Restoration after hip arthroplasty
More recently, many patients with hip arthrosis( coxarthrosis) or fractured femoral neck were doomed to complete disability due to loss of ability to move independently. Fortunately, the introduction of new technologies in medicine has allowed patients to avoid this fate, and to live up to their previous full life. One of these technologies is total hip replacement( TETS), when the entire hip joint( head, neck of the hip, cartilage surface of the acetabulum) is replaced with a synthetic prosthesis. But in order for the synthetic joint to work just as well as "the native one", it is important not only to carry out the operation at the class level. It requires competent postoperative recovery or rehabilitation after endoprosthetics. And it depends not only on the doctor, but also on the patient.
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Suprapatellar bursitis of the knee joint
TETS itself is a rather complicated technical and traumatic operation. The skin and muscles are dissected, the bone-cartilaginous tissues of the worn out joint are removed. Then the leg of the prosthesis is fixed in the canal of the femur. Severe operating injury is accompanied by pain, the release of biologically active substances from tissues to the blood. In turn, this leads to a change in the functioning of the heart, lungs, coagulating blood system. Preoperative preparation and anesthesia eliminate all these negative consequences, but only to a certain extent.
It goes without saying that people go to endoprosthetics, to put it mildly, not from a good life. Strict indications are needed for such an operation. Such indications include the destruction of joint structures due to coxarthrosis or hip fracture. With coxarthrosis, due to long-term motor disorders, atrophic changes in the muscles of the lower limb and back are developed, and the work of the pelvic organs is disrupted. The load on the spine increases, which leads to the development of lumbosacral osteochondrosis and radiculitis.
Do not forget that the vast majority of patients operated on for TETS are elderly and senile. This means that they have varying degrees of disability in the functions of the heart, respiration, and endocrine system. In some patients, the disorders are decompensated, and after the operation are aggravated. In addition, the operation itself and the postoperative bed regimen lead to disruption of the peristalsis( contractions) of the intestine until the development of atonic intestinal obstruction. It should not be forgotten that in the elderly, the ability to regenerate, heal damaged tissues during surgery, is significantly reduced. Immunity is weakened, resulting in favorable conditions for infection.
Thus, postoperative problems after hip replacement are as follows:
- Patient worried about postoperative pain
- Exacerbated atrophy of muscles
- Cardiopulmonary insufficiency worsened
- Bowel function disrupted
- Great risk of cerebral strokes due to blood pressure spikes
- Coagulation disorders maylead to thrombosis of the veins of the lower extremities and to an extremely serious condition - pulmonary embolism of the
- PosleAn operative wound can serve as an entrance gate for infection.
The main directions of rehabilitation
Measures to restore motor functions and prevent postoperative complications are complex. Needless to say, the main emphasis is on curative physical training( LFK), which is designed to ensure the optimal operation of the newly acquired joint and the entire lower limb. In addition to exercise therapy, other therapeutic measures are carried out using drugs from different groups, as well as physiotherapy procedures.And the first such action is postoperative analgesia, during which they combine non-narcotic( Renalgan, Dexalgin) and narcotic( Morphine, Promedol) funds. To prevent severe pulmonary heart failure, patients are prescribed cardiac remedies( Mildronate, Riboxin, ATP).This patient shows inhalation( inhalation) of oxygen. Oxygen in a moistened form is fed through a special breathing apparatus.
Another important point is the prevention of thrombotic complications, which often develop in patients in the elderly after surgery. At the same time, in the veins of the lower extremities, the parietal thrombi form, which, when detached, are brought into the pulmonary artery by a current of blood and clog it. Blockage of the main trunk of the pulmonary artery can cause instant death. To prevent this from happening, in the first few days after the operation, such patients are bandaged with an elastic bandage and subcutaneously injected with funds preventing blood clotting( Fraksiparin, Clexan).To eliminate postoperative atony of the intestine, assign injections of Proserin, Ubretid. Necessarily prescribe antibiotics( Ceftriaxone, Metrogil).
Principles of exercise therapyThere is a misconception that exercise therapy after hip arthroplasty can be performed only in the late postoperative period, and in the early days you need a strict rest. This erroneous tactic can lead to contractures( persistent limitations of the volume of movements) and to thrombotic complications. Therefore, some, the most simple loads, are carried out already in the first day after the operation, on leaving the anesthesia. In the exercise of exercise therapy should be observed the principle of phase, when the exercises themselves are done in several phases.
Zero phase - in the first day after the operation, when the following types of exercises are performed:
- Bringing and lifting the foot up and down several times every 10 minutes.- The so-called.foot pump
- Ankle rotation in both directions 5 times
- Short-term, for 10 min, the tension of the anterior quadriceps femoris
- Knee flexion with simultaneous pulling of the heel
- Cuts of the buttocks with subsequent tension for 5 seconds
- Retreatment of the operated leg to the side and returnin the starting position
- Raising the straightened leg for a few seconds.
