An operation, even performed at the highest level, will not bring an effect without high-quality postoperative treatment. Comprehensive rehabilitation after hip arthroplasty - exercise therapy, physiotherapy, prevention of complications - allows you to get the full potential of this type of treatment. Without rehabilitation, you run the risk of maintaining pain, lameness, and limited range of motion.
Introductory briefing
After hip arthroplasty, rehabilitation lasts an average of 3 months. It consists of stages, for each of them its own system of treatment and rehabilitation measures based on physical exercises and auxiliary procedures has been developed. 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 leg's working capacity.
Nice and calm suture about 3 days after surgery.
We hope that you will worry about such a device in advance.
Physical activity is planned and optimized in accordance with the terms and individual criteria by the physician-rehabilitation therapist. At home, you will need to take contraindicated activities seriously, train strictly according to the instructions, without forcing loads, always come to the clinic for planned examinations, and in case of any pathological manifestations (pain, swelling, hematoma, etc.), immediately contact your doctor ..
General principles of rehabilitation
The goals of rehabilitation are as follows:
- complete elimination of the inflammatory process and pain, which are the result of operational manipulations;
- normalization of the state of the musculo-ligamentous complex, which brings the articular bones (pelvic and femur) into a coordinated movement;
- strong fusion of the components of the prosthesis with the bones, which occurs gradually in the course of natural reparative processes of bone tissue renewal;
- preventing the development of negative consequences.
Drug treatment
After the operation, all prescribed medications must be strictly taken, this is vital. And if someone thinks that it is harmful to the body, then problems are not far off.
Includes taking or injections of specific medicinal formulations, namely:
- antibacterial medicines from the antibiotic spectrum (from 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.
Complex physiotherapy
Physiotherapy is an excellent addition to motor recovery.
These are procedures for electromyostimulation, electrophoresis, UHF, laser therapy, massage, balneotherapy and mud therapy, aimed at:
- reduction of pain syndrome and removal of puffiness;
- elimination of spasmodic phenomena in the muscles;
- stimulation of blood circulation and lymphatic circulation in the structures of the problem leg;
- increase in muscle tone and strengthening of the ligaments;
- activation of metabolic and regenerative processes in the lower limb.
Rehabilitation after hip replacement at home and in the hospital is a rather long and laborious process that requires strength and patience. But with its correct organization, the ability to work returns by the end of the 10th week. With a complicated course of postoperative stages, recovery after hip replacement is likely to take 2 times longer.
There is a direct relationship, patients who are not overweight and who lead an active lifestyle, as much as possible, before the operation, recover faster than others.
Description of the stages of rehabilitation
The main recovery from hip arthroplasty takes 10 weeks. Of these, 3 weeks is the early phase, from the third to 10 weeks - the late stage. And all this time, it is necessary to fruitfully perform tasks and exercises for rehabilitation after hip arthroplasty, dictated by the surgeon and the rehabilitation therapist. Together, the specialists make up an effective scheme of physiotherapy exercises.
The essence of the training exercises consists in reusable, regularly repeated and sequentially increasing physical loads, which gradually improve the indices of physical activity, dynamically improve and restore working capacity. After the entire specified period of time after surgery on the hip joint, the rehabilitation does not finally end. All the achievements to which the patient has been walking for so long and, finally, has achieved the cherished painless freedom of movement, must be consolidated.
Remarkable sanatoriums, where proper rehabilitation is provided after partial replacement and total hip arthroplasty, are located in the Leningrad Region, Krasnodar Territory, and Karelia. If we talk about foreign European resorts, Teplice and Jachymov, located in the Czech Republic, are definitely in the lead here.
Early stage
The operated person immediately after the intervention from the operating room is transferred to intensive care for 24 hours. This is done to control the main functionally significant indicators of the state of the body: heart rate, respiration, blood pressure, etc., which is mandatory after any surgical procedure. They immediately start antibiotic therapy and the introduction of anticoagulants, take tests, and if necessary, conduct a blood transfusion. Respiratory gymnastics is prescribed in order to prevent congestion in the lungs.
Compression cuffs are used to prevent thrombosis.
From the second day until the end of 3 weeks of the rehabilitation period after the replacement of the hip joint, clinical care and recovery are carried out in the inpatient unit. The patient will be worried about pain, which is a normal reaction of the body, therefore, in addition to taking NSAIDs, he will be shown physiotherapy and cold dry compresses topically. They will remove the swelling located on the outer soft integument above the replaced joint. Soreness and swelling, as soon as the suture heals, will stop causing suffering.
