An operation, even performed at the highest level, will not be effective without high-quality postoperative treatment. Comprehensive rehabilitation after hip replacement - exercise therapy, physiotherapy, prevention of complications - allows you to get the full potential from this type of treatment. Without rehabilitation, you risk maintaining pain, lameness, and limited range of motion.
Introductory briefing
After hip replacement, rehabilitation lasts an average of 3 months. It consists of stages, for each of them its own system of treatment and rehabilitation measures has been developed, based on physical exercise and auxiliary procedures. A step-by-step therapeutic effect on the prosthetic segment allows you to prevent complications, quickly eliminate swelling and painful signs, thoroughly develop the limb, restoring the functionality of the leg.
A good and calm stitch approximately on the 3rd day after the operation.
We hope that you have thought about such a device in advance.
Physical activity is planned and optimized in accordance with the timing and individual criteria by a rehabilitation physician. At home, you will need to take contraindicated types of activity seriously, train strictly according to the instructions, without forcing loads, always come to the clinic for scheduled examinations, and in case of any pathological manifestations(pain, swelling, hematoma, etc.) contact your doctor immediately.
General principles of rehabilitation
The goals of rehabilitation are the following:
- complete liquidation inflammatory process and pain that results from surgical procedures;
- normalization of the state of the muscular-ligamentous complex leading to articular bones(pelvic and femoral) into coordinated movement;
- strong fusion of the prosthesis components with the bones, which occurs gradually during the natural reparative processes of bone tissue renewal;
- preventing the development of negative consequences.
Drug treatment
After surgery, you must strictly take all prescribed medications; this is vital. And if someone thinks that it is harmful to the body, then problems are not far off.
Involves taking or injecting specific medicinal compositions, namely:
- antibacterial medications from the spectrum of antibiotics (against the development of infection);
- anticoagulant protective drugs (against venous thrombus formation);
- non-steroidal anti-inflammatory drugs (against pain and inflammation);
- gastroprotectors and drugs that improve the functioning of the urinary tract;
- protein and calcium supplements to accelerate the regeneration of bone and muscle structures.
Comprehensive physiotherapy
Physiotherapy is an excellent addition to motor recovery.
These are procedures of electromyostimulation, electrophoresis, UHF, laser treatment, massage, balneotherapy and mud therapy, aimed at:
- reduction pain syndrome and relieving swelling;
- elimination of spasmodic phenomena in muscles;
- stimulation of blood circulation and lymph circulation in the structures of the problematic leg;
- increased muscle tone and strengthened ligaments;
- activation of metabolic and regenerative processes in lower limb.
Rehabilitation after hip replacement at home and in the hospital is a rather long and labor-intensive process that requires strength and patience. But if it is organized correctly, working capacity returns by the end of the 10th week. If the postoperative stages are complicated, recovery after hip replacement will most likely take 2 times longer.
There is a direct relationship; patients who are not overweight and lead an active lifestyle as much as possible before surgery recover faster than others.
Description of rehabilitation stages
Basic recovery after hip replacement takes 10 weeks. Of these, 3 weeks are the early phase, from the third to the 10th week - late stage. And all this time it is necessary to fruitfully carry out tasks and exercises for rehabilitation after hip replacement, dictated by the surgeon and rehabilitologist. Together, specialists create an effective plan physical therapy.
The essence of training exercises is repeated, regularly repeated and consistently increasing physical activity, which gradually improves performance motor activity, dynamically improve and restore performance. After the entire specified period of time after surgery on the hip joint, rehabilitation does not completely end. All the achievements that the patient has been pursuing for so long and finally achieved the cherished painless freedom of movement must be consolidated.
Wonderful sanatoriums that provide proper rehabilitation after partial replacement and total hip replacement are located in Leningrad region, Krasnodar region, Karelia. If we talk about foreign European resorts, the clear leaders here are Teplice and Jáchymov, located in the Czech Republic.
Early stage
The person undergoing surgery is immediately transferred from the operating room to intensive care for 24 hours. They do this to control the main functionally significant indicators of the body’s condition: heart rate, breathing, blood pressure etc., which is mandatory after any surgical procedure. They immediately begin antibiotic therapy and the administration of anticoagulants, take tests, and, if necessary, perform a blood transfusion. Breathing exercises are prescribed to prevent congestion in the lungs.
Compression cuffs are used to prevent thrombosis.
From the second day until the end of 3 weeks rehabilitation period After a hip replacement, clinical care and recovery are carried out in the inpatient unit. The patient will be bothered by pain, which is a normal reaction of the body, so additionally with taking NSAIDs he will be indicated for physical therapy and cold dry compresses locally. They will relieve swelling located on the outer soft tissues above the replaced joint. Soreness and swelling, as soon as the suture heals, will stop causing suffering.
The arthrot is used from the second day after surgery for passive development of the joint.
Debilitating pain does not need to be endured; it will have a detrimental effect on both your psychological mood and the activity of the main internal organs and systems, for example, the heart, stomach, intestines, circulatory and respiratory system. Their dysfunction will prevent the normal launch of self-regulation and regeneration mechanisms. Therefore, do not torment yourself and your body, which is already weakened: if it hurts unbearably, tell the nurse or doctor about it, and they will help you. the help you need. If the painful manifestations are not severe, then, of course, it is better not to overuse pain relief.
Well, now let’s move on to consider the question: how is human activation carried out:
- Walking on crutches is possible from 2-3 days in a light mode, leaning on crutches or a walker. The technique of using means of support and the method of movement when moving in space is usually taught to the patient in the preoperative preparatory period. Walking in the first days is allowed only under the guidance of a methodologist-instructor.
At this time, drainage tubes will be placed in the wound, so even if there is no pain, walking will not be enjoyable.
- Sitting is allowed for the 3rd day, but it is important not to allow an excessive bending angle at the hip; the permissible maximum is an angle of 90 degrees and no more. You cannot stay in one “sitting” position for a long time (maximum 15-20 minutes); moreover, you must sit on a surface of normal height, not with low seats.
At first, the following rule applies: the patient either walks or lies horizontally, and cannot sit for a long time.
- When a person is lying down, a special anatomical cushion must be placed between the limbs, which will protect against unwanted adduction of the limb and its crossing with the healthy leg. For now, you can only turn on your healthy side. You need to sleep and lie exclusively on your back.
Crossing your legs increases the risk of dislocation.
- It is recommended to perform flexion-extension of the ankle and rotation of the feet during rehabilitation after surgery on the hip joints, as soon as the anesthesia wears off.
The exercise is safe and can be performed without special restrictions.
- It is proposed to work with knee flexion/extension: sliding the heel along the bed sheet, bend the leg at the knee joint to a right angle and return it in the same way to a straight horizontal position.
If it is difficult to slide your foot along the surface, remove the sock.
- You will also need to perform the following exercise while in bed: smoothly move the problematic limb to the side, while the toe of the foot strictly “looks” at the ceiling. Return to the starting position, relax, rest for 1 minute. Do 5 sets in a row. All exercises after hip replacement should not be done intensively with jerks!
In this exercise thumb The feet should point straight up.
- In the immediate postoperative period of rehabilitation after hip replacement, isometric exercises are prescribed to contract the quadriceps, gluteal, and calf muscles. Thanks to simple exercises on the tension of the corresponding segments, their tone increases, elasticity and firmness improve. Perform the workout in bed (lying on your back) according to the principle:
After leaving the hospital after hip replacement, rehabilitation in this scenario is easy to practice at home. However, the proposed range of activities must be supplemented, because then comes the late recovery phase, for which there are specific standards.