First phase of
The first phase, 1-4 days after surgery - the so-called.strict care. At this time, you are allowed to sit on a hospital bed or chair, and then move with crutches or special walkers. Important: when planting, do not bend the limb in the hip joint more than 900, do not cross the legs. On the contrary, lying on the bed, try to take your foot to the side. For this, you can put a pillow between your legs. The main types of exercises in this phase are performed in the standing position:
- Leg bending in the knee and hip joints
- Straightening of the leg in the hip joint and drawing it back
- Retracting the leg to the side.
The second phase of
The second phase of rehabilitation or deceptive opportunities - 5 days - 3 weeks after the operation. Many patients at this time feel a surge of energy, they were tired of stiffness and inaction. But the joint is not yet strong, and muscle atrophy persists. This phase shows the movement loads - movement on a horizontal surface, but not more than 100-150 m.or climbing and descending the stairs. Climbing the stairs, you should lean on a cane or on a crutch. At the same time, at the higher step, first put a healthy leg, then operated on, and then - a cane. When descending the stairs, everything is done in the reverse order.
The third phase of
The third phase of rehabilitation, the "beginning of work" - after 1-2 months.after operation. At this time, the implanted joint "caught on", and the muscles and ligaments are so strong that you can smoothly increase the load, and carry them out at home. Exercises in this period are similar to the previous ones, but they are performed with burdening. As a weigher, an elastic band can be used. One end of the tape is tied to the operated leg at the ankle level, and the other to the fixed object, for example, to the door handle, followed by bending, straightening and retraction.
During this period, you can increase the duration of walking tours - for half an hour 3-4 times a day. Even exercises on a stationary bike are shown. In this case, do not forget one rule - the emergence of pain is a signal to stop training. At the same time, do not stay for more than an hour, sit in a fixed position. The above rule of the right angle must also be observed. In general, during each hour should be a little, for several minutes, walk around.
In the course of rehabilitation after endoprosthetics, the exercise therapy is necessarily combined with physiotherapeutic procedures, among them - darsonval, phonophoresis, magnet, amplipulse. Thanks to these procedures, the edema is finally eliminated, the muscles are stimulated. The final stage of rehabilitation of hip arthroplasty is a stay at mud resorts.
Rehabilitation after hip arthroplasty: motor mode
After completion of the operation to establish an endoprosthesis in the hip joint, a course of restoring the normal functioning of the joint, as well as the muscles adjacent to it, is required. In this case, the duration and effectiveness of the rehabilitation course depends on many factors. Rehabilitation after hip arthroplasty is carried out according to different schemes. Therefore, it is necessary to apply an individual approach to each individual patient.
Much depends on the age of the patient, on his general condition and physical development of the muscles. Accordingly, the older the patient, and also, the more he is physically weakened, the longer the rehabilitation process will take place.
Also of great importance is how much time passed between the trauma and the operation. In the event that a rather long period has passed, most likely, the muscles managed to significantly atrophy, since the damaged joint could not function fully.
A similar situation may occur with arthrosis. If the operation was carried out in a timely manner, when, despite the pain, the person could still move independently, and the muscles had to work, but to the critical point the matter has not yet reached, then the recovery process will be a little faster and more successful.
But it also happens that a person suffers pain for years, hoping that everything will pass by himself. To the doctor, he turns, when the pain becomes quite unbearable, and a person can not simply walk.
In such cases, the muscles have time to atrophy. Accordingly, the process of postoperative rehabilitation will take longer and more difficult. Considering all such factors, it is possible to draw up a general rehabilitation program that is applicable to all patients. This program is based on certain principles and goals, and an individual approach to each individual patient is also applied.Want to have a good sleep? Orthopedic pillow with the effect of memory will ensure the correct position of the spine during sleep and normalizes the muscle tone of the cervical region.
On how to determine the cause and eliminate the attack of acute pain in the back, you will learn from our article.
The rehabilitation process can be broken down into several periods or phases.
This phase of rehabilitation begins a few hours after the operation. First, it is necessary to restore blood circulation. This is required for the normal functioning of the limb and preventing the formation of blood clots in the blood vessels.
As soon as the action of anesthesia passes, it is necessary to do the following exercises( it must be remembered that all exercises should be performed by both legs, not only the patient):
- Movement of the foot foot up and down, the so-called "foot pump".Exercise should be repeated several times every 10-15 minutes, as soon as the sensitivity of the foot returns. Do the exercise during the entire rehabilitation period.
