Sick leave after arthroplasty. What is the Duration of Sick leave after Hip Replacement. ... to resume intercourse

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What is arthroplasty, and in what situations is it necessary? This is an operation to replace a joint with an artificial implant, which has been affected by arthrosis. The disease is called coxarthrosis, and arthroplasty is indicated at the last stage of the disease, when coxarthrosis has already started, and conservative methods of therapy do not bring positive results.

In such a situation, surgery to replace the hip joint is considered the only correct solution, since only arthroplasty can restore the lost function of the joint and return the patient to a full life. The operation is prescribed when the doctor diagnoses the patient with absolute destruction of the hyaline cartilage.

How to treat coxarthrosis

Treatment of coxarthrosis in each case is selected individually. It depends on several factors:

  • the age of the patient;
  • stage of the disease;
  • the presence of concomitant pathologies;
  • the state of the patient's immunity.

In general, for the treatment of coxarthrosis of the hip joint, the doctor always prescribes a whole range of measures, which include the general improvement of the body. Traditional medicine methods are also used to treat coxarthrosis.

Therapeutic measures consist in both conservative and medication methods:

  1. Prescribing muscle relaxants means that reduce muscle tension around the affected area. The drugs improve blood circulation in the joint and relieve pain.
  2. Prescribing non-hormonal (non-steroidal) anti-inflammatory drugs that relieve pain. This group of drugs can be taken at any stage of coxarthrosis.
  3. Prescription of drugs that restore cartilage tissue. These include arteparone, glucosamine, etc. These drugs are most effective in coxarthrosis.
  4. Hardware traction. Used to reduce stress on the surface of the joint. Such treatment is a course treatment and is possible with the help of special equipment.
  5. Physiotherapy: phonophoresis, electrophoresis, laser therapy, cryotherapy. All these procedures are aimed at relieving inflammation and improving blood circulation in the affected area.
  6. Post-isometric relaxation, stretching of muscles and ligaments is possible without the use of auxiliary mechanisms. The patient is actively working. Its task is to strain and relax certain muscle groups. During moments of relaxation, the doctor will stretch.

Treatment of the 1st and 2nd stage of coxarthrosis

Treatment of coxarthrosis in the initial stages allows you to stop the development of the disease. If measures are taken in time, the patient will never know what grade 3 coxarthrosis is. In the first two stages, conservative and drug treatment methods are actively used.

  1. Pain relieving drugs are prescribed: non-steroidal anti-inflammatory drugs, analgesics.
  2. Significant loads on the affected joint are excluded. The patient is transferred to a sparing mode. He is prescribed a course of special exercises.
  3. Reflexology, massage.

All of these methods stimulate proper blood circulation in the joint and adjacent tissues. Allows you to restore mobility in the joint, until complete recovery.

Treatment of the 3rd stage of coxarthrosis

At this stage, it is possible to use conservative treatment (reduction of stress, injections of drugs that improve blood circulation). But such therapy will be palliative, that is, it will eliminate the symptoms, but not the cause of coxarthrosis.

How the hip joint works

To clearly understand the essence of hip surgery, you need to know its structure. It is a ball-shaped joint that can rotate in three directions: sagittal, vertical, and frontal axes.

The hip joint is formed by two bones that connect to each other: the iliac and the femoral. The femoral head is inserted into the acetabulum of the iliac bone. This apparatus is, in fact, an excellent hinge with the ability to perform various movements.

The healthy hip joint is covered with a layer of hyaline cartilage. In other words, the cavity of the acetabulum and the head of the femur are covered with cartilaginous tissue.

Articular cartilage provides smooth sliding of joints and allows cushioning of human movements. Pathologies of the hyaline cartilage and lead to the formation of osteoarthritis.

Classification of hip implants

The modern medical equipment market offers more than fifty types of endoprostheses. Any modification ensures the fulfillment of the physiological functionality of the joint. That is, the one that nature gave to man from birth. But the endoprosthesis has limitations in terms of service life.

If the operation is performed correctly, the implant will serve its owner for 15-20 years. After this period, the patient will need a second operation.

Endoprosthesis attachment methods

  1. Cementless - with this method, the bone grows into the prosthesis, which has a rough surface.
  2. Cement - the endoprosthesis is attached using polymer cement - a special bone "glue".

Both of these methods are very popular, but there is no definite answer yet which one is preferable. Each method has strengths and weaknesses. More recently, the hybrid mount is being used. This option combines all the positive characteristics of both methods.

Endoprosthetics can be:

  • Unipolar - only the head of the femur undergoes prosthetics.
  • Bipolar - in addition to the head of the hip joint, the acetabulum is also replaced.

Hip Implant Design

During the manufacture of endoprostheses, materials undergo careful control. This is necessary, taking into account the peculiarities of the use of prostheses. In the human hip joint, hyaline cartilage provides perfect glide. In an artificial analog, friction can cause rapid deformation of the prosthesis.

Therefore, implants are made of high-strength metals and polymers that can provide a long service life.

Hip endoprostheses are manufactured:

  • made of polymer plastic;
  • from a metal alloy;
  • from ceramics.

The most popular combination today is "metal + plastic", which has a normal period of operation. Of course, "metal + metal" is the leader in reliability, providing the duration of the endoprosthesis operation up to 20 years, and all this time the artificial hip joint works perfectly.

Hip replacement

The size of the future prosthesis is carefully selected. Before the operation, the doctor communicates with the patient and explains to him the possible complications and risks. The main risks are associated with the likelihood of introducing infection into the body, vascular thrombosis, and large blood loss during surgery. The possibility of dislocation of the endoprosthesis is not excluded.

The patient is hospitalized a couple of days before the operation and is fully examined. The procedure for replacing the hip joint lasts from one and a half to three hours. Endoprosthetics is performed by a highly qualified doctor, since the operation is classified as complex.

