);
- peeling and shearing of tissues around the TC;
- prosthesis installation;
- restoration of tissue integrity and suturing of the wound.
The video clearly shows how the endoprosthetics of the hip joint passes.
Possible complications of
Any surgical intervention in the body can have its negative consequences. Complications after the procedure most often occur in operated:
- with a large deformation of the joint;
- with obesity or large muscle mass;
- having a number of serious concomitant diseases - diabetes, blood, heart and whole SSS, etc.
Joint replacement can cause such complications:
- is not the correct position of the endoprosthesis;
- damage to nerve fibers, arteries;
- disturbances in the process of postoperative wound healing;
- occurrence of infections;
- fracture of hip bone, dislocation or "popping" of the prosthesis;
- thrombotic events in veins of deep occurrence.
Rehabilitation after surgery
Rehabilitation after endoprosthetics can be long and take up to 6 months.
Patient should monitor at the seam, body temperature and sensation. Pain during this period can pass and return, the patient should be ready for this and make efforts to restore the motor functions of the body.
For the first few days of , the patient is prescribed analgesics, anti-inflammatory drugs.
Further rehabilitation after the replacement of the hip joint consists in the appointment of special light gymnastics and breathing exercises.
For the prevention of scarring of tendons and skin, for the strengthening of the muscular framework around the prosthesis is prescribed therapeutic exercise ( LFK) for the patient.
As the reviews of patients who underwent endoprosthetics indicate, it is necessary to adhere to the recommendations of specialists as much as possible and then rehabilitation will be quick and practically painless.Recommendations of specialists how to move and sit, what load to allow during the rehabilitation period( power loads - running, jumping - remove, engage in swimming) will allow patients to return to normal life in the shortest possible time.
How is rehabilitation after operation on the hip joint described in detail in the video.
Where can I have an operation in Russia?
The operation for prosthetics of TC is a high-tech process.
In 2015, the inclusion of high-tech medical assistance( VMP) in the compulsory medical insurance system is provided for by the new legislative draft "On Compulsory Medical Insurance in the Russian Federation".
Therefore, here we will not specify who will pay for the operation - patient or insurance companies.
The price for the replacement of the hip consists of a prosthesis and the operation itself .To date, the cost of surgery( total hip arthroplasty) ranges from 210 to 300 thousand rubles ( depending on the cost of the prosthesis).
Replacement of hip joints in Russia is done both in federal budgetary health care institutions( FT of traumatology, orthopedics and endoprosthetics, regional clinical hospitals, research institutes) and in private clinics in Russia.
- OJSC "Medicine";
- Family Clinic;
- City Clinical Hospital No. 67( Moscow);
- KB Moscow State Medical University. Sechenova;
- CM Clinic;
- Central Design Bureau of the Russian Academy of Sciences;
- Multipurpose medical center "K + 31";
- Central Design Bureau No. 2 of JSCo «Russian Railways», etc.
In the first two days after the operation for the replacement of the hip joint with a prosthesis, procedures for UHF or magnetotherapy with exposure to radiation and temperature to the seam area are shown. They relieve swelling, have an anti-inflammatory and analgesic effect( the procedure is carried out right in the ward without removing the bandage).If there are contraindications to these procedures, it is possible to carry out UV-irradiation of the wound at the moment of dressing.
To prevent stagnant phenomena in the lungs and the development of pneumonia in the initial period of rehabilitation, breathing exercises are performed, vibromassage of the thorax is prescribed. In the initial period of rehabilitation shows a course of exercise therapy, massage and active exercises for the joints of the limbs. The patient is taught isometric exercises( muscle tension of the diseased limb), which are performed for 1-5 seconds for the shin, thigh and buttock.
Post-operative gymnastics is performed daily for 15 minutes for 3-5 visits, this allows you to mobilize the central nervous system and strengthen the complex of metabolic-trophic processes in the muscles. This gymnastics is especially indicated for bilateral hip joint lesions.
Four days after the operation to replace the hip joint on the prosthesis, one must start learning to walk on the stairs in the houses, always leaning on the handrails and do not more than one step at a time.
To restore mobility of the operated limb after joint replacement, the LFK course and massage are shown.
Climbing the stairs in the house:
- stepping up a healthy foot;
- rearrange the operated leg on a step above;
- put on a step a crutch / cane.
Descending the stairs in the house:
- put the cane / crutch on the lower level;
- to make a step down the operated leg;
- put a healthy leg.