Late period
Successfully completed early stage rehabilitation measures culminate in the patient being discharged from the hospital. Now we either have to undergo rehabilitation after hip surgery at home or in a specialized treatment and rehabilitation center. There they will organize high-quality, vocational rehabilitation After surgery, it is unlikely that it will be possible to develop the hip joint at home so comprehensively and competently. Unless, of course, you yourself are an orthopedic traumatologist or exercise therapy instructor.
Balance exercises allow you to use stabilizer muscles that are not involved in normal life activities.
What are the specifics of late rehabilitation after hip replacement, and what new exercises are added?
- Walking, starting from the 22nd day, is carried out up to 3-4 times a day for about half an hour, and closer to the third month, the total duration of walking daily should be approximately 4 hours. It is important to practice the correct posture of the body and gait when moving, to get rid of the usual adaptive postures and movements that a person is accustomed to long before the operation.
- Walking with full load on the prosthetic limb is possible after 1-1.5 months if a cemented prosthesis model was used. If a cementless method was used, it is not advisable to create a full support until at least 2 months have passed.
- The abolition of crutches and walkers, as a rule, occurs at the turn of 1.5-2 months, then the patient switches to a cane. It is not recommended to stop using a cane until the lameness disappears and you have absolute confidence in walking.
- Late rehabilitation exercises after hip replacement include more varied and active types of training, but your doctor should recommend them to you. We suggest that you familiarize yourself with what common methods of exercise therapy are usually used in specialized centers.
- Work with a rubber band, with exercises for abduction and flexion of the limb with resistance (do not cross your legs!).
- You can use a tourniquet or simply press on your knees with your hands if you don’t have one.
- Starting position lying on your back. Alternately bend your legs knee joints, raising the limbs, the direction of movement of the knee is towards you.
Your hands can be placed on your stomach or extended along your body.
- Lie on your stomach. Bend your legs simultaneously or alternately, bringing your feet closer to your buttocks. In the same position, lifting the straightened legs up (alternately) is useful. You can also imitate swimming, with only your arms actively working, your chest raised, your limbs straight (if it is not difficult for the patient, he can slightly lift his legs off the floor).
Try to touch your heel to your buttock. It is unlikely that you will succeed, but this should be the goal.
- Alternate abduction of straightened limbs in the lateral direction from a lying position on the back and on the stomach. To do this, you need to slightly raise your working leg and move it to the side, then carefully return to the starting point. By analogy, we do gymnastics after hip replacement and in a vertical position.
The toe is directed strictly upward as the exercise progresses.
- Lifting straight limbs one by one, while pulling the toe towards you. The task can be performed in both a lying and standing position. If the patient is exercising while standing, then you need to hold on to any support suitable for insurance, for example, the back of a chair.
Hold for a few seconds at the end point.
- Raising a bent leg, extending it in weight, followed by bending, and at the end, place a flat limb on the floor. This technique, as you might understand, is done in a horizontal position of the body.
You can give additional load by placing your healthy leg on top of the sore leg.
- If you had surgery on the hip joint 1-1.5 months ago, rehabilitation is proceeding well, then you can include the “bicycle” exercise in your daily routine.
A bicycle is the best equipment for physical activity.
- In addition to the listed methods of training, partial squats, quiet exercises on an exercise bike, on balancing equipment to develop support strength and balance are included, as well as various techniques movements with a ball and weights. Additionally, a visit to the pool is prescribed, where therapeutic exercises in water and recreational swimming will be carried out.
Distant phase
It makes sense if it's late the timing will pass rehabilitation after hip replacement in a sanatorium. In addition to rehabilitation and physical education methods, which are implemented using various rehabilitation equipment and exercise equipment in the gym or in the aquatic environment, health clinics specialize in the use of natural healing sources, unique in their chemical and biological composition.
Start visiting the pool, it is very useful.
In sanatoriums, recovery after hip replacement is based on the use of peloid therapy courses (therapeutic mud applications) and balneotherapy in the form of brine (mineral), radon, carbon dioxide, pearl baths, etc. Swimming in the pool. Organic and inorganic substances contained in healing mud and waters penetrate into the body at the time of the treatment session and fruitfully contribute to:
- strengthening bones, increasing muscle endurance;
- resorption of skin, tendon, muscle scar formations, mobility increases not only at the site of the artificial joint, but also in other osteochondral organs;
- improving blood supply and nutrition in problem segments;
- eliminating swelling of soft tissue structures;
- getting rid of the pain factor, which often continues to disturb to one degree or another, even after a long time has passed from the moment of prosthetics;
- coherence of the central nervous system, mental harmony, positive attitude, normalization of sleep and daytime vigor.
Hip arthroplasty is the replacement of a damaged element of the joint. For this purpose, special implants are used. Endoprostheses may be required for a variety of reasons (injuries and diseases of the hip joint). After hip replacement, certain recommendations must be followed.
Reasons for prosthetics
The most common reasons why endoprostheses may be required are:
- Launched and severe stages rheumatoid arthritis.
- Injuries to the femoral neck (most often fractures).
- Development of hip dysplasia.
- Availability aseptic necrosis heads, which is called avascular necrosis.
- Severe stages of coxarthrosis.
The need for an endoprosthesis may arise due to post-traumatic consequences (for example, arthrosis).
The life of a patient after endoprosthetics, as a rule, changes: a number of recommendations appear that the patient must strictly follow. After endoprosthetics, some restrictions arise, the patient needs special therapeutic exercises.
At first, the patient is forced to walk on crutches. How long will it take to recover?
The postoperative period and complete recovery depend on the patient’s age, his general condition and many other factors. In order to avoid complications after hip replacement, it is necessary to follow all the recommendations of the attending physician.
Exercises after hip reconstruction surgery should be performed strictly under the supervision of a qualified specialist. Living with a new regime will speed up the recovery process. The patient will be able to walk without the help of crutches much faster.
Pain after endoprosthetics, as a rule, is pronounced. Under no circumstances should you take any measures on your own, otherwise serious complications may arise.
Features of a modern hip endoprosthesis
Today, orthopedics has made significant progress in its development. Feature modern endoprosthesis is a complex technical design. The prosthesis, which is cementless, contains the following elements:
- head;
- leg;
- cup;
- insert.
The difference between a cemented endoprosthesis is a solid acetabular element (cup and
). Each individual element has its own dimensions. The surgeon must select and install the size that is ideal for the patient.
The types of fixation of hip joint endoprostheses have the following differences:
- Cement fixation.
- Cementless fixation.
- Hybrid type of prosthesis fixation.
Reviews about each individual prosthesis are quite different, so it is recommended to collect as much information as possible before replacing the hip joint.
A hip joint endoprosthesis can be:
- total;
- single-pole.
The use of a particular prosthesis depends on the number of elements being replaced. The friction unit is the interaction in an artificial joint. How long can a hip replacement last? This will depend on the type and quality of the material used in the friction unit.
When does a patient need endoprosthetics?
The main indications for surgical treatment are the results of clinical and radiological studies and the symptoms that accompany the disease. The symptoms that the patient complains about are one of the most significant factors indicating the need for surgery.
Read also: Trouble with a sprained finger
In some cases, despite the fact that coxarthrosis is on one of last stages development (this is evidenced by x-ray examination), the patient is practically not worried about anything. There may be no need for surgery.
How are the operations carried out?
Hip replacement surgery is performed by two teams (operating and anesthesiological). The operating team operates under the guidance of a highly qualified operating surgeon.
On average, an operation to replace a hip joint with an endoprosthesis takes 1.5-2 hours, while the patient is under the influence of spinal anesthesia or anesthesia. In order to exclude infectious complications, it is necessary intravenous administration antibiotic.