- Rotate the ankle to the right, then to the left 5 times. It should be remembered that rotation should be performed only at the expense of this joint. The knee does not participate in this exercise.
- Work of the anterior muscle of the thigh( four-headed muscle).It is necessary to strain the front of the thigh, straightening. You can pull the socks forward. At first, there will be no full leg straightening, there may be pain. But it is necessary to try, and eventually the exercise begins to work out. Keep the muscles of the front of the thigh in tension takes 5-10 seconds. Repeat the exercise for 10 approaches for both( !) Legs.
- Bend the knee, moving the heel towards the buttocks. The heel should be pressed against the surface. The knee should not rotate to the other leg. The hip joint should not bend more than 90 degrees. Repeat exercise 10 times.
- Squeeze the buttocks and hold in tension for 5-7 seconds. Repeat the exercise should be at least 10 times.
- In the lying position, move the elongated leg sideways to the maximum possible distance, then return it to its original position. In postoperative days, this exercise is likely to fail, but over time it begins to work out. Repeat exercise 10 times.
- Raise the straightened leg up a few centimeters. As in the previous case, this exercise can not be performed first. Repeat the exercise 10 times.
The first phase of
The next phase of rehabilitation after endoprosthetics begins on the 2nd day after the operation. At this time, the patient will be able to get up and move gently on crutches, leaning against the injured leg, but not at full strength. Over time, this load will increase.
The purpose of the 1st phase of rehabilitation is to restore the person's ability to move independently, including on the stairs( at first, of course, using crutches).
When traveling, it is important to follow certain rules, namely:
- To prevent dislocation, it is necessary to bend the leg in the hip joint by no more than 90 degrees. It is forbidden to cross your legs, squat and toss your foot on your leg, when such an opportunity will appear due to the subsidence of pain.
- In order to avoid similar actions in a dream, it is necessary to lay cushions between the legs.
- You can sit down only on such chairs, where the knees will not rise above the level of the navel, that is, the hip joint will not bend over 90 degrees.
- In the position lying on the back of the legs should be slightly diluted to the sides, as in the sitting position.
- Do not bend lower than the navel, when dressing shoes or other activities while sitting, lying or standing. Always remember about 90 degrees!
Exercises 1st phase:
- In standing position, lift the elbow parallel to the ground. Hold the foot in this position for 5 seconds, then lower it. Several approaches are required for this exercise.
- In the standing position, straighten the leg and slowly pull back( the back in the lower back can be held by hand).Hold the limb in this position for 5 seconds, then lower it. Repeat the exercise several times.
- Standing elongated leg to the side. Hold the limb for 5 seconds, then lower it. Repeat the exercise several times.
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The second phase of
This phase of rehabilitation after hip arthroplasty begins about a week after the operation, includes exercises whose task is tomoving the patient on the stairs. They are carried out only with the supervision and assistance of a doctor, so here we will not touch on these exercises, since it is necessary to guide the attending physician, which is based on the patient's condition, as well as some other factors.
Video: "Endoprosthetics of the hip joint: exercises"
Third phase of
The third phase of rehabilitation begins 4-8 weeks after the operation, depending on the physical condition and age of the patient.
In this phase, you need to learn to move without crutches, but still with the help of a cane.
For the successful implementation of the third phase, the following exercises will help:
- The elastic band is fastened in front around the ankle, and the other end - to a secure support. In the standing position, move the leg forward, then return it to its initial position. Repeat several times for each leg. This exercise should be done 10 times a day, in the morning, in the afternoon and in the evening.
- The exercise described above is exactly the same, only the elastic band is attached to the back of the ankle. In the standing position, take the leg back, then return it to the initial position. Repeat several times for each leg. This exercise should be done 10 times a day, in the morning, in the afternoon and in the evening.
- Elastic band fastened to the side of the ankle. Take the straightened leg to the side, return the limb to its initial position. Repeat the exercise several times. Perform 10 sets per day.
- The exercises on the exercise bike perfectly strengthen the muscles of the legs and develop the mobility of the joints. It is important to adjust the seat so that the legs are as straight as possible and hardly reach the pedals at the lowest point. First you should practice 10-15 minutes 2 times a day. Over time, the load should be increased and dealt with for 30 minutes 3-4 times a week, or more often.
- It is important to conduct exercises for balance training. To do this, you must stand on one leg, leaning your hand against the wall, and rise up on your toe. Perform 10 repetitions per foot.
- Walking on the treadmill in the opposite direction. The foot rolls from the fingers to the heel. When the entire foot is placed on the treadmill, the knee is fully straightened. The speed of the track should be 1-2 km / h.
