Exercises after surgery on the knee joint

Recovery periods after knee replacement

Replacement of the knee joint is not such a simple matter. Your life after prosthetics will never be the same. Rehabilitation after knee arthroplasty - what should it be?

Reconstruction after knee replacement

Rehabilitation is the second half of the success of knee replacement


Rehabilitation after knee replacement

To perform an operation to replace the joint is not all.

  • A complex exercise program for the joint
  • will be required. The load on the joint will have to be limited, as well as some types of exercises:
    • for convolution
    • jogging and jumping
  • It will be necessary to abandon many sports( light and heavy athletics, wrestling, mountain and water skis, parachutes andetc.)
  • Within a few years after the operation, it will be necessary to observe the doctor

It may seem that after the operation you will have to spare and protect the knee painfully. This is not quite true:

A gentle mode for several days will certainly be, but the first exercises will need to start literally on the second day. And then the load will only increase

.

It takes a long time to develop the joint after the operation, and even more nerves and patience. I'll have to work through overcoming pain. How else?

Rehabilitation is needed to ensure that :

  • No contracture occurs and the prosthesis bends and rotates with the same approximate amplitude as the once healthy joint
  • The risk was not in vain( the operation is always a risk) and the expended funds

What determines the success of the

rehabilitation Halfsuccess depends on the skill and skill of the surgeon, and the second half only on the patient :

  • Will he go through the entire rehabilitation program
  • Will not he relax after a few weeks and even years
  • Will he deal withshould not only be in the rehabilitation center, but also at home

. When the rehabilitation program is performed, the patient is not alone: ​​

  • Patient should not guess:
    • will not dangerous or undesirable exercises that hurt him
    • will not the side complications arise
  • He does not need to produceself-selection of exercises
  • There is no need to purchase mechanical simulators( they should be in the rehabilitation center) Exercises after knee arthroplasty

    Special treadmill in the rehabilitation center

All these issues are solved by leaschy doctor and Rehabilitation.

Surgeons are aware of the main dangers of the early postoperative period:

  • Risk of developing blood clots :

    Risk of thrombosis due to pain, swelling and redness below or above the knee

  • Risk of developing infectious inflammation:

    Elevated temperature, the surges of leukocytes in the blood can be alarming symptoms of

To prevent postoperative complications, coagulants( blood thinners) and antibiotics

are prescribed. The rehabilitator visits the patient within a few hours afterie the operation and shows the first necessary exercises that it will need to perform.

After the discharge, the question of the rehabilitation center is usually put, however, studies there are not expensive, and therefore many patients decide to be engaged in the rehabilitation themselves.

But if a person does not intend to undergo rehabilitation at all( nowhere in the center or at home), then it is better to abandon the very operation

. Is it possible to independently repair the house

? Probably, yes, because the impossible is really nothing.

But in practice alone and for a long time to restore the joint after prosthetics difficult :

  • There is a lack of purely specific knowledge that orthopedists-traumatologists own
  • . Because of the fear of pain, a barrier arises that reduces the volume and amplitude of
  • movements. The self-pity, the disorganization of the schedule of activities, etc., interfere.

Orthopedics practice mechanotherapy - the method of passive rehabilitation, when movements of the diseased limb are carried out by mechanical simulators that are always in the rehabilitation center

Exercises of the early operational period

These exercises are necessary to prevent thrombosis and muscle atrophy and maintain the functions of the musculoskeletal system

The first two daysafter operation

  1. Exercises for hands

    • Squeeze and unclench fists
    • Bend and unbend arms in elbows
    • Rotation kuvarnishes in both directions
    • Similar rotation with elbows
    • "Box" with separation of the blades from the bed
    • Straight and cross "scissors"
    • Tightening
  2. Exercises for a healthy leg

    The terms of rehabilitation in the endoprosthetics of the knee

    The goals of such exercises are to control thrombosis and muscular atrophy

    • Circumferential motion of the ankle
    • Compression and unclenchingfingers
    • Leg bending in the knee
    • Raising the straight leg
    • Leaning on the heel and elbows, lift the buttocks
    • We start to sit down with the help of the handrail, first without lowering our legs to the floor, and on the secondwe drop them
  3. Exercises for a sick leg

    • Squeeze and unclench fingers
    • Pull the foot on yourself and away from yourself
    • Alternately bend and unbend your legs while lying down and sitting
    • In the sitting position, put the feet on the bench, raise and lower them without taking off the heels

    The gymnastics of the first two days is performed at a slow pace :

    • Several exercises take breaks from three to five minutes
    • Some exercises are combined with the respiratory rhythm

    After it turned out to sit on the bed withlowered legs, you need to learn to stand on crutches or walkers.