Rehabilitation process
After endoprosthetics, the patient remains in the intensive care unit for some time, under the close supervision of doctors. For 7 days, the patient continues to be given antibiotics and drugs that can prevent blood clotting. In order to fix a certain distance between the legs, a pillow is installed. The legs should be in an abducted position. Temperatures after hip replacement surgery are often unstable, so doctors monitor this closely.
How long will it take to recover from hip replacement? This is impossible to predict. In order to speed up the rehabilitation process, you must carefully follow all the doctor’s recommendations.
The patient is advised to move the next day. Without getting up from the pastel, the patient can sit down and even do therapeutic exercises. Exercises after hip replacement, which the patient performs in the first month after surgery, are as simple as possible.
In order to fully restore mobility, it is necessary to constantly work on the hip joint, while following all the recommendations of the attending physician. In addition to exercise therapy, the patient is prescribed breathing exercises.
In most cases, already on the third day of rehabilitation, the patient can walk, using crutches and relying on the help of a specialist. After how many days can stitches be removed? It depends on how quickly the patient recovers. On average, stitches are removed 10 to 15 days after hip replacement surgery.
How to live after being discharged from the hospital? Many people wonder: how to live after returning home? In the hospital, the patient is constantly under the supervision of medical staff, who monitor the entire rehabilitation process. Life with a hip replacement is somewhat different from normal life. As already mentioned, in order to restore mobility, you need to constantly work on the hip joint.
The patient should walk as much as possible, without allowing severe fatigue. Exercise therapy plays a major role in the rehabilitation process; all exercises must be approved by the attending physician. After discharge from the hospital, the patient can visit special centers where qualified exercise therapy instructors will work with him.
This brochure is dedicated to people undergoing hip replacement surgery. You have been diagnosed with damage to the hip joint. You long time passed conservative treatment, used everything possible drugs for pain relief. You hoped that you could return to your normal lifestyle.
In reality, miracles do not happen. There comes a moment when life becomes unbearable and you cannot live without pain, walk without pain, movements in the joint are limited. You can no longer carry out everyday activities, you feel your own limitations in everyday life. This is usually accompanied by severe pain and limited mobility in the hip joint. Based on these symptoms, as well as medical examination data, doctors recommend implantation of an artificial joint. The purpose of our brochure is to familiarize you with the possibilities, features and benefits of total hip replacement surgery. We will try to help you prepare for surgery and avoid unnecessary anxiety during your hospital stay.
Of course, this information does not replace consultation with your doctor, orthopedic surgeon, rehabilitation specialist and other medical personnel. If you have any questions or are unsure about anything, you should discuss this with a specialist. Remember! The result of treatment will depend on the strict implementation of all the recommendations of the attending physician and your commitment to recovery.
To better understand possible operations, let's try to imagine the anatomy of the hip joint.
So the hip joint is a ball and socket joint. It is surrounded by muscles and ligaments and allows movement of the hip and the entire lower limb in all planes. In a healthy joint, smooth cartilage covers the head of the femur and the acetabulum of the pelvic joint. With the help of surrounding muscles, you can not only support your weight while supporting your leg, but also move. In this case, the head slides easily inside the acetabulum. In a diseased joint, the affected cartilage is thinned, has defects and no longer functions as a kind of “lining”. The articular surfaces, altered by the disease, rub against each other during movements, stop sliding and acquire a surface like sandpaper. The altered femoral head rotates in the acetabulum with great difficulty, and pain occurs. Soon, in an effort to get rid of pain, a person begins to limit movements in the joint. This in turn leads to shortening of muscles, ligaments and even greater contracture. The pressure exerted by the muscles on the head of the femur increases; over a long period of time, the weakened bone “crushes,” changes its shape, and flattens. As a result, the leg becomes shorter. Bone growths (so-called ossifications or osteophytes) form around the joint. The changed joint can no longer fully perform its function.
What is total hip replacement
Radically break this whole chain disease processes Only surgery to completely replace the diseased joint or total hip replacement can be done.
In principle, total arthroplasty is the replacement of a damaged joint with an artificial endoprosthesis. Total endoprosthetics is one of the main achievements of this century. Many decades ago, the relatively simple design of the hip joint inspired doctors and medical technicians to create an artificial replica. Over time, research and improvement in surgical techniques and materials used have led to tremendous advances in the field of total hip replacement. The design of endoprostheses perfectly follows the human anatomy. The endoprosthesis consists of two main parts: a cup and a leg. The spherical head is located on the stem and inserted into the cup of the endoprosthesis. The materials used for the artificial joint are special metal alloys, heavy-duty polyethylene and ceramics, developed specifically for endoprosthetics. They provide excellent tissue compatibility, absolutely painless movement, maximum strength and durability of the endoprosthesis. Typically, the surfaces of the endoprosthesis in contact with each other include a ceramic or metal head mounted in a polyethylene cup. They can also be all metal or all ceramic. 
There are mainly three types of fixation of endoprostheses:
Endoprosthesis with cementless fixation y, in which both the cup and the leg of the endoprosthesis are fixed in the bone without the use of bone cement. Long-term fixation is achieved by germination of the surrounding bone tissue into the surface of the endoprosthesis.
Endoprosthesis with cement fixation, in which both the cup and the stem are fixed using special bone cement.
Hybrid (combined) endoprosthesis, in which the cup has a cementless fixation, and the leg has a cemented fixation (i.e., it is fixed in the bone using special bone cement.) There is a very wide range of models for all types of endoprostheses, produced in the required range of sizes. The choice of the required type of endoprosthesis is determined physiological characteristics, medical indications, as well as the patient’s age, weight and level of physical activity. The correct choice greatly contributes to the success of the operation. The orthopedic traumatologist will conduct preoperative planning, during which it will be determined required size, endoprosthesis model and location of its parts. However, during the operation he should be able to install an endoprosthesis of a different size, making changes to the original plan. (This depends on the individual characteristics of the patient, the structure and density of the bone substance, the specific conditions and objectives of the operation performed.)
Before surgery
The decision to undergo surgery lies primarily with the patient. In many cases severe pain and taking a huge amount of analgesics (painkillers) make a person’s life so unbearable that surgery becomes vital. The exact time of the operation must be discussed taking into account all the necessary factors and features. It is necessary to properly prepare for implantation of an endoprosthesis. Before surgery, you can contribute to a favorable course of the postoperative period, namely:
Stop smoking.
Normalize your own weight. If you are severely obese, your doctor may delay surgery to give you time to lose weight (a body mass index greater than 35 is a relative contraindication for arthroplasty due to the high risk of postoperative complications).
Sanitation of the oral cavity and other possible foci of chronic infection is necessary. Such preliminary preparation will reduce the risk of wound infection that accompanies any surgical intervention.
If you have any chronic diseases, be sure to undergo all the necessary additional examinations so that there is time to correct their treatment.
During total hip replacement surgery, there is always some loss of some blood. This may require a transfusion. In order to prevent immunological conflict or infection, it is advisable to prepare your own blood for transfusion during surgery. You should discuss this possibility with your doctor and he will give you the necessary advice.
Currently, the quality of artificial joints and surgical techniques have reached very high level and allowed to significantly reduce the risk of various postoperative complications. But, despite this, certain complications associated with inflammation of the tissues around the joint or early loosening of the elements of the endoprosthesis are always possible. Strict adherence to the doctor’s recommendations will reduce the risk of complications.
Day of surgery
The operation can be performed under general, combined or regional anesthesia (pain relief). Regional anesthesia of the lower limb affects the general condition to a lesser extent and is therefore preferable. In addition to the anesthesia, you will be given a sedative (calming agent). During the operation you will not experience any pain.