The arthromot is used from the second day after surgery for passive joint development.
The debilitating pain does not need to be endured, it will adversely affect both your psychological mood and the activity of the main internal organs and systems, for example, the heart, stomach, intestines, circulatory and respiratory systems. Their dysfunction will interfere with the normal start of the mechanisms of self-regulation and regeneration. Therefore, do not torment yourself and your body, which is already weakened: if it hurts unbearably, tell the nurse or doctor about it, and you will be provided with the necessary help. If the painful manifestations are mild, then, of course, it is better not to abuse it with anesthesia.
Well, now let's move on to considering the question: how is the activation of a person performed:
- Walking on crutches is possible from 2-3 days in a light mode, leaning on crutches or a walker. The technique of possession of means for support and the method of movement when moving in space of the patient is usually taught even in the preoperative preparatory period. Walking in the early days is allowed only under the guidance of a methodologist-instructor.
During 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 3 days, while it is important not to allow an excessive bend angle in the hip, the maximum permissible 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 lowered seats.
At first, the following rule applies - the patient either walks or lies horizontally, it is impossible to sit for a long time.
- When a person lies, a special anatomical roller is necessarily placed between the limbs, which will protect against unwanted adduction of the limb and its crossing with a healthy leg. So far, you can only turn on your healthy side. Sleep, you need to lie exclusively on your back.
Crossing your legs increases the risk of dislocation.
- It is recommended to perform during rehabilitation after surgery on the hip joints, as soon as the effect of anesthesia ends, flexion-extension of the ankle, rotation of the feet.
The exercise is safe and can be performed without special restrictions.
- It is proposed to work with knee flexion / extension: the leg, sliding the heel on the bed sheet, bend in the knee joint to a right angle and return in the same way to a straight horizontal position.
If it is difficult to slide your foot over the surface, remove the sock.
- You will also need to perform the following exercises while in bed: smoothly move the problem 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 replacing the hip joint should never be done intensively with jerks!
In this exercise, the big toe should point straight up.
- In the near postoperative period of rehabilitation after hip arthroplasty, isometric exercises are prescribed to reduce the quadriceps, gluteal, and leg muscles. Thanks to simple exercises for the tension of the corresponding segments, their tone increases, elasticity and firmness improve. Do the workout in bed (lying on your back) according to the principle:
After leaving the hospital after hip replacement surgery, this scenario is easy to practice at home. However, the proposed range of activities should be supplemented, because then comes the late recovery phase, for which there are standards.
Late period
Successfully completed early recovery measures are completed with the patient's discharge from the hospital. Now he will either have to rehabilitate after hip joint surgery at home, or in a specialized treatment and rehabilitation center. There, you will be provided with high-quality, professional rehabilitation after surgery, the hip joint at home is unlikely to be developed so comprehensively and competently. Unless, of course, you yourself are an orthopedic traumatologist or exercise therapy instructor.
Balance exercise allows 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 being added?
- Hiking, starting from 22 days, 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 about 4 hours. It is important to practice the correct positioning of the body and gait when moving, to get rid of the usual adaptive postures and movements to which a person is accustomed long before the operation.
- Walking with a full-volume load on the prosthetic limb is possible after 1-1.5 months if a cement-retained prosthesis was used. If the cementless method was used, it is undesirable to create full support until at least 2 months have passed.
- Cancellation 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 the cane until the lameness has disappeared and you have complete confidence in walking.
- Late rehabilitation exercises after hip arthroplasty include more varied and active types of training, but they should be recommended by your doctor. 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 it is not there.
- The starting position is lying on your back. Alternately bend the legs at the knee joints, raising the limbs, the direction of movement of the knee is towards oneself.
Hands can be placed on the stomach or extended along the body.
- Lie on your stomach. Perform simultaneous or alternate bending of the legs, bringing the feet closer to the buttocks. In the same position, it is useful to raise the straightened legs up (alternately). You can also imitate swimming, while only the arms are actively working, the chest is raised, the limbs are straight (if it is not difficult for the patient, he can slightly lift his legs off the floor).
Try to reach the buttocks with your heel. It is unlikely that you will succeed, but the goal should be like this.
- Alternating abduction of straightened limbs in the lateral direction from a supine and prone position. To do this, you need to slightly raise the working leg and take it to the side, then carefully return to the starting point. By analogy, we do gymnastics after hip arthroplasty and in an upright position.
The toe is directed straight up during the exercise.