First, the hip joint, which affected the coxarthrosis, is removed, then an artificial implant is mounted. In this case, one of the above methods is used. In the postoperative rehabilitation period, the patient is prescribed anti-inflammatory analgesic drugs.

A small roller can be placed under the hip region to fix the pelvis in the desired position. The day after surgery, little activity is usually acceptable in a hospital bed. On the second day, the doctor allows some static movements and squats.

After arthroplasty, the sutures are removed by the end of the second week.

Rehabilitation program

After 10-15 days after the operation, the patient is discharged home. At home, it is necessary, observing all the doctor's prescriptions, to carry out further rehabilitation. If complications of the patient have arisen after the operation, it is advisable to transfer to a special rehabilitation center. There he will be provided with the supervision of rehabilitation doctors and proper care.

The operated person must comply with the restrictions on the loads on the artificial hip joint. This period is usually up to two months. . From 5 to 15% of all operations are complications. This percentage is getting smaller every year. This is explained by the fact that more advanced means are used, and the technique is constantly being refined.

Important! In 95% of hip joint replacement surgeries with an artificial implant, a person regains the ability to bend, move, play sports and fully return to normal life.

The term of operation of the endoprosthesis is from 10 to 15 years. It should be borne in mind: the more load the prosthesis receives, the sooner the implant will wear out. High mobility of the hip joint (for athletes who return to their previous lifestyle) and excess weight reduce the life of the endoprosthesis.

Endoprosthetics surgery costs the patient from 2 to 10 thousand. Summing up, it should be noted that endoprosthetics for such a disease as coxarthrosis is the last way to make the patient's life easier. In other words, when it becomes clear that there is no other way to get rid of the disease.

Therefore, it is impossible to start coxarthrosis, the disease must be treated in the early stages. Then surgery can be avoided.

  • Relieves pain and swelling in joints with arthritis and arthrosis
  • Restores joints and tissues, is effective in osteochondrosis

In order for rehabilitation after hip arthroplasty (HJ) to proceed without complications, and the artificial joint to take root and function normally, it is important to strictly follow the doctor's recommendations. In the early recovery period, drug therapy and light physical training are prescribed. As you recover, it expands, the set of exercises becomes more varied, and the load gradually increases.

So that in the postoperative period the patient is not distracted by extraneous matters, a sick leave is issued.

Rehabilitation stages: requirements and limitations

Recovery after hip arthroplasty takes a long time, and at each subsequent stage a person's life changes. To normalize the condition and fully recover, at least six months must pass. Immediately after prosthetics, the patient is in the hospital for 2-3 weeks, because during this period there are restrictions that cannot be violated. Further, when the seam heals and the danger of complications has passed, the adaptation period continues at home. All this time, the development of the artificial joint and the training of the muscle corset are taking place. If you lead a healthy lifestyle, play light sports and follow the doctor's recommendations, a person will live a full life the same as before implantation.

Early postoperative

General principles


You can use crutches for movement.

The period begins immediately after the removal of the affected joint and replacement with a hip joint endoprosthesis. Lasts up to 15 days. Once the anesthesia has passed, the patient is allowed to sit down, but not to concentrate the weight on the operated area. Starting from the second day, you can lower the affected leg out of bed to prevent blood clots, elastic bandages are applied around the limb. Basic rules for early recovery after hip replacement surgery:

  • Sleeping in the first week is allowed only on the back.
  • The motor regime should be limited for now. Sudden movements and long walking are prohibited.
  • You can sit for a short time, while it is not recommended to bend your legs more than 90 °.
  • It is contraindicated to bring together and cross limbs. To prevent this from happening, it is recommended to place a roller between your legs.
  • So that it does not form, and there are no stagnant processes in the veins, exercise therapy is prescribed after the replacement of the hip joint.
  • When moving, you need to use a support. It can be a walker, it is also allowed to walk on crutches.

Healing exercises

Physiotherapy at an early stage is aimed at improving the blood supply to the operated area, developing muscles and preventing the development of complications. During this period, the patient should be under the supervision of a physiotherapist. He will teach you how to do exercises correctly, and which postures are contraindicated.


Patients can be rotated while lying down.
  • Lying on your back, bend-unbend the toes of both legs, trying to feel the muscles.
  • Rotate the feet in different directions, then move back and forth.
  • Lying in bed, try to maximize the back of the thigh to the bed.
  • Take turns to strain the healthy limb first, then the operated limb.
  • Pull the limbs bent at the knees towards you, helping with your hands.
  • Small pillows or rollers are placed under both legs, after which, alternately, the straight limb rises and lingers for 10-15 seconds.

Recovery exercises should not be painful or uncomfortable. If a new activity caused an acute pain symptom and a deterioration in well-being, it is worth informing the doctor about this and reducing the load on the diseased limbs.

Expansion of motor activity


As the patient recovers, they can sit on a chair.

If the initial rehabilitation period passes without complications, the stitches are removed, and the patient feels better, the exercise expands. The patient is allowed to bend over a little, sit for a while on a chair, walk with a walker or crutches. If the patient has already learned how to maintain balance, it is recommended to expand the training complex with such exercises:

  • Leaning on the back of a chair or bed, lift and hold on the weight first a healthy, then a diseased limb.
  • Holding on to the support, raise the legs bent at the knee to the sides in turn.
  • In a standing position, first raise the limbs forward, then take them back.
  • During all exercises, the legs must be bandaged or an orthopedic orthosis must be used.

Second stage: what exercises are added?

If the removal of the affected joint was successful, and during the first period in the hospital the patient did not have any complications, then they recover at home, but under the supervision of a doctor. This stage lasts 3 months. As before, elastic bandages are applied to the operated limb; if necessary, the patient is still taking medications prescribed by the doctor. The person is still on sick leave, the extension period of which depends on the individual characteristics of the organism.


Sleep on the side is allowed two months after the operation.