Climbing the stairs in the house always begins with a healthy leg, and descent - with the operated.4-5 day is not in vain called the phase of "deceptive opportunities", because severe pain and weakness in the leg to the 5th day passes, and the patient wants to fully feel the limb after the replacement of the joint on the prosthesis. Do not neglect the rules and start overloading your leg, otherwise you can get a dislocation of the hip joint.
In the period from 2 to 3 weeks after endoprosthetics( after the removal of stitches) the restoration program includes massage of the TBS zone, using non-rough massage techniques and without pain. The following exercise complex of exercise therapy is shown:
- exercises for small joints of the limbs;
- exercises for diaphragmatic and chest breathing;
- sitting in bed with the help of hands.
Special attention should be given to laying and fixing with special rollers of the operated limb after endoprosthetics. The rollers are placed under the knee joint and from the outside to exclude the external rotation of the thigh.
In the period from 4 to 8 weeks it's time to increase the load on the muscles, train them, restore strength and balance of movements. This is necessary to "change" from the crutches to the cane. It is necessary to perform the following set of exercises, post-natal for the development of the muscles of the lower extremities and the hip joint:
- Classes with elastic band( resistance).Performed three times a day for 10 times. One end of the elastic band is attached around the ankle, the other - to any heavy furniture.
- Flexion in the hip( with resistance).Stand with your back to the wall, where an elastic band is attached, slightly set aside your leg. To lift it forward, the knee is straightened. Return to and.
- Legs in standing position. Stand up to the attached ribbon in a healthy side, the operated leg is taken to the side, return to and.etc.
During recovery after joint replacement, it is necessary to train with the help of special simulators
. Walk with a cane until you are sure of balance. Walking - daily for 5-10 minutes three times a day. Later, the time and the frequency of walking should be increased.
After endoprosthetics, simplified exercises are recommended on the simulators( consult a trainer or watch a special video).It is best to practice on a conventional exercise bike, which is used to restore muscle strength and hip joint mobility after endoprosthetics. At the beginning of the pedal to turn only back, then - forward( do not raise the high knee), after about a month you can gradually increase the load. The exercise bike is important to be specially adjusted in accordance with the growth.
Late stage of
At the heart of the late rehabilitation period after the operation to replace the prosthesis is the passage of a health course within a specialized center or a sanatorium equipped with special equipment. Restorative treatment is selected individually for each patient, taking into account the characteristics of the body, the form and stage of the disease. The following complex of procedures for restoration can be used in the sanatorium:
- Therapeutic massage - the actions of a manual specialist are aimed at restoring muscles and ligaments, relieving tension, improving blood flow, and removing pain.
- Acupuncture - reduces pain after surgery, eliminates spasm of blood vessels, improves nutrition of tissues.
- Physiotherapy - effect on the restoring area with the help of laser, ultrasound, temperature, electric current and other physical factors.
- Gryazerapiya - curative mud contains active minerals that activate metabolic processes, improve the nutrition of tissues.
- Hydrotherapy - aqua aerobics, salt and coniferous baths of a certain temperature, shower-sharko, etc. can be used.
Replacement of a weaker load with a heavier load is allowed no earlier than 2-3 months, if the rules are not observed, complications can arise. Up to six months, it is recommended to carry out restorative measures at home: exercise gymnastics for 10-15 minutes a day, observe a special diet, drink medications prescribed by a doctor.
Hip replacementhttps: //www.youtube.com/ watch? V = DjAhV3hkNOw
http: //Geromed.ru/https: //www.youtube.com/ watch? V = lx0Ggz-Nf6w
Hip replacement in Germany - 2. www.glorismed.de
Hip endoprosthetics in Germany.
The first part: http: //youtu.be/ IRdqz_R2TtQ
In the second part of the video, the patient from Russia Valery tells why, when choosing a hip joint implant, he preferred the method of restoring the surface of the head of the joint. The patient wanted to lead an active lifestyle, not limiting his mobility.
The technique of endoprosthesis replacement by McMean requires high qualification of surgeons, for this reason Valery decided to go to surgery in Germany. Having sent inquiries all over Germany and received answers to them, he chose the option offered by GLORISMED, which suits him most at the price of treatment and the qualification of the operating doctor.
Three days after the hip replacement in a specialized center of the DRC clinic, the patient could already walk well on crutches. The operation was followed by a three-week rehabilitation in Germany, not far from Berlin, in the Sana Sommerfeld clinic. During the course of rehabilitation Valery could already go through 3-4 km without the help of crutches and swim 1 km in the pool.
Detailed information: http://www.glorismed.de