  4. Walking on walkers or crutches

    Walking with auxiliary tools is already on the second day of .Walking on crutches is somewhat more difficult, since more physical strength is required. For the elderly it is preferable not to walk on crutches, but on the walker

    It's easier, of course, to see or experiment with crutches before the operation, but the general technique is simple:

    Rehabilitation after knee arthroplasty

    Walking on crutches with the help of an instructor is already on the second day

    • To get up,for the handrail, the other for the handle of a crutch or walker, with the support of a healthy leg

    • Walking on both crutches and walkers is built on the same principle :

      • They serve as additional support for the body:
        We rely on the crutchand armpits, and on the walker with the hands of
      • First we move forward at a distance of a small step both crutches or walkers
      • With a healthy foot we make a step and tighten the sliding foot on the floor with the operated leg
      • The leg should first touch the floor with the heel and then the whole foot
    • with additional support should be short-lived and carried out with the help of the instructor

Two to seven days after the operation

The patient by this time independently sits in the bed, having lowered his legs to the floor, and the course itselft on crutches.

  • Repeat all previous exercises in the supine and sitting position, but more actively and in larger amplitudes

  • Increase the number of repetitions

  • The following exercises are added:

    • retention of the elongated foot
    • retention of the straight leg
    • raised by 20-30 раз with the heel inserted under the heel
    • isometric exercises with tension of buttock muscles and quadriceps femoris
    • tilts and turns of the trunk with outstretched arm
    • imitation of walking
    • exercises in the lying position on the side( on zdofoot joint) with the roller between the legs
  • Starting from the second day, the development of the knee joint with the help of mechanotherapy begins - passive flexion-extension of the knee joint on the mechanical simulator with gradual increase in speed, angle and duration.

    Half a year after knee replacement

    Passive flexion-extension of the knee joint on the mechanical simulator:Exercises begin two days after surgery

Ninth day after surgery

Replacement of knee joint

Exercise in sitting position - swing with foot

Dynamics of exercises for the operated leg in

  • Lying on the side bend and unbend the leg in the ankle
  • Pull the toe up and raise the foot by 10 cm( specialist's help is allowed)
  • We make small flails with a sick leg
  • We add exercises with the emphasis on the handrails standing:
    Swing forward and raising the leg ona small angle

Rehabilitation of the house

Extract usually occurs after two weeks.

Walking on crutches will last an average of six to eight weeks, although some patients refuse them and before

at home you will repeat all those exercises that were done in the hospital in all three positions plus the will be added:

  • abdominal exercises
  • sit-ups
  • risings on tiptoes

It is also necessary to repeat passive mechanotherapy: at home, this can be done with a conventional elastic band.

Recovery after knee replacement

Passive exercises for knee joint with elastic band

Task of home exercises :

  • Do not allow contracture
  • Restore function of knee joint
  • Improve trophic of soft tissues of lower leg and hip

Late recovery period

It begins 1.5 months after the operation.

Objectives of the late recovery period - restoration of the functions of the aching limb

Adding exercises with support and load on the injured leg :

  • Makhi standing on a sick leg
  • Walking on bent legs, holding the handrails
  • Exercises "scissors" and "bicycle", etc..

Late rehabilitation period

This period is usually considered to be a period of more than two months after the operation. However, for all its terms.