It is allowed to sleep on its side if two months have passed after the prosthetics, and during this period after replacement the X-ray shows positive results, you can move around with a cane. The postures taken during charging should not cause discomfort. Exercises after hip arthroplasty in the second stage:

  • In the supine position, make rotational movements with bent limbs, imitating cycling. To increase the load, a pillow is placed under the lower back.
  • In the same starting position, take turns to raise straight limbs 45 ° from the floor, lingering for 15-20 seconds.
  • Roll over on your stomach, bend-unbend both legs at the same time.
  • Stand upright, put a support near you, for example, chairs. Holding on to the back, slowly squat, trying to feel the muscles of the thigh.
  • Sit on a chair, thread your legs through a loop made of elastic fabric. Spread both limbs to the sides, straining all the muscles.

The third stage of rehabilitation after hip arthroplasty

Lasts an average of 6 months. Human motor activity is expanding, new, intense exercises are added, and it is also allowed to move up the stairs. During this period, the gait should be leveled, the person can already bend over without using the support. In addition to charging, you can connect a course of massage procedures. But do not forget that if the condition has not fully recovered, and in the early rehabilitation period the stitches did not heal for a long time, and there were other complications, massage after hip replacement is contraindicated.


In the third recovery stage, you can raise and lower your straight legs while lying down.

The training complex includes the following exercises:

  • Lie on the operated side, straighten your leg, take your healthy leg a little to the side. Raise the affected limb, trying to hold it in a hanging position for 5-7 seconds.
  • Lying on the mat, raise both straight limbs at a right angle, then slowly lower them to the floor.
  • Stand straight, place a dais in front of you that imitates a step. To go up and down from it, first with a healthy limb, then with the operated limb.
  • Put on a clamp made of elastic fabric on the door handle. Pass the affected leg into the loop and pull the clamp towards you with maximum effort.

Hip replacement surgery is one of the most difficult, after which a long recovery is required. If a person works, and more often than not it happens, you have to worry not only about your health. At work, they require a sick leave. The problem is that immediately after the operation it is impossible to say for sure how long the rehabilitation will last and how the artificial prosthesis will behave: a person will be able to lead a full-fledged lifestyle or they will have to register a disability and leave work.

Recovery period after arthroplasty

According to the law, after such an operation, rehabilitation lasts 3 months: a person is in the hospital for 2 weeks under the supervision of doctors and then continues to be treated at home. Immediately after discharge, an open sick leave is issued for a period of 3 months.

Why is this happening:

  • a person must adhere to an individual schedule of classes under the supervision of exercise therapy specialists, therefore, be at home;
  • at first, heavy loads should not be given, because the prosthesis has not yet taken root in the body and there is a danger of dislocation, a person should always be able to lie down and rest - this is impossible at work;
  • 90% of people after endoprosthetics experience severe pain in a sitting position, therefore, frequent changes in position and taking painkillers are required - if the work is sedentary, a person needs to go through the recovery stage in a calm environment;
  • if you do not adhere to the regimen for a year after the operation, complications in the form of dislocation, fractures are possible. The risk increases in elderly people with concomitant diseases or endocrine disorders; working retirees after arthroplasty should be more careful about their health after surgery.

Even a year after replacing the hip joint, up to 22% of patients complain of painful sensations. These are official statistics, so you need to be ready to extend your sick leave in case of continuous pain that will prevent you from working normally.

The primary development of the joint should be under the strict supervision of the medical staff.

Discharge from the hospital after hip joint surgery occurs in 3 weeks. Must pass:

  • the acute stage and the end of the inflammatory reaction;
  • wound healing, which is monitored by doctors;
  • recovery initial period, also supervised by the clinic staff.

At home, the late recovery period lasts, in which bone tissue is renewed and the body adapts to the prosthesis.

3-4 months is the minimum period that is given to a patient whose health is normal. It is difficult to imagine that when bone tissue is destroyed, the body works like a clock. In most cases, going to work after hip replacement is postponed.

How to extend sick leave after arthroplasty

If, after 3 months, a person is not able to go to work for health reasons, the issuance of sick leave is transferred to the jurisdiction of the attending physician. He can issue sick leave for up to 15 days, based on the patient's well-being. That is, a person must come to the hospital 2 times a month or more often - as the doctor says.

After 4 months from the date of the onset of temporary disability, sick leave certificates are closed. Further, the following is possible:

  1. The man goes to work.
  2. The doctor applies for the recognition of the patient as disabled. A medical and social examination is appointed and the person is recognized as a disabled person. The group is determined by the members of the commission on the basis of the available documents on the state of health.

If health is not improving or a person wants to spend more time at home and devote to his recovery, an option with a temporary disability is possible. Immediately after the joint replacement surgery, documents for disability are submitted, the amount of payments is determined and the patient sits at home. A year later, the documents are submitted again, after which the disability can be removed and the person starts to work. In case of health problems, the disability is extended and he then receives disability benefits.

The sheet of temporary disability with slow recovery and adaptation, but with positive dynamics, can be extended up to 7 - 8 months.

Difficult situations with recognition of disability

If conservative treatment does not help a person, they have to resort to surgical intervention. But it often happens that after the operation, a person is not able to fulfill his labor obligations. How does the medical and social examination proceed in this case:

  1. Logically, an operation is performed on a person in order to improve his well-being. After the operation, the patient should feel better, but he applies to the authorized bodies to be recognized as a disabled person.
  2. Disability may not be prescribed and the patient is at a loss - how to continue to live.

The solution is as follows: to sue a medical organization, justifying this by the fact that the person did not have a disability before the operation, but after the surgery he needed it because his condition worsened. Thus, it is possible to appeal against the ITU decision.

Controversial situations with sick leave, temporary disability and disability arise when a person is simultaneously operated on both hip joints. The term of sick leave after hip arthroplasty on both sides depends on the patient's condition, the dynamics of the healing process, but does not exceed 2 - 3 months. Further, it is possible to extend the sick leave or temporarily obtain a disability. Much depends on the position that a person occupies: if this is an office sedentary job, then he is theoretically able to perform it. If it is hard physical, associated with lifting weights or being constantly on your feet, then it is better to immediately issue a disability and adapt to prostheses. After a year, the group may not continue.