The day before your surgery, your doctor will visit you to discuss anesthesia and the procedure. He will then select the medications you can tolerate best and the most appropriate method of surgery. During the operation, the affected joint will be removed and replaced with an artificial one. Implantation will require a skin incision about 15 cm in length. This way, the surgeon can approach the hip joint, remove the affected femoral head and damaged acetabulum, and replace them with an artificial cup and stem with a ball-and-socket head. After installing the cup and foot artificial joint checked for mobility and then sutured surgical wound. A drain introduced into the wound prevents the accumulation of leaking blood. After the operation, a pressure bandage is applied and the first control x-ray is taken.
The entire operation usually takes 1.0-1.5 hours.
The artificial joint implantation procedure is a common operation. For this reason, the following information about possible complications should not be a cause for concern and should only be considered as general information for patients. Described below possible complications relate directly to the artificial joint implantation procedure. The general risk that exists with any operation is not mentioned here.
Hematomas (bruises)
They may appear after surgery and usually go away within a few days. The previously mentioned drains are installed to prevent major hemorrhages, i.e. for evacuation of blood.
Thrombosis
Thrombosis (formation of blood clots) can lead to increased coagulability blood (blood clots can obstruct the flow of blood in the veins of the extremities), which can lead to a pulmonary embolism (when the blood clot reaches the lungs). To reduce the risk of thrombosis, special medications are prescribed, in the form of tablets or injections, before and after surgery, as well as elastic stockings or tight bandaging of the lower leg and foot and physical therapy.
Infection
Infection at the site of a surgical wound is a fairly rare complication and can usually be successfully treated with antibiotics. However, deep infection may lead to loss of the endoprosthesis and the need for reoperation. For this reason Special attention is given to sterility and protection from bacteria. In addition, antibiotics are prescribed before and after surgery.
Dislocation (displacement), dislocation
They occur quite rarely (mainly in early postoperative period until they heal soft fabrics) and usually occur only in cases of extreme mobility or falls. As a rule, in this case, the doctor adjusts the displaced endoprosthesis under anesthesia. The doctor must accurately inform you about the range of movements that are permissible in different times during rehabilitation.
Allergy
In very rare cases, tissue reactions may develop upon contact with an artificial joint. This reaction may be caused by a chrome-nickel allergy. By using modern alloys available today, the risk of allergies is reduced to a minimum.
After operation
When you wake up, you need to perform several exercises that reduce swelling of the limb and prevent the formation of blood clots in the blood vessels. They need to be performed while lying in bed.
Breathing exercises. Raise your hands up, take a deep breath. Lower your arms down to your sides and take a deep, energetic exhalation. This exercise must be repeated 5-6 times a day
Foot pump. When you're lying in bed (or later when you're sitting in a chair), slowly move your feet up and down. Do this exercise several times every 5 or 10 minutes.
The first days after surgery are the most important. Your body is weakened by the operation, you have not yet fully recovered from anesthesia, but in the first hours after waking up, try to remember more often about the operated leg and monitor its position. As a rule, immediately after surgery, the operated leg is placed in an abducted position. A pillow is placed between the patient's legs to ensure moderate separation. The first day you will lie in bed. If any medical manipulations or examination, you will be transported on a gurney. For 6-8 weeks after surgery you will have to wear compression hosiery(wrap your legs with elastic bandages or wear compression stockings). You also need to remember that:
In the first days after surgery, you should sleep only on your back, preferably with a pillow or cushion between your legs
You can only turn on your operated side, but not earlier than 7 days after surgery.
When turning in bed, place a pillow between your legs
To reduce the risk of dislocation of the endoprosthesis, you should not bend the operated leg at the hip joint more than 90 degrees, or rotate the leg in the operated joint, turning its toe in and out. That is, to you FORBIDDEN:
Sit on low chairs, armchairs or beds
Squat down
Bend below waist level, pick up objects from the floor
Pulling the blanket over your feet in bed
Put on clothes (socks, stockings, shoes), bending towards your feet
Sleep on your healthy side without a pillow between your legs
Sit cross-legged, cross your legs
Turn your body to the side without simultaneously turning your legs
When sitting in bed or going to the toilet after surgery, you need to strictly ensure that there is no excessive flexion in the operated joint. When you sit on a chair, it should be high. A regular chair should be cushioned to increase its height. Low, soft seats should be avoided.
Some patients with an advanced process continue to have certain difficulties when putting on socks. We recommend using a simple device in the form of a stick with a clothespin at the end, or a special clamp sold in prosthetic and orthopedic enterprises.
Wear shoes using a horn with a long handle, try to buy shoes without laces
Place the blanket next to you or use a blanket puller.
Wash in the shower on a non-slip mat using a long-handled washcloth and flexible shower head.
Devote most of your free time to physical therapy exercises.
The first goal of physical therapy is to improve blood circulation in the operated leg. This is very important to prevent blood stagnation, reduce swelling, and speed up healing postoperative wound. The next important task of physical therapy is restoring the strength of the muscles of the operated limb and restoring the normal range of motion in the joints and the support of the entire leg. Remember that in the operated joint the friction force is minimal. It is a hinge joint with ideal gliding, so all problems with limited range of motion in the joint are solved not through its passive development like rocking, but through active training of the muscles surrounding the joint.
In the first days after surgery, physical therapy is performed while lying in bed. All exercises must be performed smoothly, slowly, avoiding sudden movements and excessive muscle tension. During physical therapy exercises, it is important correct breathing- inhalation usually coincides with muscle tension, exhalation - with their relaxation.
The first exercise is for calf muscles. You have already used this exercise on the day of surgery. Bend your feet toward and away from you with slight tension. The exercise should be performed with both legs for several minutes up to 4-5 times within an hour.
Rotation at the ankle joint: Rotate the foot of the operated leg first clockwise, then in the opposite direction. Rotation is carried out only due to ankle joint, not the knee! Repeat the exercise 5 times in each direction. 
Exercise for the quadriceps femoris muscle: Tighten the muscle on the front of your thigh and try to straighten your knee while pressing the back of your leg into the bed. Hold in tension for 5 - 10 seconds. 
Repeat this exercise 10 times for each leg (not just the operated one) 
Knee flexion with heel support: Move your heel toward your buttocks by bending your knee and touching your heel to the surface of the bed. Don't let your knee rotate toward your other leg and don't flex your hip more than 90 degrees. Repeat this exercise 10 times. 
If at first it is difficult for you to perform the exercise described above on the first day after surgery, then you can hold off on it. If you continue to have difficulty later, you can use tape or a folded sheet to help tighten your foot.
Contractions of the buttocks: Squeeze your butt muscles and hold them tight for 5 seconds. Repeat the exercise at least 10 times.
Abduction exercise: Move the operated leg as far as possible to the side and return it back. Repeat this exercise 10 times. If at first it is difficult for you to perform this exercise on the first day after surgery, then you can hold off on doing it. Very often this exercise fails in the first days after surgery. 
Straight leg raise: Tighten your thigh muscles so that the knee of your leg lying on the bed is fully straightened. After this, raise your leg a few centimeters from the surface of the bed. Repeat this exercise 10 times for each leg. If at first it is difficult for you to perform this exercise on the first day after surgery, then you can hold off on doing it. Like the previous one, very often this exercise does not work out in the first days after surgery.
Continue all these exercises later, on the subsequent second, third, and so on days after hip replacement surgery.
First steps
In the first days after surgery, you should learn to get out of bed, stand, sit and walk so that you can do this safely yourself. We hope that our simple tips will help you with this.
You must immediately remember that before sitting down or standing up, you must bandage your legs with elastic bandages or wear special elastic stockings to prevent thrombosis of the veins of the lower extremities!!!