The tasks of this period are mainly adaptive :

  • The patient learns to walk with a cane
  • Executes exercises with weighting
  • Begins to work on an exercise bike

In the photo below - exercises with thrust for knee joint development:

Bubnovsky exercises after prosthetic knee joint

Exercise with traction for knee joint

How long it takes to recover

Exercises after knee arthroplasty

Follow-up examinations at the doctor after endoprosthetics are performed every year

Actually, the care of the joint will last a lifetime. It is impossible to forget about the prosthesis immediately after the rehabilitation.

  • Six months after the operation, it is necessary to conduct a follow-up inspection of the knee from the surgeon
  • Then to visit the
  • a year each year. For several years, you need to practice active active exercises every day.
  • . Then you can simply perform daily gymnastics, maintaining your normal weight.
  • . Ten years after surgery,a thorough examination, since the prosthesis resource could come to an end

Video: Rehabilitation after knee replacement

If you have planned an endoprosthesis operationknee joint, see the full methodology of the Federal Center for Traumatology, Orthopedics and Endoprosthetics:

  • How is the preparation for operation
  • A full set of exercises after knee replacement in various rehabilitation periods

ZaSpiny.ru

How to restore and develop the meniscus after surgery?

The cartilage layer in the knee joint, located between the surfaces of the femoral and tibia, is called the meniscus. It performs the function of a shock absorber and stabilizer, but under certain kinds of load, especially during sports, there may be a rupture. Injury is one of the most frequent and occupies about 75% of all closed knee joint injuries.

The recovery of a meniscus after a rupture is possible by stapling with a special thread. If this can not be done, then it is deleted. In some cases, implantation of synthetic prostheses takes place, which take on the functions of the meniscus.

Rehabilitation after surgery is in physiotherapy and physical therapy, the duration of this recovery period depends on the nature of the injury.

menisci of knee joint

Rehabilitation exercise complex

If the resection of the meniscus( its complete or partial removal) was performed arthroscopically *, then the recovery complex can be started 1-7 days after the operation.
* That is, using special video equipment through two punctures from the sides of the knee joint.

If the injury was damaged ligament or removal of the meniscus was performed in an open method, then the physical therapy will have to be postponed, because for the first time the knee needs rest. The same situation is observed in the case of stitching the edges of the meniscus, which need to be consolidated, before re-loading the knee. This period can take up to 5-7 weeks after the operation, depending on the individual characteristics.

Early recovery of

The main goals that pursue early rehabilitation after surgery include:

  • normalization of blood circulation in the damaged joint and elimination of inflammation;
  • strengthening of the hip muscles for the purpose of stabilizing the knee;
  • preventive maintenance of contracture( restriction of volume of movements).

Physiotherapy exercises should be performed in different positions of the body:

  • sitting, passively unbending the operated leg, placing a roller under the heel;
  • standing on a healthy limb;
  • lying, straining the muscles of the thigh for 5-10 seconds.

All these exercises can be performed only with the permission of the attending physician in the absence of effusion( inflammatory fluid) and blood in the joint after the operation.

Later recovery of

The tasks of late rehabilitation are:

  • elimination of contracture in case of its formation;
  • normalization of gait and restoration of joint function;
  • strengthening of the muscles, stabilizing the knee.

For this, the most effective exercises in the gym and in the pool. Very useful cycling and walking. Do not forget that the first few weeks after a meniscus resection is not desirable squat and run.

tennis player suffered a knee injury

Examples of exercises

Squats with the ball. Starting position: standing, slightly leaning back, the ball is located between the waist and the wall. Do squats to the angle of 900. Deeper is not necessary, since the load on the knee joint is significantly increased.
  • Walking backwards. It is advisable to perform this exercise on the treadmill, sticking to the handrails. The speed should not be above 1.5 km / h. It is necessary to strive for complete straightening of the leg.

  • Exercises on the step( a small platform, used for aerobics).After the operation, first use a low step about 10 cm, gradually increase the height. When performing the descent and lifting it is important to ensure that the shin does not deviate to the right or left. It is desirable to control this visually - in the mirror.

  • Exercise using a 2 meter long rubber tape that is fixed to a fixed object on one side and to a healthy leg on the other. Performing the flies aside, train the muscles of both extremities.

  • Jumping on the leg first through the line, then through the bench. It trains the coordination of movements and the strength of the muscles.