A controversial situation in which the help of a lawyer and the advice of a doctor will be needed is associated with the alternate replacement of the TBS. If the duration of the sick leave after hip arthroplasty on one side is 3-4 months, and the next operation is scheduled in 5-6 months, is it worth going to work, or spending time at home, taking care of your own health. Practicing lawyers who specialize in social issues advise to formalize disability after the first operation, calmly wait for the next one and recover after two surgical interventions.

There are cases when the ITU decision allows a person to be sent for retraining, if the previous place of work is unavailable for health reasons, and to receive temporary disability benefits. In any case, the terms of extending the sick leave are in the competence of the attending physician, who also sends the person to the commission and writes his opinion on the condition of the operated joints. Therefore, you need to turn to him for help.

To apply for the ITU, documents are collected - X-rays, the length of the sick leave after surgery to replace the hip joint or both, a copy of the diploma, work record book. The presence of concomitant diseases and the length of stay in hospital are of great importance.

Date of publication of the article: 03.08.2016

Date of updating the article: 05.12.2018

Rehabilitation after hip arthroplasty is an integral stage of postoperative treatment aimed at restoring muscle tone and leg functionality. Rehabilitation consists in limiting (peculiarities) physical activity in the period after surgery and in performing physiotherapy exercises.

Principles of the recovery period after hip arthroplasty:

  • early start,
  • an individual approach when carrying out rehabilitation measures,
  • sequence,
  • continuity,
  • complexity.

There are three periods of rehabilitation after arthroplasty: early, late and late. A specific gymnastics complex has been developed for each of them. The total duration of rehabilitation is up to a year.

The restoration of the leg performance begins in the hospital, where the patient underwent surgery. The approximate stay there is 2-3 weeks. You can continue rehabilitation at home or in a rehabilitation center, and end it in a dispensary or a specialized rehabilitation clinic. If you are doing at home, it is important not to interrupt exercise therapy and therapeutic walks, so that the recovery is complete - only then the musculo-ligamentous apparatus will reliably fix the artificial joint, and all leg functions will be restored.

Lack of rehabilitation after endoprosthetics threatens with dislocation of the head of the endoprosthesis due to ligament weakness, periprosthetic fracture, development of neuritis and other complications.

Rehabilitation after any type of joint surgery, including the replacement of a hip with an endoprosthesis, is carried out by a rehabilitation therapist and (or) a physical therapy doctor. He will draw up an individual program taking into account the patient's physical condition, the degree of adaptation to physical activity, his age, the presence of concomitant diseases.

After the endoprosthesis is installed, it is possible to restore working capacity. Perseverance, desire to recover, strict implementation of the doctors' recommendations are the main criteria for a positive outcome of rehabilitation after arthroplasty.

Three periods of rehabilitation

Early rehabilitation period after arthroplasty

This period begins immediately after the withdrawal from anesthesia and lasts no longer than 4 weeks.

Six rules of the early period

    Sleep on your back only for the first few nights after your replacement surgery;

    you can turn on your healthy side with the help of a nurse at the end of the first day after the operation, on your stomach - after 5–8 days;

    do not make sharp turns or rotations in the hip joint - this is contraindicated;

    do not bend the affected leg so that the flexion angle is greater than 90 degrees;

    neither close or cross your legs - put a wedge-shaped pillow between your legs;

    do simple exercises regularly to prevent blood stagnation.

Early goals

  • Improve blood circulation in the operated hip region;
  • learn how to sit down in bed correctly, then get up from it;
  • prevent the development of complications (bedsores, thrombosis, congestive pneumonia, pleurisy);
  • accelerate the healing of the postoperative suture;
  • reduce swelling.

Basic exercises

The table shows exercises for the calf, gluteal, and thigh muscles of both legs:

(if the table is not fully visible, scroll to the right)

Exercise name Description

Wiggling toes

Bend-unbend the toes of both the healthy leg and the operated one.

Foot pump

Do immediately after coming out of anesthesia: bend the ankle back and forth. For an hour, do up to 6 approaches for several minutes - until the state of slight fatigue in the muscles.

Rotation of the feet

Rotate the foot first 5 times clockwise, then 5 times counterclockwise.

Isometric gymnastics with quadriceps muscle tension

Start with a healthy limb. Try to squeeze the popliteal fossa to the bed as much as possible, hold the muscle tension for 5-10 seconds. From 3-5 days, perform the same action with the sore leg, keeping the muscles in good shape for 2-5 seconds. Do 10 times each.

Isometric contraction of the gluteal muscles

Alternately strain the right and left gluteus muscles, holding the tension until slight fatigue.

Knee flexion

Slide your feet along the surface of the bed and pull your leg towards you, bending it at the knee. Put it down. Do it slowly 10 times.

Leading a straight leg to the side

First, take one leg away from the other, then bring it back and do the same with the other leg. Multiplicity - up to 10 times with each leg.

Extension of the leg at the knee

Place a small roller or pillow under your knee. Straighten your leg, holding it in this position for 5-7 seconds. Do the same with the other leg.

Straighten Leg Raise

Alternately lift your straight leg 10 times a few centimeters.

Exercise rules:

  • do several visits a day, spending 15–20 minutes out of each hour during the day;
  • keep a slow and smooth pace;
  • combine exercises with breathing exercises according to the following scheme: with muscle tension - deep inhalation, with relaxation - prolonged exhalation;
  • do breathing exercises to avoid lung congestion.
  • first, do exercises in the early period only while lying on your back (although you need to get up on your feet already for 2-3 days), and then do the same gymnast while sitting on the bed.