How to get out of bed
As a rule, you are allowed to get up on the third day after surgery. A physical therapy instructor or attending physician will help you get back on your feet for the first time. At this time, you still feel weak, so during the first few days someone must help you, supporting you. You may feel a little dizzy, but try to rely on your strength as much as possible. Remember, the faster you get up, the faster you will begin to walk. The medical staff can only help you, but nothing more. Progress is entirely up to you. 
So, you should get out of bed in the direction of the operated leg. Sit on the edge of the bed, keeping your operated leg straight and in front. Before standing up, check if the floor is slippery. Place both feet on the floor. You can also stand on the side of your healthy leg, provided that you do not bend the operated hip more than 90 degrees and do not bring it to midline bodies. Using crutches and your non-operated leg, try to stand up.
If you want to go to bed, all steps are performed in the reverse order: first you need to put the healthy leg on the bed, then the operated leg.
How to use crutches correctly
It is necessary to stand up and place the crutches forward at the length of a step and towards the toes. Keep your elbow slightly bent and keep your hips as straight as possible. When walking, firmly hold the handles of your crutches. When walking, you need to touch the floor with your operated leg. Then increase the load on your leg, trying to step on it with a force equal to the weight of your leg or 20% of your body weight. The load can be determined using ordinary scales, on which you need to stand with the operated leg with the required load. Remember the feeling and try to step on your foot with this load when walking.
Attention: the main weight should be supported by the palms, not the armpits!
If you are allowed to use only one crutch, then the crutch should be on the side of your healthy leg. 
How to sit down and stand up correctly
To sit down, walk towards the chair with your back turned until you feel its edge. Move both crutches towards your healthy leg. Sit on a chair, leaning on the armrests and extending your operated leg.
Bend your legs at a slight angle and sit up straight. To get up from a chair, slide forward. Grab the armrests of the chair with your hands to stand on your healthy leg, slightly extending your still operated leg. Then use the crutches with both hands to stand on your operated leg.
| 1-4 days after surgery |
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| Goals |
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| Dangers |
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| Rehabilitation |
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HOW TO GO UP AND DOWN STAIRS
Warning: Do not take your first steps up the stairs on your own!
4-5 days after the operation you need to learn to walk up the stairs. Climbing stairs requires both joint mobility and muscle strength, so if possible, it should be avoided until full recovery. But for many of us this is not possible, because even to the elevator in many houses you need to climb the stairs. If you have to use stairs, you may need assistance. Always use the hand opposite the operated joint to rest on the railing when climbing stairs and take one step at a time.
Climbing stairs:
1. Step up with your healthy leg. 
2. Then move your operated leg up one step.
3. Finally, move your crutch and/or cane to the same step.
Descending the stairs, everything in reverse order:
1. Place your crutch and/or cane on the step below.
2. Take a step down with your operated leg.
3. Finally, move your healthy leg down.
Remember the basic rule: THE HEALTHY LEG IS ALWAYS ABOVE THE SICK LEG!
When you learn to get up and stand steadily, you can expand the complex of physical therapy. When performing these exercises in a standing position, hold on to reliable support (headboard, table, wall or sturdy chair). Repeat each exercise 10 times during each session 3 times a day.
Standing Knee Raise: Raise the knee of the operated leg. Do not raise your knee above waist level. Hold your leg for two seconds and lower it on the count of three. 
Straightening the hip joint in a standing position: Slowly move your operated leg back. Try to keep your back straight. Hold your leg for 2 or 3 seconds, then return it back to the floor. 
Leg abduction in a standing position: Make sure your hip, knee, and foot are pointing straight ahead. Keep your body straight. Keeping your knee pointed forward at all times, move your leg to the side. Then slowly lower your leg back so that your foot is back on the floor. 
AFTER DISCHARGE
Your compliance with your doctor's instructions is very great importance for a speedy recovery:
If you will use a walker or crutches to walk, ask your doctor how much weight you can put on your operated leg. Do not forget that, most likely, you will get tired faster than before. You should include 30 – 60 minute rest periods throughout the day.
It is easier and safer to sit down and get up from a chair, putting the main weight on your hands. It is unacceptable to sit on low and soft chairs or beds. To sit at a sufficient height, you can add sofa or sleeping pillows.
A sufficiently high toilet seat will help reduce the stress on the hip and knee joints when standing up and sitting on the toilet.
A shelf screwed into the shower at chest level will help eliminate the need to bend over to reach toiletries when showering.
A seat (bench) in the bathroom will allow you to take a bath safely and comfortably in a sitting position.
To wash the lower parts of your legs, use a long-handled washcloth. Women use a special razor extension to shave their legs.
You cannot sweep, wash or vacuum the floor. To wash high or low-lying objects, you can use a mop with a long handle.
Traveling in a car is not prohibited, but instructions must be followed when getting in and out of the vehicle. To increase the height of the seat, you can place a pillow on it. When traveling, try to move the seat back as far as possible, taking a semi-reclining position.
Most likely, your doctor will prescribe you painkillers. Be sure to follow your doctor's instructions for taking these medications.
A slight swelling of the tissue around the postoperative wound is not a deviation. Therefore, to prevent pressure on the wound, you should wear comfortable and loose clothing. Ask your doctor or other qualified medical worker about how to treat a surgical wound.
All this is needed in order to move from crutches to a cane and then begin to walk completely independently. It is impossible to give up crutches earlier, when the muscles are not yet able to fully support the joint, much less react to possible non-standard situations (for example, a sharp turn).
Exercises with elastic band (with resistance). These exercises should be performed in the morning, afternoon and evening 10 times. One end of the elastic band is secured around the ankle of the operated leg, the other end - to a locked door, heavy furniture or wall bars. To maintain balance, you should hold on to a chair or headboard. 
Hip flexion with resistance: Stand with your back to a wall or heavy object to which an elastic band is attached, with your operated leg slightly to the side. Raise your leg forward, keeping your knee straight. Then slowly return your leg to the starting position.
Hip extension with resistance: Stand facing a wall or heavy object to which an elastic band is attached, with your operated leg slightly to the side. Extend your leg at the hip joint, keeping your knee straight. Then slowly return your leg to the starting position. 
Leg abduction with resistance in a standing position: stand with your healthy side facing a door or heavy object to which a rubber tube is attached, and move your operated leg to the side. Slowly return your leg to the starting position. 
Walking: Use the cane until you are confident in your balance. At first, walk for 5-10 minutes 3-4 times a day. As your strength and endurance increase, you will be able to walk for 20-30 minutes 2-3 times a day. Once you are fully recovered, continue regular walks of 20-30 minutes 3-4 times a week to maintain your muscle strength. Use the cane only on the side of your healthy leg.
TIPS FOR THE FUTURE
About 6-8 weeks after surgery, your doctor may allow you to drive and will talk about your driving habits. If your car is not equipped with an automatic transmission, discuss any restrictions on driving your car with your doctor. Before you drive out onto the road, you should make sure that braking your car does not cause you discomfort.
Patients often experience constipation after surgery. This is caused by low mobility and the use of painkillers. Discuss your diet with your doctor. If the doctor has no objections, then you should include fresh fruits and vegetables in the menu, and also drink eight full glasses of liquid every day.
Watch your weight - everyone extra kilos will accelerate wear and tear on your joint. Remember that no special diets for patients with a replaced hip joint. Your food should be rich in vitamins, all necessary proteins, mineral salts. No one food group has priority over the others, and only together can they provide the body with complete, healthy food.
Your artificial joint is a complex structure made of metal, plastic, ceramics, so if you are going to travel by plane, take care to obtain a certificate of the operation performed, because This can be useful when going through security at the airport. On long trips, take your endoprosthesis passport with you.