- Raising straight limbs in turn, while the toe stretches towards itself. The task can be performed both in a lying and standing position. If the patient is engaged in standing, then you need to hold on to any support suitable for insurance, for example, the back of a chair.
Fix for a few seconds at the end point.
- Raising the bent leg, unbending it on weight, followed by bending, at the end - put an even limb on the floor. This technique, as you could understand, is done in a horizontal position of the body.
You can give an additional load by placing your healthy leg on top of the sore one.
- If you underwent surgery on the hip joint 1-1.5 months ago, and the rehabilitation is going well, then you can include the exercise "bicycle" in your daily complex.
A bicycle is the best equipment for physical activity.
- In addition to the above training methods, incomplete squats, quiet exercises on a stationary bike, on balancing apparatus to develop support strength and balance, as well as various techniques of movements with a ball and weights are included. Additionally, a visit to the pool is prescribed, where therapeutic exercises in the water and recreational swimming will be carried out.
Distant phase
It is reasonable if at a later date there will be rehabilitation after a hip replacement in a sanatorium. In addition to restorative and physical training methods, which are implemented on various rehabilitation apparatus and exercise equipment in the gymnasium or in the aquatic environment, health clinics specialize in the use of natural healing springs, unique in their chemical and biological composition.
Start visiting the pool, it is very useful.
In sanatoriums, recovery after replacing the hip joint is based on the use of peloidotherapy 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 the healing mud and waters penetrate the body at the time of the treatment session and fruitfully contribute to:
- strengthening bones, enhancing muscle endurance;
- resorption of skin, tendon, muscle cicatricial formations, increased mobility not only at the site of localization of the artificial joint, but also in other osteochondral organs;
- improving blood supply and nutrition in problem segments;
- elimination of puffiness 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 from the moment of prosthetics;
- consistency of the central nervous system, mental harmony, a positive attitude, normalization of sleep and daytime vigor.
Replacement of a damaged joint element is called hip arthroplasty. For this, special implants are used. Endoprostheses may be required for a variety of reasons (injuries and diseases of the hip joint). After hip arthroplasty, certain guidelines must be followed.
Reasons for prosthetics
The most common reasons why endoprostheses may be required are:
- Advanced and severe stages of rheumatoid arthritis.
- Femoral neck injuries (most often fractures).
- Development of hip dysplasia.
- The presence of aseptic necrosis of the head, which is called avascular necrosis.
- Severe stages of coxarthrosis.
The need for an endoprosthesis may arise in connection with 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 full recovery depend on the age of the patient, his general condition and many other factors. In order to avoid complications after hip arthroplasty, it is necessary to follow all the recommendations of the attending physician.
Exercise after hip reconstruction surgery should be performed strictly under the supervision of a qualified professional. Living with the new regime will speed up the recovery process. The patient will be able to walk much faster without the aid of crutches.
Pain after arthroplasty is usually pronounced. In no case should you take any measures on your own, otherwise you can provoke serious complications.
Features of a modern hip joint endoprosthesis
Today orthopedics has made significant progress in its development. A feature of a modern endoprosthesis is a complex technical design. The prosthesis, which is notable for cementless fixation, has the following elements:
- head;
- leg;
- Cup;
- liner.
The difference between a cement-retained endoprosthesis is a one-piece acetabular element (cup and
). Each individual element has its own dimensions. The surgeon must select and fit 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 fixation of the prosthesis.
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 endoprosthesis can be:
- total;
- unipolar.
The use of a particular prosthesis depends on the number of replaced elements. A friction knot is the implementation of 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 the patient complains about is one of the most significant factors indicating the need for surgery.
Read also: Dislocated toe troubles
In some cases, despite the fact that coxarthrosis is at one of the last stages of development (as evidenced by an X-ray examination), the patient is practically not worried about anything. Surgery may not be necessary.
How are the operations carried out?
Hip replacement surgery is performed by two teams (operating and anesthesia). The operating team operates under the guidance of a highly qualified operating surgeon.
On average, the operation to replace the hip joint endoprosthesis takes 1.5-2 hours, while the patient is under the influence of spinal anesthesia or anesthesia. In order to exclude infectious complications, intravenous administration of an antibiotic is necessary.
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 receive antibiotics and drugs that can prevent blood clotting. In order to fix a certain distance between the legs, a pillow is installed. In this case, the legs should be in the abducted position. Fever after hip replacement surgery is often unstable, so doctors monitor this closely.