A set of exercises for rehabilitation after arthroplasty

I presented the exercises described in the table above in the order of priority of their implementation, they are relevant throughout the entire rehabilitation course. This complex of exercise therapy is suitable for the rehabilitation of patients after almost any operation on the joints of the legs.

Additional exercises

In the first 2-10 days after endoprosthetics, doctors teach the patient to sit on the bed, roll over, stand up, and walk on crutches.

Having already learned how to keep balance and lean on the operated leg, the patient must supplement the complex with other exercises - they must be done every day from a standing position, holding on to the back of the bed or chair. Here they are:

(if the table is not fully visible, scroll to the right)

Initial position Exercise

Stand facing the headboard, grab it with your hands

Begin to alternately raise the right and then the left leg, bending it at the knee. This is similar to walking in place with support in front of you.

Leaning on one leg, move the other to the side, lifting it slightly. Then change your legs.

Everything is the same, only slowly take your leg back, unbending the hip joint.

The sooner the patient starts to get up and walk after endoprosthetics, the less likely it is to develop muscle (limitation of mobility) in the hip region.

Late postoperative rehabilitation

Late rehabilitation after hip arthroplasty begins 3-4 weeks after surgery and lasts up to 3 months. The duration of rehabilitation for each patient varies depending on his age and other factors.

Two goals of the late period:

    muscle training to strengthen them, increase tone,

    restoration of range of motion in the joints.

After the patient already confidently gets out of bed, sits on a high chair, walks on crutches for 15 minutes or more 3-4 times a day, the motor regimen is expanded by training on an exercise bike (no longer than 10 minutes 1-2 times a day). The patient is also taught to walk up the stairs.

Start climbing a step with a healthy leg, substituting the operated one to it. When descending, lower it down a step: first with crutches, then with a sore leg and then with a healthy one.

Long-term rehabilitation period

This period begins 3 months after the hip replacement surgery; and lasts up to six months and longer.

  • full restoration of the functioning of the artificial joint;
  • acceleration of bone regeneration;
  • improvement of the functional state of ligaments, muscles, tendons.

The adaptive motor mode involves preparing the patient for more intense physical activity and adaptation in everyday life. Exercise therapy is supplemented with physiotherapy (mud or paraffin applications, balneotherapy, laser therapy and other physiotherapy).

Exercises to do at home

Later, the above gymnastics of the early period after arthroplasty is supplemented with more complex exercises.

Examples of exercises that patients do at home after discharge. Click on the photo to enlarge

(if the table is not fully visible, scroll to the right)

Initial position Execution order

Lie on your back.

Alternately bend and pull your legs towards your stomach, simulating cycling.

Lying on your back.

Alternately pull your legs to your stomach, bending at the knee joints and helping yourself with your hands.

Lying on the non-operated side with a flat bolster between the legs.

Raise your straight leg and hold it in this position for as long as possible.

Lying on your stomach.

Bend-unbend your knees.

On the stomach.

Raise your straight leg, taking it back, then lower it. Repeat the same steps with another.

Standing with your back straight.

Do half squats, holding on to some kind of support.

Stand up straight. Put a flat, stable block in front of you - a step - 10 cm high.

Step onto the step platform. Slowly get down from it, taking a step forward with your good leg, then lower the operated one. Return in the same sequence. And so 10 times.

Stand in front of the step, take a step on it with your good leg, shifting your body weight onto the leg with the endoprosthesis, which you then lift to the step.

Stand up and rest your hand on the back of a chair. On the ankle of the operated leg, put a loop made of an elastic tourniquet - and fix the other end of the tourniquet (for example, tie it to a sofa leg).

Stretch the sore leg straight forward (with a tourniquet).

Then turn around so that you extend your straight leg back (also with a tourniquet).

Stand with your healthy side to the object to which the tourniquet or elastic band is attached, and hold on to it with one hand.

Take the straight operated limb to the side, slowly return it back. And so 10 times in one approach.

The last two exercises and the rest, where movements must be made with movements of a straightened leg, are necessary after surgery on the hip joint, since they are aimed at developing a hip endoprosthesis. For the recovery period when replacing another large joint of the leg, they are only additional.

Step platform

Gymnastics on simulators

The adaptive motor regime in the long-term period is expanded due to physiotherapy exercises on simulators. By this time, the ligaments and muscles have already sufficiently strengthened after the operation, so the intensity of the loads can be increased. The table below shows the most common exercises to fully restore the range of motion in the hip joint.

(if the table is not fully visible, scroll to the right)

Exercise name Sequence of execution

A bike

First, on the stationary bike, pedal backward. If it works effortlessly, skip forward (15 minutes, 2 times a day). Gradually increase the time to 25-30 minutes. Do classes 3-4 times a week. Remember the right angle rule: do not lift your knees above the hip joints.

Extension of the hip joint

Place the operated leg on the special roller of the simulator (you need a roller that you can press on - that is, not rigidly fixed) so that it is located under the thigh closer to the knee, hold the handle with your hands. Emphasis on the good leg. Press on the roller as if shaking the pump - you perform flexion-extension movements of the endoprosthesis with effort, since a weight is attached to the roller on the other side of the simulator (gradually increase its weight).

Exercise on a stationary bike with a low pedal position

Simulate cycling. Adjust the pedals so that each leg is fully extended as you lower the pedals.

Walking backwards on a treadmill

Stand with your back to the control panel, grab the handrails. Start walking backward at a slow pace (set the speed 1–2 km / h). When the foot fully touches the track, the leg should be straight.

Conclusion

At each stage of rehabilitation, the control of a physiotherapy doctor is important. He will tell you when you can complicate the exercises, increase the load.

Doing hip exercises on your own after arthroplasty, especially with the use of simulators, can have serious consequences. You cannot do gymnastics through pain or, conversely, stop it ahead of time, even if you feel well and the endoprosthesis, as you think, moves well. Only a clear fulfillment of all the tasks set by the doctor will make your new joint work fully.