  • Balance training is carried out using a special oscillating platform. The main task is to keep the balance.

  • When exercising on a stationary bike, you need to make sure that at the bottom point the leg is straightened.

  • Jumps can be on a flat surface or on a step. For greater efficiency, you need to jump right and sideways.

  • Running by stepping steps and walking in water can be performed after the wound is completely healed.

  • step platform

    Step platform

    Physiotherapy

    Physiotherapy in the postoperative period is aimed at improving blood circulation and metabolism in the knee joint area, as well as accelerating regeneration processes. For these purposes, massage, laser therapy, magnetotherapy and muscle electrical stimulation are effective.

    Massage should be performed with swelling and knee mobility restriction. For greater efficiency, it is advisable to teach the patient self-massage, which he will perform several times a day. The joint itself in the early postoperative period should not be massaged. To perform other physiotherapy procedures, you will need to visit the clinic.

    Surgical restoration of the meniscus

    Meniscus plays an important role in the normal operation of the knee joint, so during the operation it is not removed completely, but tries to keep the maximum amount of undamaged tissue. There are two main methods for restoring a meniscus after a surgical trauma:

    • A suture that is performed in cases of a linear rupture, if no more than a week has passed since the injury. To impose it makes sense only in the zone of good blood supply. Otherwise, the fabric will never grow together and after a while there will be a repeated rupture.
    • Meniscus prosthesis using special plastic plates is rarely used, usually with extensive destruction and removal of most of the cartilage tissue. In addition, there is the possibility of transplanting donor fresh frozen tissues.

    In conclusion, it is worth recalling that if you have a knee injury - it is necessary to contact an experienced trauma specialist. The doctor will determine the nature of the damage and will carry out the necessary treatment. Performing simple exercises for the rehabilitation and restoration of the meniscus function after the operation will very soon allow you to forget about an unpleasant incident and return to your old active life.

    SustavZdorov.ru

    Rehabilitation after knee surgery: arthroscopy, prosthetics

    • 1.2.1 LFK

    Knee joints are more susceptible to injuries and diseases. This is explained by their structure and location. In the elderly, it is the knees that begin to ache before other joints, especially if a person is obese and leads a sedentary lifestyle.

    In young people, knee joints suffer more often with injuries, because they take the brunt of the fall. The same happens with athletes, but they also exacerbate the situation by excessive training and non-compliance with security measures.

    Methods for the treatment of knee joints

    Mild forms of diseases and injuries are treated conservatively - tablets, ointments, compresses. Usually they proceed without complications.

    The consequences of severe trauma can be varied:

    • tearing or tearing of the meniscus;
    • patella dislocation;
    • rupture of cruciate and other ligaments of the knee joint.

    These cases require surgical intervention to prevent unpleasant consequences in the form of suppuration, contractures and immobilization of the articulation.

    The modern standard for the diagnosis of these conditions is arthroscopy. In the case of an advanced form of deforming arthrosis or severe trauma of the knee joint with its destruction, traumatologists resort to endoprosthetics.

    Both arthroscopy and prosthetic knee replacement are surgical interventions. They require preoperative preparation and development of articulations after treatment, may be accompanied by complications.

    Arthroscopy

    Arthroscopy is an examination of the knee joint with the help of an endoscope from the inside. During the examination, not only the diagnosis is established, but the necessary operational manipulations are performed:

    • restoration of the meniscus with slight tearing or partial rupture;
    • removal of the meniscus as needed;
    • removal of cartilage and bone fragments or their movement;
    • binding of ligaments.

    Arthroscopy can be performed under local or general anesthesia. But more often surgeons resort to a conductor or spinal anesthesia. To unpleasant consequences of arthroscopy it is possible to carry:

    1. Infection of an articulate cavity.
    2. Bleeding and hemorrhage into the joint cavity.
    3. Stretching of the knee ligament apparatus.
    4. The inefficiency of the operation associated with the insolvency of the seams, incorrectly chosen tactics.
    5. Thromboembolic complications( clotting of the blood vessel with a blood clot) in the early postoperative period.
    6. Complications associated with the action of anesthesia.