Video: "Rehabilitation after hip arthroplasty: support and movement"
So, after completing the entire rehabilitation course after hip arthroplasty, as a result of the exercises, a person should completely return the opportunity to walk normally without the help of a cane. In this case, the hip joint restores its functions. This usually occurs 7-8 weeks after the operation. It should be remembered that in order to prevent injuries in the future, you must constantly maintain your body in good physical shape, and after completing the rehabilitation course, you must perform all the above exercises.
Hip Endoprosthetics: Recovery and Rehabilitation
The hip joint is the largest joint in the human body. Connecting the torso and legs, it gets a lot of work, so the diseases and lesions of this joint cause unbearable pain, which requires immediate medical intervention.
Among hip joint diseases: coxarthrosis, infectious arthritis, pathology of blood supply to the bones, and others. Endoprosthetics of the hip joint is the replacement of the destroyed joint element on the implant. The implant can be made of materials such as metal or ceramics and contain stainless steel, cobalt, chromium or titanium. The surgeon selects the appropriate material and size of this material, based on individual indicators. The prosthesis( older people) serves a lifetime, but younger patients may need to undergo a second operation on the hip joint.
Operation on the hip joint
These operations are carried out for thirty years and every year it is carried out using more and more advanced technologies that significantly improve the results. As a result, patients suffer unbearable pain that accompanies any hip joint damage. In order to avoid complications during and after surgery, tell your doctor full information about your health condition. If you smoke, the doctor must know about it, since nicotine affects both the speed of rehabilitation and the patient's well-being during the operation. That there were no unforeseen circumstances, also it is not necessary to place the stomatologist before operation - the blood from a mouth can get in a blood flow, having infected a joint. Endoprosthetics of the hip requires a thorough examination.
During the operation, sometimes the blood of a patient suddenly suddenly becomes necessary - better hand over yours in advance, because it is not known how the body will react to someone else's blood, which usually is prepared by doctors for every firefighter.
Total hip arthroplasty( replacing both pelvic and femoral joint elements) is, first of all, a more long-term operation of the implant, which eliminates the need for revision hip arthroplasty. In addition, in this case, the implant performs its function better, although there are disadvantages: this operation is more dangerous and blood loss in this case is greater.
Complications of hip arthroplasty are and depend on the characteristics of the body and the lifestyle of the patient, and also on the quality of the operation and the knowledge of the surgeon conducting it. Statistics show that the most common complications arose with the use of low quality implants - these are the first implants of the last century. With the progress in modern medicine, the number of complications has significantly decreased. After carrying out endoprosthetics of the hip joint, the patient can apply for a pension. The disability group after hip arthroplasty and the size of the pension, respectively, is determined by the indicators of the patient's ability to move, go to the store and so on.
Recovery after hip joint surgery
The duration of recovery after surgery depends on the patient - each rehabilitation period is individual. Recovery after hip arthroplasty does not include any specific technique, but some rules should still be followed.
- Sitting on a chair, put a pillow on the seat so that your knees are below your hips.
- Avoid excessively sharp movements, turns with your legs, crosses and so on - all these manipulations will negatively affect the patient's well-being and the speed of his rehabilitation.
- Lying on your side( only not on the leg that was operated on), lay a small pillow between your legs to avoid displacement.
If symptoms such as fever appear, pain increases, swelling or other similar phenomena occur, then immediately consult a doctor.
It is worth remembering that it is important when exactly the operation was performed - immediately after the joint failure or after a long time. Of course, in the first case, the work of muscles can recover completely, which can not be said about the second case.
Rehabilitation after hip arthroplasty begins already in the hospital and continues for about another month at home. To increase the chances of completely rehabilitating, the patient must strictly follow the recommendations of doctors.
It is more difficult to rehabilitate old patients, so medical rehabilitation is begun before the operation. Of course, endoprosthetics of the hip joint, whose rehabilitation takes time, is a complicated procedure, but do not despair - you will succeed.
Exercises for rehabilitation after hip arthroplasty
Exercises are an important part of restoring the muscles that will atrophy if they are not done. Exercises after hip arthroplasty are quite painful, since pain immediately after the operation does not subside. However, do not spare yourself too much, because then it will be much more difficult to recover.
It is important that the patient knows what he is facing. Endoprosthetics of the hip joint, the video of which can be viewed on the Internet, will give you an idea of this.
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Rehabilitation after hip arthroplasty
Termak Krka undergoes complex rehabilitation after the replacement( ie, endoprosthetics) of the hip joint, thanks to qualified spa personnel, modern facilities and equipment.
Operative interventions on the hip joint are performed in the leading medical institutions located near the spa resorts of Term Krka.
In the rehabilitation program a team of specialists of the resort is involved, which includes: a rehabilitation physician, an exercise physician, an occupational therapist, a sports coach, a nurse and a massage therapist.