Owner and responsible for the site and content: Afinogenov Alexey.

Your comments and questions to the doctor:

    Victor | 07/06/2019 at 19:43

    Hello. I am 67 years old. On March 15 and September 19, 2018, he underwent arthroplasty of the left and right hip joints (1 year 4 months, 10 months, respectively, expired). Couples metal + polyethylene + ceramics. Non-cemented. Rehabilitation is proceeding normally, I move without crutches and canes, I drive a car, I passed the driver's commission without any problems. I don't feel pain or discomfort. Please tell me what LIFETIME restrictions exist for such operations? Is it allowed: 1. In a sitting position, placing the foot of the right / left leg on the knee of the opposite leg in order to put on socks without assistance? 2. Full (deep) crouch? 3. In a standing position, bend forward, hands on the floor? (washing the floor) 4. Swimming in the pool with fins for scrolling, diving? (the difference in the design of the fins and, accordingly, the load on the muscles and hip joint). 5. In the supine position, placing the legs behind the leg (left-right)? 6. Avoiding the use of a wedge-shaped pillow between your legs? After how long? 7. After what period of rehabilitation is it allowed (or is it forever forbidden ?!) to raise the knees to an angle of more than 90 °? Inversion of the raised knee left-right? Thank you in advance for your detailed answer. Sincerely...

    mikhail | 04/25/2019 at 03:25

    Hello, please tell me the operation was done 17 days ago, I changed the hip joint, I'm 28 years old. the situation is such muscles ache and in the morning the leg is heavy as a stone tell me is this normal?

    Valentina Viktorovna | 03/04/2019 at 14:05

    Operation PTB 06.12.2017 still hurts the thigh and buttock, the doctor who operated on said that the pain from the back because it is possible osteochondrosis. The thigh along the suture is swollen, when touched, the sensation is as if numb, but the pain is felt. I walk with a cane on the street, and at home without a cane, I do exercises every day while lying on the couch, thanks in advance.

    Vladimir | 09.11.2018 at 01:20

    Hello, during the prosthetics of the thigh bone, the femur burst during the subsequent operation, fixed with 5 ties along the length of the bone, the sutures were discharged, the recommendations not to step on the leg were removed 3 months that from the set of exercises you recommend, you can do it for me after the operation, 3 weeks have passed in advance thanks for the answer

    Olga | 09/17/2018 at 14:13

    Temperature, pain, redness is not present. I will take note of your recommendations, thank you.

    Olga | 16.09.2018 at 12:59

    Hello! ; September was the endoprosthetics of the right hip joint. The leg is still very swollen, it is difficult to bend at the knee. When I was discharged, they said that everything would go away, but almost two weeks had passed. This was not the case with surgery on the left joint in February of this year. I live in a village, I haven't reached my clinic yet. Tell me if there is any danger and what to do, thanks.

    Svetlana | 09/06/2018 at 20:25

    Hello, my mother (70 years old) is preparing for a total hip replacement. She has polyarthritis and severe pain in her elbows and shoulders, and I'm afraid she won't be able to use crutches properly. Is it possible to use a walker that has a support on wheels in front and legs like a chair on the side of a leaning person?

    Mina Minskaya | 09/05/2018 at 14:51

    In January, she underwent hip arthroplasty.
    Since then, the sensitivity of the toes has been impaired. What is your advice to restore normal sensitivity. Thanks in advance, Mina.

    Yana | 08/30/2018 at 11:14

    Hello! How long after endoprosthetics can a full body massage be done? I visited a physiotherapist, she prescribes different procedures, prescribed ALIMP, about massage she said that early, after 3 months, (one and a half months have passed). In the ward, we all took off our stockings after a week, and those who baked their heels, so the sisters cut the stockings on the heels to give freedom to the vessels. I walk for one and a half, sometimes 2 hours in the air with crutches, this is probably a lot? I want to go to the sea, why not go to the sea? When a month will pass after endoprosthetics - is it really impossible? Thanks!

    svetlana | 08/29/2018 at 16:52

    Hello! I am preparing for the replacement of TB of the right joint, I live on the 5th floor of a house without an elevator, can I go home after the operation? If you write that there is no more than one flight of stairs, thank you in advance.

    Olga | 08/09/2018 at 15:56

    IM 42 years old. We had an operation to replace the right hip joint on 06/05/2018, i.e. two months have passed. I'm doing gymnastics. Added an exercise bike. I walk with a cane, but my gait is uneven. I can't even lie down on the operated side (pulling pain along the entire leg arises). I have several questions:
    1) When can you break the 90-degree rule and sit low?
    2) When can the compression stockings be removed?
    3) Will a straight gait be restored and what to do for this?

    Valery | 07/29/2018 at 17:13

    I am 61 years old. On July 6, 2018, an operation for endoprosthetics of the left hip joint was performed. A metal-ceramic joint (manufactured by Zimmer) was installed. Three weeks have passed. The state of health is good. There are no acute pain sensations. Used axillary crutches. One crutch under the elbow for the last week. Is not it too early? And another question: is it possible to go to the sea in late September or early October?

    Alexander | 07/06/2018 at 12:37

    Hello! I confess, I like to lie in the bathroom, after what time can I take a full bath after replacing the TBS, almost 2 months have passed at the moment?

    Natalia | 24.06.2018 at 19:35

    Good afternoon. Made 40 days ago to replace the right hip joint. I walk with a stick. Question: Which side should you hold the wand on? From the side of a sore or healthy leg? It is written differently on different sites. I'm holding the stick on the side of my good leg! ??? Food question: How long after the operation (approximately) can I go to the pool or swim in the sea? Thank you.

    Alexander | 06/17/2018 at 06:09

    Hello! A month ago, there was an oleration to replace the TBS. I am 70 years old, can I use an elliptical trainer instead of an exercise bike for rehabilitation? I feel well, there are no pains in the joint, and there never was. When can I start using the machine? Thanks!