Remember that your joint contains metal, so deep heating and UHF therapy on the area of the operated joint using the transverse technique are undesirable.
Usually, with complete restoration of limb function, patients have a desire to continue playing their favorite sports. But, taking into account the peculiarities of the biomechanics of an artificial joint, it is advisable to avoid those types of sports activities that involve lifting or carrying heavy objects, or sharp blows to the operated limb. Therefore, we do not recommend horse riding, running, jumping, weightlifting, etc. Walking (regular and Nordic), swimming, gentle cycling and skiing are recommended.
Avoid colds chronic infections, hypothermia - your artificial joint can become that “ weak point", which will undergo inflammation.
Rehabilitation at the outpatient stage
Each patient requires an individual program taking into account concomitant pathology. The goal of rehabilitation is to form a correct gait and eliminate muscle imbalances.
Physiotherapy:
Magnetic therapy of the hip joint and lower limb
Calcium electrophoresis on the hip joint area
Electrical stimulation of the gluteal, quadriceps muscles of the thigh (DDT, SMT, Miorhythm, IFT)
Heparin phonophoresis on the area of hematomas (if any)
Hydrotherapy, swimming (after complete healing of the postoperative wound)
Heat therapy (after 6 weeks)
Massage of the operated limb (allowed from 12-14 days after removal of postoperative sutures).
Physiotherapy
Continue the exercises you did before.
Special gymnastics lying on your side (non-operated), on your stomach, standing with support.
Cycling training
Dosed walking
Remember that your artificial joint will not last forever. The average service life of a normal endoprosthesis is 15-20 years, in the best cases it reaches 25 years. Of course, you should not constantly think about the inevitability of repeated surgery (especially since most patients manage to avoid it). Your new joint“loves” an attentive, careful attitude. It is very important that you remember this and remain in good health at all times. physical fitness and on your feet. Taking into account some of the precautions that we talked about above, you will be able to fully recover and return to a normal active life, to your favorite job or hobby.
WE WISH YOU HEALTH!
Article publication date: 08/03/2016
Article updated date: 12/05/2018
Rehabilitation after hip replacement is an integral stage of postoperative treatment aimed at restoring muscle tone and functionality of the leg. Rehabilitation consists of limiting (particularly) physical activity in the period after surgery and performing physical therapy.
Principles of the recovery period after hip replacement:
- early start,
- individual approach when carrying out rehabilitation measures,
- subsequence,
- continuity,
- complexity.
Rehabilitation after endoprosthetics has three periods: early, late and long-term. A specific gymnastics complex has been developed for each of them. The total duration of rehabilitation is up to a year.
Restoration of the leg's functionality begins in the hospital, where the patient underwent surgery. The approximate length of stay there is 2–3 weeks. You can continue rehabilitation at home or in a rehabilitation center, and finish it in a dispensary or specialized rehabilitation treatment clinic. If you are working out at home, it is important not to interrupt exercise therapy and therapeutic walks so that recovery takes place in full - only then the muscular-ligamentous system will reliably fasten the artificial joint, and all functions of the leg will be restored.
Lack of rehabilitation after endoprosthesis replacement threatens the occurrence of dislocation of the head of the endoprosthesis due to weak ligaments, periprosthetic fracture, development of neuritis and other complications.
Rehabilitation after any type of joint surgery, including replacement of a hip with an endoprosthesis, is carried out by a rehabilitation specialist and (or) a physical therapist. He will create an individual program taking into account physical condition the patient, the degree of adaptation to physical activity, his age, the presence of concomitant diseases.
After installation of an endoprosthesis, it is possible to restore working capacity. Persistence, the desire to recover, and strict adherence to doctors’ recommendations are the main criteria for a positive outcome of rehabilitation after endoprosthetics surgery.
Three periods of rehabilitation
Early rehabilitation period after endoprosthetics
This period begins immediately after recovery from anesthesia and lasts no longer than 4 weeks.
Six Rules of the Early Period
Sleep only on your back for the first few nights after hip replacement surgery;
You can turn on your healthy side with the help of a nurse at the end of the first day after surgery, 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 more than 90 degrees;
do not bring your legs together or cross them - place a wedge-shaped pillow between your legs;
do it regularly simple exercises to prevent blood stagnation.
Early goals
- Improve blood circulation in the operated hip area;
- learn how to sit up in bed correctly and then get out of it;
- prevent the development of complications (bedsores, thrombosis, congestive pneumonia, pleurisy);
- accelerate the healing of the postoperative suture;
- reduce swelling.
Basic exercises
The table contains exercises for the calf, gluteal, and thigh muscles of both legs:
(if the table is not completely visible, scroll to the right)
| Exercise name | Description |
|---|---|
|
Wiggle your toes |
Bend and extend the toes of both the healthy leg and the operated one. |
|
Foot pump |
Do it immediately after coming out of anesthesia: bend your foot at the ankle back and forth. Per hour, do up to 6 approaches for several minutes until the muscles become slightly fatigued. |
|
Rotation of feet |
Rotate your foot first 5 times clockwise, then 5 times counterclockwise. |
|
Isometric gymnastics with quadriceps tension |
Start with the healthy limb. Try to press the popliteal fossa to the bed as much as possible and hold the muscle tension for 5–10 seconds. From 3-5 days, perform the same action with the sore leg, keeping the muscles toned for 2-5 seconds. Do 10 times of each. |
|
Isometric contractions of the gluteal muscles |
Alternately strain your right and left gluteal muscle, maintaining tension until slight fatigue. |
|
Knee flexion |
Slide your foot along the surface of the bed and pull your leg towards you, bending it at the knee. Lower it. Do it slowly 10 times. |
|
Straight leg abduction to the side |
First move 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. |
|
Leg extension at the knee |
Place a small cushion or pillow under your knee. Straighten your leg, holding it in this position for 5–7 seconds. Do the same with the other leg. |
|
Straight leg raise |
Alternately lift your straight leg a few centimeters 10 times. |
Rules for doing the exercises:
- make several passes per day, spending 15–20 minutes out of every hour during the day;
- keep a slow and smooth pace;
- combine exercises with breathing exercises according to the following scheme: when muscles are tense, take a deep breath; when relaxing, take a long exhale;
- perform breathing exercises to avoid congestion in the lungs.
- At first, do the exercises in the early period only while lying on your back (although you need to get on your feet already on the 2-3rd day), and then do the same gymnast while sitting on the bed.
A set of exercises for rehabilitation after endoprosthetics
I presented the exercises described in the table above in the order in which they were performed; they are relevant throughout the entire rehabilitation course. This exercise therapy complex suitable for the rehabilitation of patients after almost any operation on the leg joints.
Additional exercises
In the first 2–10 days after endoprosthetics, doctors teach the patient to sit up correctly in bed, roll over, stand up, and walk on crutches.
Having already learned to maintain 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 onto the headboard of a bed or chair. Here they are:
(if the table is not completely visible, scroll to the right)
| Initial position | Performing the exercise |
|---|---|
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Stand facing the headboard of the bed, grab it with your hands |
Begin to alternately lift your right and left leg, bending it at the knee. This is reminiscent of walking in place with support in front of you. |
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Leaning on one leg, move the other to the side, slightly lifting it. Then change your legs. |
|
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Everything is the same, only slowly move your leg back, straightening the hip joint. |
The sooner the patient begins to get up and walk after endoprosthetics, the less likely muscle development (limited mobility) in the hip area.
Late postoperative rehabilitation
Late rehabilitation after hip replacement begins 3–4 weeks after surgical intervention and lasts up to 3 months. The duration of rehabilitation for each patient varies depending on his age and other factors.