    Postoperative period

    In the postoperative period, the patient has certain complaints. Most patients are concerned about swelling in the knee area, pain and limitation of movement. Pain is only when moving or constant, more often it is dull, aching. Can increase at night.

    Pain syndrome and knee stiffness are usually the result of joint edema. When performing exercise exercises, active joint development, this period quickly passes without serious consequences.

    Rehabilitation

    Rehabilitation after arthroscopy of the knee joint determines a further prognosis. From its program, it depends how long the patient will need to complete recovery.

    In the early postoperative period, it is important to remove swelling in the knee area. To this end, non-steroidal anti-inflammatory drugs and cold on the area of ​​the operated knee are used. Sometimes, in order to eliminate swelling, lymph drainage is prescribed.

    Edema can build up when moving in the knee area right after the operation. Orthoses are used to ensure immobility of the knee joint. The terms of the early postoperative period vary from 3 to 7 days. Usually during this time, unpleasant manifestations disappear.

    Full recovery after arthroscopy of the knee joint takes longer. Its terms can range from six months to a year.

    The main role in the development of knee joint belongs to the exercises of physiotherapy exercises.

    Therapeutic physical training

    LFK after arthroscopy begins with the first day. Active knee development in the first period is prohibited due to postoperative edema and pain syndrome.

    In the first day only exercises for isometric contractions of the femoral muscles and movements in the ankle joint are allowed. On the second day passive movements in the knee joints are resolved, which do not cause pain in patients. Accurately enter the active movement.

    If an arthroscopic removal of the meniscus was performed, then active movements can begin as early as the end of the first day.

    For the first three weeks, the following exercise exercises are performed:

    Isometric contractions of the femoral and gluteal muscles.
  • Active painless movement in the knee joints. It is important that the heels do not come off the surface when performing these exercises.
  • Slow lifting of the leg in a supine and standing position.
  • Water exercises of physiotherapy exercises - in the pool.
  • From the end of the first month, it becomes possible to walk in the lock, without a cane. Flexion and extension in the joint should be painless and exceed 90 degrees. The main gymnastic elements are for strengthening the femoral muscles.

    The second-third month of rehabilitation requires training on an exercise bike, active swimming in the pool, exercises with a platform. Walking is allowed without restrictions, but with an orthosis. Later the patient is offered regular jogging.

    Sports loads are limited to six months, then they are resolved using the knee.

    Team games, which significantly increase the risk of knee injury, are prohibited on average for a year.

    A special approach requires the removal of the meniscus. After this operation, joint development should be strengthened to reduce the risk of arthrosis and stiffness. In the case of ineffectiveness of arthroscopic treatment and the progression of degeneration, endoprosthetics are performed.

    Knee replacement

    Endoprosthetics are replacement of a damaged joint with a synthetic one. For the knee, prosthetics is performed in case of severe forms of arthrosis or serious injuries. The task of this operation is to restore the volume of movements in the knee as much as necessary for the patient's active life.

    Endoprosthetics do not always involve complete replacement of the joint elements. In the case where the joint is not completely destroyed, a partial or single-pole prosthesis is performed. The more part of the intact knee joint, the lower the risk of rejection of the synthetic implant.

    Endoprosthetics is a more serious operation than arthroscopy. It is usually performed under general anesthesia. After the knee prosthesis is performed, the following actions come to the fore:

    • fight against pain syndrome;
    • elimination of postoperative edema;
    • prevention of infectious complications.

    As with arthroscopy, analgesics and decongestants, cold therapy, lymph drainage, antibiotics,

    are prescribed for this purpose.

    The development of the knee joint after endoprosthetics is extremely important because of the high risk of contraction and stiffness. Widely used exercise exercises physical therapy:

    1. Passive movements in the knee joint. Used in the early recovery period.
    2. Active movement. They are performed with assistance - with the help of a healthy leg, bend and unbend the operated. Squats with the ball. The patient holds the ball behind his back, leans against him and on the wall.
    3. Active bending of the operated joint from sitting position.
    4. Exercises with a rubber shock absorber. After arthroplasty of the joint, a good effect is given by exercises in which the extension in the knee is carried out without detaching the heels from the surface. This is called a closed kinematic chain.
    5. Climbing and descending stairs. Legs alternate. It is important not to allow overtaking on the patient side.