    Ekaterina | 06/13/2018 at 06:12

    Good day! I am 70 years old, after the operation to replace the hip joint 4.5 months have passed (01/25/2018), in general, nothing bothers me while I go home without a cane (I walked on crutches for about 3 months). But going out into the street I use a cane, it is worth walking about 200 meters. The operated leg immediately gets tired and I am looking for a place to sit down. Tell me what is the reason? At the consultation with the doctor with the pictures was in May, they said everything is fine. Thank you for your reply

    Olga | 05/14/2018 at 04:25

    Hello! I read all the comments, many thanks to everyone, I learned a lot of useful things for myself. Question: they write that you need to exercise on a stationary bike, and I have a cardio simulator - walking, can I walk and how much - I have a replacement of the left hip joint 2.02.18g. Right - severe pain, September 3, 2018 there will be an operation.

    Victor Nikolaevich | 05/08/2018 at 23:39

    Hello. I am 66 years old. The operation for total arthroplasty of the right hip joint was performed on March 15, 2018. May 15th 2 months after surgery. The pair is cementless, polyethylene - ceramics. The suture is tightened, the sutures have resolved, the condition is normal. With the permission of the treating person, I now walk on one crutch. After the discharge of control images and examination, there was still no, treating on an internship abroad. There is his correspondence permission to lie on the operated side, the sensations are normal. Please tell me when it will be possible during sleep, when getting out of bed, etc. refuse to use a wedge-shaped pillow between the thighs ?! And second: when, in terms of time and season (we have very hot weather and promise the same summer) is it better to have surgery on the second hip joint? Thanks for the answer.

    Tatiana | 04/30/2018 at 09:24

    Good day! In February there was an operation to replace the vehicle, now, that is, in May, you can get another vaccination against tick-borne encephalitis. Thanks for the answer.

    Maryam | 04/07/2018 at 04:59

    Hello! 02/27/2018 I had an operation to change the vehicle. While doing gymnastics. When can I go to the rehabilitation center? And when can I get behind the wheel? Right leg. Left-hand drive car. Thanks in advance for your reply!

    Sergey | 01.03.2018 at 20:28

    Thanks for the answer. In the pictures with exercises Exercises for performing at home the Long-term rehabilitation period No. 3, 6, 12 movements that doctors usually forbid to do. In these pictures, the movements and loads are like on a healthy joint. Does this mean that over time, all movements will be restored. Frightens that in life you will not be able to tie your laces and just squat down. I am 44 years old, but before the injury I led an active sports lifestyle. Therefore, the question. Traumatologists have no consensus on the current state of either waiting up to six months or prosthetics. no nicrotic processes are observed, but there is no fusion. Here you are trying to assess what can expect you after the prosthetics.

    Svetlana | 01.03.2018 at 08:52

    Hello! I have a question. Hip arthroplasty was performed in November 2016. I would like to know what I am strictly forbidden to do for life. I want to go to the gym on which simulators I can work out.

    Sergey | 02/28/2018 at 21:01

    Good afternoon. I have a fracture of the femoral neck with displacement, intra-articular. For six months, the fracture has not healed. There is a high probability of prosthetics. Tell. After completing the rehabilitation course - a year, two, three, will it be possible to bend the leg more than 90 degrees. To what extent is it possible to restore the degree of leg movement without fear of joint damage or dislocation. Knee to chest, squats, etc. Or does it depend on the brand of the prosthesis?

    karina | 02/26/2018 at 15:20

    Good afternoon. I want to ask, a week has passed since the operation. I have read a lot, but it is not clear how long you can walk, I am hyperactive, it is difficult for me to sit and lie down. Thank you.

    Christina | 02/25/2018 at 06:23

    Alex admin, thank you very much for your answer. Have a new one, how long do you need to sleep on your back after surgery? It's just that my husband is already tired, he wants to roll over onto his non-operated side. It took 2 weeks after the operation.

Modern surgery at a high level performs knee replacement surgery, which was previously considered impossible. According to statistics, after surgery, patients after such an operation return to their previous, healthy life. In addition to the main treatment, rehabilitation after knee arthroplasty is needed, otherwise the therapeutic outcome will not be achieved. You can familiarize yourself with the methodology for carrying out the rehabilitation period in our article.

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Features of the operation

Endoprosthetics is an operative surgical intervention, as a result of which a damaged joint is replaced with a prosthesis (implant). Joint replacement is performed when the methods of conservative treatment do not give results, and the destroyed joint loses its functioning ability.

A common case of prosthetics is a knee joint injury, arthrosis. In this case, the cartilaginous layer between the articular bones wears out over time. Other causes of pathology can be chronic infection, rheumatism, metabolic disorders.

The aim of the procedure is to remove the worn out joint and to insert a new special element. Such an event will eliminate the deformity of the limb, restore motor function and save the injured bone.

During the operation, the doctor removes cartilage from the tibia and corrects the position of the knee joint. After that, the joint is replaced, and the endoprosthesis is fixed. To fill in bone defects, tissue from a patient or donor is used.

At the final stage, the surgeon checks the stability and strength of the installed component. Performs versatile knee movements at an angle, evaluates smoothness. Knee surgery contributes to the return of mobility, full leg function, and pain relief.

Basically, the endoprosthetics operation is positive, without complications and gives an excellent result. But it is worth noting that it depends on the qualifications of the surgeon, the quality of the medical action performed, and the characteristics of the knee joint. It also requires a long postoperative recovery period.

Possible complications

Endoprosthetics is a planned operation, which includes examination of the patient, conducting a study of the patient's condition. It is almost impossible to insure yourself against emerging complications after surgery. After all, they are primarily due to the signs of the structure of the knee joint, and only then ignoring the recommendations for strengthening the knee. The operation can provoke a breathing problem, heart failure, a failure of blood flow to the cerebral cortex, a violation of blood vessels, and a fracture of bone tissue.