Two late period goals:
training muscles to strengthen them, increase tone,
restoration of range of motion in joints.
After the patient confidently gets out of bed, sits on a high chair, walks on crutches for 15 or more minutes 3-4 times a day, the motor mode 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 stairs.
Start climbing the step with your healthy leg, placing the operated leg next to it. When descending, lower one step lower: first the crutches, then the sore leg and then the healthy one.
Long-term rehabilitation period
This period begins 3 months after hip replacement surgery; and lasts up to six months or longer.
- complete restoration of the functioning of the artificial joint;
- acceleration of bone regeneration;
- improving the functional state of ligaments, muscles, tendons.
Adaptive motor mode involves preparing the patient for more intense physical activity and adaptation in everyday life. Exercise therapy is supplemented with physical therapy (mud or paraffin applications, balneotherapy, laser therapy and other physical procedures).
Exercises to do at home
Later the above gymnastics early period After endoprosthetics, they are supplemented with more complex exercises.
Examples of exercises that patients perform at home after discharge. Click on photo to enlarge
(if the table is not completely visible, scroll to the right)
| Initial position | Execution order |
|---|---|
|
Lie on your back. |
Alternately bend and pull your legs towards your stomach, imitating riding a bicycle. |
|
Lying on your back. |
Alternately pull your legs towards your stomach, bending your knees and helping yourself with your hands. |
|
Lying on your unoperated side with a flat cushion between your legs. |
Raise your straight leg and hold it in this position for as long as possible. |
|
Lying on your stomach. |
Bend and straighten your knees. |
|
On the stomach. |
Raise your straight leg, moving it back, then lower it. Repeat the same steps on the other one. |
|
Standing with your back straight. |
Do half squats while holding onto some support. |
|
Stand up straight. In front of you, place a flat, stable block - a step - 10 cm high. |
Step onto the step platform. Slowly get down from it, taking a step forward with your healthy leg, then lower the operated one. Return in the same order. And so 10 times. |
|
Stand in front of the step, step onto it with your healthy leg, shifting your body weight onto the leg with the endoprosthesis, which you then lift onto the step. |
|
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Stand up and rest your hand on the back of a chair. Place a loop of elastic bandage around the ankle of the operated leg, and secure the other end of the bandage (for example, tie it to the leg of a sofa). |
Stretch the affected 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 towards the object to which the tourniquet or elastic band is attached, and hold on to it with one hand. |
Move the straight operated limb to the side and slowly return it back. And so 10 times in one approach. |
The last two exercises and the rest, where movements must be done with a straightened leg, are necessary after surgery specifically on the hip joint, since they are aimed at developing hip endoprosthesis. For the recovery period when replacing another large joint legs – they are only additional.
Step platform
Gymnastics on simulators
The adaptive motor regime in the long-term period is expanded through physical therapy on simulators. By this time, the ligaments and muscles have already become sufficiently strong after the operation, so the intensity of the load can be increased. The table below shows the most common exercises for full recovery range of motion in the hip joint.
(if the table is not completely visible, scroll to the right)
| Exercise name | Execution Sequence |
|---|---|
|
Bike |
First, pedal backwards on the exercise bike. If this happens without effort, proceed to scrolling forward (15 minutes, 2 times a day). Gradually increase the time to 25–30 minutes. Conduct classes 3-4 times a week. Don't forget about the right angle rule: don't lift your knees higher than your hip joints. |
|
Hip extension |
Place the operated leg on a 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. Focus on the healthy leg. Press the roller as if pumping a pump - you perform flexion-extension movements of the endoprosthesis with force, since a weight is attached to the roller on the other side of the simulator (gradually increase its weight).
|
|
Exercise on an exercise bike with low pedals |
Simulate riding a bike. Adjust the pedals so that each leg is fully straightened when the pedals are lowered.
|
|
Walking backwards on a treadmill |
Stand with your back to the control panel and grab the handrails. Start walking backwards at a slow pace (set the speed to 1–2 km/h). When the foot completely touches the track, the leg should be straightened.
|
Conclusion
At each stage of rehabilitation, the supervision of a physical therapy doctor is important. He will tell you when you can complicate the exercises and increase the load.
Doing exercises for the hip joint on your own after endoprosthetics, especially using exercise machines, can lead to serious consequences. You cannot do gymnastics through pain or, conversely, stop it prematurely, even if you feel well and the endoprosthesis, as you think, moves well. Only strict implementation 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 for the doctor:
Victor | 07/06/2019 at 19:43
Hello. I am 67 years old. On March 15 and September 19, 2018, he underwent endoprosthetics of the left and right hip joints (1 year 4 months, 10 months have expired, respectively). Pairs of metal + polyethylene + ceramics. Uncemented. Rehabilitation is going well, I can walk without crutches or a cane, I drive a car, and I passed the driver’s examination without any problems. I don't feel any 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 outside help? 2. Full (deep) crouch? 3. In a standing position, bend forward with your hands on the floor? (mopping the floor) 4. Swimming lessons 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. When lying on your back, cross your leg behind your leg (left-right)? 6. Stop using a wedge-shaped pillow between your legs? After what period? 7. After what period of rehabilitation is it possible (or forever prohibited?!) to raise the knees to an angle of more than 90°? Turning the raised knee left and right? Thank you in advance for your detailed answer. Sincerely...
mikhail | 04/25/2019 at 03:25
hello, please tell me the operation was performed 17 days ago, they replaced the hip joint, I am 28 years old. The situation is such that the muscles hurt and in the morning the leg is as heavy as a stone, tell me, is this normal?
Valentina Viktorovna | 03/04/2019 at 14:05
Operation PTB on December 6, 2017, the hip and buttock still hurt, the doctor who operated said that the pain was from the back because... this is possible osteochondrosis. The thigh along the suture is swollen, when touched it feels as if numb, but the pain is felt. I walk with a cane on the street, but at home without a cane. I do exercises every day while lying on the couch, thank you in advance.
Vladimir | 09.11.2018 at 01:20
Hello, during the hip replacement, the femur burst during the subsequent operation, they were secured with 5 ties along the length of the bone, the sutures were discharged, they were removed, recommendations were not to step on the leg for 3 months, what of the set of exercises you recommended can I do after the operation, 3 weeks have passed, thanks in advance for the answer
Olga | 09/17/2018 at 14:13
There is no temperature, pain, or redness. I will take your recommendations into account, thank you.
Olga | 09.16.2018 at 12:59
Hello! ; September I had endoprosthesis replacement of the right hip joint. My leg is still very swollen and it’s difficult to bend my knee. Upon discharge, they said that everything would pass, but almost two weeks passed. This was not the case during surgery on the left joint in February of this year. I live in a village and haven’t gotten to my clinic yet. Tell me if there is any danger and what to do, thank you.
Svetlana | 09/06/2018 at 20:25
Hello, my mother (70 years old) is preparing for 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 at the front, and legs like a chair on the side of the person leaning on?
Mina Minskaya | 09/05/2018 at 14:51
In January I had hip replacement surgery.
Since then, the sensitivity of the toes has been impaired. What do you recommend to restore normal sensitivity? Thanks in advance, Mina.
Yana | 08/30/2018 at 11:14
Hello! How long after endoprosthetics can I do a full body massage? I saw a physiotherapist, she prescribed different procedures, prescribed ALIMP, and said about massage that it was too early, in 3 months (one and a half months had passed). In the ward, we all took off our stockings after a week, and those whose heels were baked, the sisters cut the stockings at the heels to give freedom to the blood vessels. I walk for an hour and a half, sometimes 2 hours in the air with crutches, is this probably a lot? I want to go to the sea, why don’t I go to the sea? When a month passes after endoprosthetics - is it really impossible? Thank you!