How long will it take to recover from hip arthroplasty? 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 very next day. Without getting up from the pastel, the patient can sit down and even engage in therapeutic exercises. Exercises after hip arthroplasty, 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 observing all the recommendations of the attending physician. In addition to exercise therapy, the patient is assigned 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 the stitches be removed? It depends on how quickly the patient is recovering. On average, the stitches are removed 10-15 days after hip replacement surgery.
How to live after being discharged from the hospital? Many people ask themselves the question: how to live after returning home? In the hospital, the patient is constantly under the supervision of the medical staff, who oversees the entire rehabilitation process. Life with a hip replacement is somewhat different from the usual life. As already mentioned, in order to restore mobility, it is necessary to constantly work on the hip joint.
The patient should walk as much as possible, while avoiding severe fatigue. Exercise therapy plays an important 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 instructors in exercise therapy will work with him.
This brochure is dedicated to people who are going to have hip replacement surgery. You have been diagnosed with a hip injury. You have undergone conservative treatment for a long time, used all possible drugs for pain relief. You were hoping that you could return to your normal life.
In fact, there are no miracles. 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 on the data of a medical examination, doctors recommend that you have an artificial joint implantation. 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 your surgery and avoid unnecessary anxiety during your hospital stay.
Of course, this information does not replace consultation with your doctor, orthopedic surgeon, rehabilitation therapist and other medical personnel. If you have any questions or uncertainty about something, you should discuss it with specialists. Remember! The result of treatment will depend on the strict implementation of all the recommendations of the attending physician and your mood for recovery.
To better understand the possible operations, let's try to imagine the anatomy of the hip joint.
So, the hip joint is a ball 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 the surrounding muscles, you can not only support your weight when leaning on your leg, but also move. In this case, the head slides easily inside the acetabulum. In the diseased joint, the affected cartilage is thinned, has defects and no longer performs the function of a kind of "pad". The articular surfaces altered by the disease rub against each other during movement, stop sliding and acquire a surface like sandpaper. The altered femoral head rotates with great difficulty in the acetabulum, and pain occurs. Soon, trying to get rid of pain, a person begins to limit movement in the joint. This, in turn, leads to shortening of muscles, ligaments and even greater contracture. The pressure exerted by the muscles on the femoral head increases; over a long period of time, the weakened bone is "crushed", its shape changes, and flattened. As a result, the leg becomes shorter. Bone growths (the so-called ossification or osteophytes) are formed around the joint. The altered joint can no longer fully perform its function.
What is total hip arthroplasty
Only an operation to completely replace the diseased joint or total hip arthroplasty can radically interrupt this entire chain of painful processes.
In principle, total arthroplasty is the replacement of a damaged joint with an artificial endoprosthesis. Total arthroplasty 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 of the surgical technique and the materials used have led to tremendous advances in the field of total hip arthroplasty. The design of endoprostheses ideally follows the human anatomy. An endoprosthesis consists of two main parts: a cup and a stem. The ball-shaped head is located on the stem and inserted into the endoprosthesis cup. The materials used for the artificial joint are special metal alloys, ultra-strong polyethylene and ceramics, specially developed for arthroplasty. 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 fully metallic or fully ceramic. 
There are mainly three types of endoprosthesis fixation:
Endoprosthesis with cementless fixation d, in which both the cup and the stem of the endoprosthesis are fixed in the bone without the use of bone cement. Long-term fixation is achieved by the invasion of the surrounding bone tissue into the surface of the endoprosthesis.
Cement-retained endoprosthesis, in which both the cup and the stem are fixed with special bone cement.
Hybrid (combined) endoprosthesis, in which the cup is cementless and the stem is cemented (i.e. 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 by the physiological characteristics, medical indications, as well as the age, weight and degree of physical activity of the patient. The correct choice greatly contributes to the success of the operation. An orthopedic traumatologist will conduct preoperative planning, which will determine the required size, model of the endoprosthesis and the location of its parts. However, during the operation, he must be able to install an endoprosthesis of a different size, making changes to the original plan. (It depends on the individual characteristics of the patient, the structure and density of the bone substance, the specific conditions and tasks of the operation being performed.)
Before surgery
The decision in favor of the operation is mainly with the patient. In many cases, severe pain and taking a huge amount of analgesics (pain medications) 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 the implantation of the endoprosthesis. Before the operation, you can contribute to a favorable course of the postoperative period, namely:
Quit smoking.
Normalize your own weight. If you are severely obese, your doctor may postpone the operation to give you time to lose weight (body mass index greater than 35 is a relative contraindication for arthroplasty due to the high risk of postoperative complications).