In such situations, the following complications may appear:

  • inflammatory process of the limb;
  • knee infection;
  • bone fracture near the fixed implant;
  • displacement of the patella;
  • destruction of the vascular or nerve bundle;
  • deformation of the implant;
  • high temperature;
  • thrombosis;
  • swelling and fluid accumulation;
  • failure of the respiratory system;
  • allergy;
  • crunch during movement;
  • displacement of the element itself (implant);
  • limitation of mobility;
  • the formation of scar tissue.

After surgery, there is a risk of puffiness and thrombosis formation, so you need to take medications that thin the blood, use a special stocking, bandage. In order to avoid complications, it is necessary to adhere to the doctor's recommendations, avoid unnecessary stress, injuries, undergo a study to detect allergies to the drug.

Prosthetics provides an opportunity for the victim to get rid of pain syndrome and enjoy an active lifestyle. Of course, rehabilitation is indispensable - a long recovery period, but it will help the body avoid the risk of negative complications.

Recovery and rehabilitation

After the operation, the rehabilitation of the knee cartilage begins immediately. It is allowed to get out of bed after the first day, but very slowly and smoothly leaning on your elbows. On the second day, it is allowed to lower your legs from the hospital bed. Next, you need to learn how to sit correctly. To do this, grasp the endoprosthetic leg with your hands and gradually lower it to the floor. To avoid the risk of abnormalities, an elastic bandage should be applied to the damaged area.

After 4-6 days, the patient can stand on his feet completely, but it is impossible to rely heavily on a weak limb. The first movement is carried out first on the healthy leg, the injured leg is in a straightened position. It is advisable to touch the floor with it, use an orthopedic device. The patient stays in the hospital for up to 7-10 days, after which he is discharged and continues therapeutic exercises at home. It will take about 24 weeks for the joint to heal and fully recover.

Exercise therapy

For the first three months, the patient slowly moves around the house with the help of another person or an additional device. Further flexion, extension of the leg at an angle of 90 degrees, balance on the leg are practiced. The effectiveness of strengthening the knee joint is accompanied by the following activities:

    1. Raising a straightened leg, keeping it in good shape (2-3 seconds).
    2. Knee flexion, extension no higher than an angle of 90 degrees.
    3. Perform extension movements in the ankle joint, increase repetitions gradually.
    4. Abduction of the straightened and raised leg back at an angle of 45 degrees.
    5. The straightened leg is taken to the side and fixed in a raised position for 3-5 seconds.

If you regularly and diligently perform gymnastic exercises, then the rehabilitation of the knee joint can be completed by 12 weeks of the recovery period. But you should not abruptly suspend gymnastics, it is advisable to continue it by cycling, swimming, long walking. When your knee hurts during exercise, it is possible to treat the pain with a cold compress, pain reliever, or ointment. But it is better to immediately contact your doctor.

It happens that a patient cannot cope with rehabilitation after knee replacement on his own. For this, there are sanatoriums in which procedures are performed for patients under the supervision of a medical worker. But it is worth considering the condition that treatment is paid in such an institution. Naturally, if he is not lazy, then you can achieve the same result at home.

Physiotherapy

Physiotherapy is an integral part of the rehabilitation process after arthroplasty. Its main task is to prevent displacement of the joint, to educate the patient in the correct use of the new prosthesis. In addition, it helps to strengthen the muscles near the localization of the prosthesis with the help of special exercises.

The physiotherapist will prescribe the patient a physical set of exercises for self-fulfillment. He will analyze and approve what postures are good for the knee joint, what kind of load the knee can withstand.

Medicines

The rehabilitation period after knee arthroplasty is not just gymnastic exercises with a small load. A prerequisite for tightening the wound, preventing inflammation is taking medications. The doctor prescribes, according to the nature of the disease, antibiotics, non-steroidal anti-inflammatory drugs. They will help relieve muscle spasm, normalize humoral function.

Chondroprotectors are important means for restoring cartilaginous areas. Angioprotectors provide tissues with nutrients, increase blood circulation.

Massage

Massage is an important addition to drug therapy and physiotherapy. He also provides all possible assistance for the operated knee joint. To do this, you need to massage the affected area with the use of a drug.

The patient should take a comfortable position, relax. The masseur performs light movements without pressing on the diseased area of ​​the joint. They should gradually increase with slight pressure. Rubbing is performed with the pads of the fingers, massage manipulations are desirable to be smooth, slow, soft. The event will not be superfluous, as it will complement the postoperative recovery period.

Sick leave after surgery

For how many days can a certificate of incapacity for work be issued? In case of temporary disability due to a disease of the knee bone tissue, the attending physician issues a sick leave. The duration of the document is initially 15 days. In case of complications, the sick leave may be extended by the decision of the medical commission.

After the end of this rehabilitation period of time, a patient with an unfavorable prognosis undergoes a medical and social examination in accordance with the Order of the Ministry of Health “On approval of the Procedure for issuing certificates of incapacity for work”. Accordingly, the document is extended for another 4 months from the date of the original date of incapacity for work. Otherwise, receiving a refusal, the sheet is closed.

Disability assignment

Patients who suffer from bone pathology are entitled to a disability allowance. It is possible to issue social assistance if you provide all X-ray images, a doctor's conclusion confirming the diagnosis. That is, to officially confirm that a person cannot fully and independently move.

Rehabilitation after knee arthroplasty in order to receive a disability benefit is no exception. This social benefit is provided for a year. In order to extend it after the expiration of the term, it is necessary to undergo a second examination and present a full package of documents to the members of the medical commission.

But one factor should be taken into account, if a person can be in a standing position for about two hours a day, then the disability, unfortunately, is not prolonged. With such a personality indicator, it is allowed to work in a sitting position without harming one's health.

Knee Recovery Exercise Video

This video provides a methodology for performing knee rehabilitation exercises after prosthetics. It is suitable for the patient to do exercises at home.

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