Svetlana | 08/29/2018 at 16:52
Hello! I’m preparing to replace the TB of the right joint, I live on the 5th floor of a building without an elevator, will I be able to 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
I am 42 years old. We had surgery to replace the right hip joint on 06/05/2018, i.e. two months have passed. I do gymnastics. Added an exercise bike. I walk with a cane, but my gait is not straight. I can’t even lie on my operated side ( nagging pain occurs along the entire leg). I have several questions:
1) When can you break the “90 degree” rule and sit low?
2) When can I take off compression stockings?
3) Will straight gait be restored and what should be done for this?
Valery | 07/29/2018 at 17:13
I am 61 years old. On July 6, 2018, an operation to replace the left hip joint was performed. A BC metal-ceramic joint (manufacturer "Zimmer") was installed. Three weeks have passed. I feel good. Acute painful sensations are missing. Used axillary crutches. last week one subulnar crutch. Is not it too early? And another question: is it possible to go to the sea at the end of September-beginning of October?
Alexander | 07/06/2018 at 12:37
Hello! I confess, I love to lie in the bathtub, how long before I can take a full bath after replacement of the hip joint, on this moment has it been almost 2 months?
Natalia | 06/24/2018 at 19:35
Good afternoon. Done 40 days ago to replace the right hip joint. I walk with a stick. Question: Which side should you hold the stick on? On the side of the sore or healthy leg? It is written differently on different sites. I'm holding the stick on the side of my good leg!??? Question: How long after surgery (approximately) can you 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 operation to replace the hip joint. I am 70 years old, can I use an elliptical trainer instead of an exercise bike for rehabilitation? I feel good, there is no pain in the joint and never was. When can I start exercising on the machine? Thank you!
Ekaterina | 06/13/2018 at 06:12
Good afternoon I am 70 years old, 4.5 months have passed since the operation to replace the hip joint (01/25/2018), in general, nothing bothers me as long as I walk at home without a cane (I walked on crutches for about 3 months). But when I go outside I use a cane, I have to walk 200 meters. The operated leg immediately gets tired and I look for a place to sit down. Tell me what is the reason? I consulted a doctor with pictures in May and they said everything was fine. Thank you for your reply
Olga | 05/14/2018 at 04:25
Hello! I read all the comments, thank you very much to everyone, I learned a lot of useful things. Question: they write that you need to exercise on an exercise bike, but I have a cardio exercise machine - walking, is it possible to walk and how long - I had a replacement of my left hip joint on 02/2/18. Right - severe pain, September 3, 2018. there will be an operation.
Viktor Nikolaevich | 05/08/2018 at 23:39
Hello. I am 66 years old. The operation for total endoprosthetics of the right hip joint was performed on March 15, 2018. May 15 this year 2 months after surgery. The pair is cementless, polyethylene - ceramics. The seam has healed, the stitches have dissolved, the condition is normal. With the permission of the doctor, I now walk on one elbow crutch. After the discharge, there were no follow-up images and no examination yet; the doctor was on an internship abroad. There is his absentee 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. stop using a wedge-shaped pillow between the thighs?! And secondly: when in terms of time and season (we have very hot weather and the summer is promised to be the same) is it better to have surgery on the second hip joint? Thanks for the answer.
Tatiana | 04/30/2018 at 09:24
Good afternoon In February there was an operation to replace the vehicle; now, that is, in May, you can get another vaccination against tick-borne incephalitis. Thanks for the answer.
Maryam | 04/07/2018 at 04:59
Hello! 02/27/2018 I had surgery to change the vehicle. While I'm doing gymnastics. When will I be able to go to rehabilitation center? And when will you be able to drive? Right leg. The car is left-hand drive. Thanks in advance for your answer!
Sergey | 03/01/2018 at 20:28
Thanks for the answer. Pictures with exercises Exercises to do at home Distant period rehabilitation No. 3, 6, 12 movements that doctors usually prohibit doing. These pictures show movements and loads as if they were on a healthy joint. Does this mean that over time all movements will be restored? It’s scary that in life you won’t be able to tie your shoelaces and just squat down. I am 44 years old, but before the injury I led an active sports lifestyle. That's why the question. Traumatologists do not have a consensus on the current condition: either wait up to six months or get prosthetics. no nicrotic processes are observed, but there is no fusion. You are trying to assess what can await you after prosthetics.
Svetlana | 03/01/2018 at 08:52
Good afternoon! I have a question. I had hip replacement surgery in November 2016. I would like to know what I am strictly prohibited from doing for life. I would like to go to Gym what exercise machines can you use?
Sergey | 02/28/2018 at 21:01
Good afternoon. I have a displaced intra-articular fracture of the femoral neck. Within six months the fracture had not healed. There is a high probability of prosthetics. Tell. After completing a 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 movement of the leg without fear of breaking the joint or dislocating it? 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’ve read a lot, but it’s not clear how long I can walk, I’m hyperactive, it’s 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. A new one has arisen, how long should you sleep on your back after surgery? It’s just that my husband is already tired and wants to roll over onto his non-operated side. 2 weeks have passed since the operation.
Rules to follow after hip replacement:
- In the first days after surgery, you can only sleep on your back; turning on your side is allowed after 3 days under the supervision of medical staff and on the non-operated side. You can sleep on your non-operated side two weeks after endoprosthetics.
- In the first days, you need to avoid a large range of movements: do not move suddenly, turn your leg, etc.
- When sitting on a chair or toilet, make sure that the operated joint does not bend more than 90 degrees; you cannot bend over, squat, cross your legs or throw them over one another. It is advisable to sleep on a high bed, the chairs should also be high (like bar chairs)
- For the first six weeks after surgery, try to avoid taking hot bath, giving preference to a warm shower. It is strictly forbidden to visit baths or saunas during the first 1.5 - 3 months of the postoperative period (to avoid thromboembolic complications).
- You need to do physical therapy exercises regularly.
- Sexual relations are allowed 1.5-2 months after surgery
- It is better to exclude sports such as horse riding, running, jumping, and weightlifting, giving preference to swimming and walking.
Nutrition after hip replacement
After discharge and return home, the patient should eat a balanced diet. In this case, on the advice of a doctor, it is advisable to:
- take certain vitamins;
- monitor your weight;
- replenish the diet with iron-containing foods;
- Limit consumption of coffee, alcohol and excessive intake of vitamin K.
When should you see a doctor after joint replacement surgery?
Alarming symptoms indicating possible inflammation and complications of the rehabilitation period may be: heat(above 38 degrees), redness of the skin around the suture, discharge from the wound, chest pain, shortness of breath, increased joint pain, swelling. When these alarms You should immediately contact your doctor.
In some cases, after hip replacement, the patient is recommended to periodically undergo x-rays, urine and blood tests so that doctors can monitor the healing process.
The first follow-up examination is usually carried out 3 months after surgery. During it, it is determined how the joint “stands” and whether the leg can be fully loaded. The next follow-up examination is in 6 months. The purpose of this examination is to find out if you have osteoporosis or other bone pathologies. The third follow-up visit is carried out one year after the joint replacement. In the future, it is recommended to visit your doctor at least once every 2 years. Typically, the prosthesis lasts 15 years, sometimes 20-25, after which it is recommended to replace it.
Factors that accelerate joint wear and lead to complications:
- hypothermia, colds leading to inflammation;
- excess weight: increases the load on the joint;
- the development of osteoporosis (loss of bone strength), the appearance of which is facilitated by a sedentary lifestyle, smoking, alcohol, the use of steroid hormones, and poor nutrition;
- carrying heavy weights, sudden movements and jumping on the operated leg.
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