    The duration of recovery after surgery depends on the amount of intervention. Exercises exercise should be permanent and prolonged. You can not stop exercising when you achieve a positive result, otherwise there will again be a risk of stiffness.

    Rehabilitation after arthroscopy and endoprosthetics is no less important stage than the operation itself.

    MedOtvet.com

    Rehabilitation after arthroscopic knee joint surgery

    Recommendations for restorative treatment after arthroscopic knee joint surgery.

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    The timing of hospitalization for arthroscopic treatment of the pathology of the knee joint may be different. At present, there is a tendency to reduce the length of stay in the hospital. The stationary stage of treatment, with the majority of operations on meniscuses, ranges from several hours to 1 day, with arthroscopic plasty of cruciate ligaments from 1 to 3 days.

    Inpatient treatment period:

    • Intraoperative antibiotic prophylaxis is a single intravenous injection of a broad-spectrum antibiotic, if necessary, repeated administration after 24 hours.
    • Prevention of thromboembolic complications - compression knitwear, or elastic bandage of limbs during surgery and in the postoperative period( up to 3-5 days), administration of low-molecular-weight heparin preparations( up to 10 days), tableted anticoagulants.
    • Cryotherapy in the postoperative period - cold locally, with intervals of 30-40 minutes during 1-3 days.
    • Ensuring the rest of the joint in the early postoperative period. If necessary, the joint is fixed by an orteal bandage. Normally, the limb is in the forward position. When plastics of cruciate ligaments are used, fixing the joint with a postoperative tutor or a hinged orthosis in a closed position( fixation in the orthosis with a flexion angle of 20 degrees is possible).
    • Anesthetic therapy, non-steroidal anti-inflammatory drugs( NSAIDs).
    • Lymphatic drainage.
    • Therapeutic physical training for the first period of 1 day - isometric tension of the muscles of the thigh, movements in the ankle joint.2 days - drainage is removed, passive movements in the knee joint are added, in a painless range, activation is carried out.
    • When activated, additional support / cane or crutches are used, depending on the degree of permitted load on the foot.

    Outpatient treatment period, 1-3 weeks:

    • Dressings. Usually the examination of the traumatologist and dressings are carried out on the 1st day after the operation, 3-4 days, and 7-12 days. Aseptic dressings are changed, if necessary, puncture of the joint to evacuate the fluid. Seams are removed on the 7-12 day.
    • Use of anti-inflammatory and vascular drugs.
    • Elastic bandage of the limb up to 3-7 days.
    • Cryotherapy up to 3 -5 days.
    • Lymphatic drainage.
    • Depending on the type of operation performed, some degree of activity is allowed.

      After a meniscactomy, walking with a measured load on the leg is allowed from the first day after the operation. It is recommended to limit loads, use a walking stick, or crutches with an elbow support up to 5-7 days after surgery. When performing a suture of the meniscus, walking with crutches is recommended without foot rest up to 4 weeks.

      When plastic PKS in the early postoperative period is also recommended walking with crutches( it is possible to use crutches with support to the elbow) to 3 weeks. First, walking is done without loading the leg. Then, when walking the foot( not the sock) is put on the floor, but without transferring the weight to the operated limb. If there is no pain syndrome, a gradual increase in the axial load on the straight leg is carried out.

    • Additional fixation of the knee joint.

      In operations on the meniscus, elastic bandaging of the joint area is used, or wearing a soft( or semi-rigid) knee. When PKC is used, joint fixation is performed with a postoperative articular orthosis, with a gradual increase in the allowed bending angle. Movement can be started within 3-5 days after the operation, the angle of permitted flexion gradually increases to 90 degrees within 2-3 weeks after the operation. For the night, the brace may be blocked in the extension position.

    • Electrostimulation of the hip muscles( not necessary).
    • Physiotherapy.
    • Easy massage, mobilization of the patella by its passive shifting up and down and to the sides.
    • Full extension in the knee joint in a prone position( without overextending the joint!).
    • Passive movements in the knee joint. A good effect gives the use of the apparatus "Artromot" for the development of passive movements in the joint.
    • Physiotherapy exercises for periods.

      Isometric tension of muscles of flexors and extensor muscles of the thigh, gluteal muscles, motion of the foot continues. Add active movements in the knee joint, flexion-extension in a painless range. The movements are carried out in a "closed loop", that is, in such a way that the heel during movement is always in contact with the surface. For example, lying on the back, bending at the knee joint is performed, so that the heel slides over the surface of the couch, you can help bend your hands, capturing the lower third of the thigh. Add exercises to gradually strengthen the muscles of the limb, but without significant loads and taking into account the pain syndrome: slow lifting of the straight leg, lying down( sock to yourself), and keeping the weight for 5-7 seconds. Raising a straight leg while standing. Exercises with a tourniquet for the calf muscle. Possible exercises in the pool. Classes are held 2-3 times a day, for 10-15 reps.

    4-6 week:

    • Walking is possible with full support of the leg( in the orthosis), walking with one crutch, or without additional support.
    • Development of the volume of movements in the joint. The allowed amount of flexion is more than 90 degrees( up to the full volume of movements).By this time, a full extension must be achieved and preferably a 90 degree bend in a painless mode.
    • Forming the right gait. To walk it is necessary slowly, not by the big steps, trying not to limp on the operated leg.
    • Therapeutic physical training, aimed at strengthening the muscles of the thigh. It is desirable to conduct exercises under the supervision of a physician of physiotherapy exercises and taking into account the reaction of the joint to the load.

    Classes are held 2-3 times a day, for 10-15 repetitions. Raise and hold the straight leg( sock to yourself).Not deep slow springing squats( flexion 30-40 degrees), exercises with light resistance( rubber tourniquet), exercise bike with minimal load and a slight angle of flexion in the joint, strengthening of the leading and withdrawing portions of the quadriceps muscle of the thigh, exercises in the pool -walking in the water.

    If the joint swells, the pain in the joint after exercise increases, the joint is not restored by morning - the load should be reduced and consulted by the doctor in charge.

    6-8 week:

    • Walking and exercises in functional orthosis are possible, with a full range of movements.
    • Continuation of strength training. Exercise bike, active flexion and extension, ghost and lead in with elastic resistance( rubber tourniquet), not deep slow sit-ups( bending up to 60 degrees), swimming lessons, walking and running in water, swimming with a style of breaststroke. Classes on block simulators are possible, without using the loader of the front group of hip muscles.
    • Training aimed at coordinating movements. Swaying the body on the half-bent legs, step on the step, exercises on the platform, with insurance, holding on to the support.

    It is necessary to avoid sharp openings and overextensions of the leg, fly movements, jumps, twisting loads. Despite the reduction in pain, the ligament is in the process of adjustment at this time, its strength is reduced and the joints need to be protected.

    8-12 week:

    • Walking without restrictions.
    • Continuation of exercises aimed at strengthening the limb muscles, exercise bike, swimming, block trainers, exercises with a platform.
    • Training for coordinating movements - keeping balance on an unstable platform on straight and half-bent legs, with open and closed eyes, keeping balance on the inflatable cushion, exercises on 1 foot, accurate attacks, side steps.

    4-6 month:

    • Continued training aimed at strengthening the muscles and coordinating movements.
    • It is possible to jog on a flat surface.
    • Use of the knee in case of stress, danger of awkward movements( transport, trips) and exercise therapy.

    It is necessary to avoid premature increased loads, early return to sports, sharp leg extensions, especially shin movements "flush," jumps, running along a hard or uneven surface, twisting loads, falls, uncontrolled movements during sports exercises.

    Restriction of sports loads after performing PKC plastics is necessary up to 4-6 months. Limitation of employment by contact or game sports up to 9-12 months.

    I would also like to emphasize that the selection of a rehabilitation program should be carried out individually and take into account a variety of factors. This is a sufficiently long and responsible stage of treatment, without which it is unlikely to achieve good functional results of treatment.

    artro-s.ru

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