Reorganization 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 go through all the necessary additional examinations so that you have time to correct their treatment.
There is always a certain amount of blood loss during total hip replacement surgery. This may necessitate 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 the technique of surgery have reached a very high level and have significantly reduced the risk of various postoperative complications. But, despite this, there are always possible complications associated with inflammation of the tissues around the joint or with early loosening of the elements of the endoprosthesis. Strict adherence to the doctor's recommendations will reduce the risk of complications.
Day of operation
The operation can take place 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 preferred. In addition to the anesthesia, you will be given a sedative. During the operation, you will not experience any pain.
The day before the operation, the doctor will visit you to discuss the anesthesia and the course of the operation. He will then select the medication 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 an incision in the skin about 15 cm in length. Thus, the surgeon will be able to approach the hip joint, remove the affected femoral head and damaged acetabulum and replace them with an artificial cup and stem with a ball-shaped head. After installing the cup and leg, the artificial joint is checked for mobility, and then the surgical wound is sutured. A drain introduced into the wound prevents the accumulation of oozing blood. After the operation, a pressure bandage (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 on possible complications should not be a cause for concern and should only be considered as general information for patients. The possible complications described below relate directly to the procedure for implanting an artificial joint. The general risk that exists in any operation is not mentioned here.
Hematomas (bruises)
They can appear after surgery and usually go away after a few days. The previously mentioned drains are installed to prevent large hemorrhages, i.e. for the evacuation of blood.
Thrombosis
Thrombosis (the formation of blood clots) can result from increased blood clotting (blood clots can obstruct blood flow in the veins of the extremities), which can lead to pulmonary embolism (when the blood clot reaches the lungs). To reduce the risk of thrombosis, special drugs are prescribed, in the form of tablets or injections, before and after the operation, as well as elastic stockings or tight bandaging of the leg and foot and physiotherapy exercises.
Infection
Infection in the area of the surgical wound is a rather rare complication and is usually successfully treated with antibiotics. However, deep infection can lead to loss of the endoprosthesis and the need for reoperation. For this reason, special attention is paid to sterility and protection against bacteria. In addition, antibiotics are prescribed before and after surgery.
Dislocation (displacement), dislocation
They occur quite rarely (mainly in the early postoperative period, until soft tissues have healed) and usually occur only in cases of extreme physical activity or falls. As a rule, in this case, the doctor will carry out the reduction of the displaced endoprosthesis under anesthesia. The doctor must accurately inform you about the range of movements that are permissible at different times during rehabilitation.
Allergy
In very rare cases, tissue reactions may develop upon contact with an artificial joint. This reaction can be caused by a chromium - nickel allergy. By using the modern alloys available today, the risk of allergies is minimized.
After operation
When you wake up, it is necessary to do several exercises that reduce the swelling of the limb and prevent the formation of blood clots in the vessels. You need to perform them while lying in bed.
Breathing exercises... Raise your arms up, take a deep breath. Lower your arms through the sides down, take a deep, energetic exhalation. This exercise must be repeated 5-6 times a day.
Foot pump... When you are in bed (or, later, when you are 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 the operation are the most important. Your body is weakened by the operation, you have not yet fully recovered from anesthesia, but already in the first hours after waking up, try to remember more often about the operated leg, to monitor its position. As a rule, immediately after the operation, the operated leg is placed in the abducted position. A pillow is placed between the patient's legs to ensure moderate dilution. The first day you will lie in bed. If any medical manipulations or examinations are required, you will be taken on a gurney. For 6-8 weeks after the operation, you will have to wear compression hosiery (bandage your legs with elastic bandages or wear compression stockings). You also need to remember that:
Sleep in the first days after the operation is necessary only on the back, preferably with a pillow or roller between the legs
You can only turn on the operated side, but not earlier than 7 days after the operation
When turning in bed, place a pillow between your legs
To reduce the risk of dislocation of the endoprosthesis, it is impossible to bend the operated leg in the hip joint more than 90 degrees, rotate the leg in the operated joint, turning it with its toes inward and outward. That is, you FORBIDDEN:
Sit on low chairs, armchairs, or beds
Squat down
Lean below the waist, pick up objects from the floor
Pulling the covers off your feet in bed
Put on clothes (socks, stockings, shoes), leaning towards your feet
Sleep on a healthy side without a pillow between your legs
Sit cross-legged, cross-legged
Turn to the side with the body without simultaneously turning the legs
When sitting in bed or going to the toilet after surgery, you need to be careful to avoid excessive flexion in the operated joint. When you sit down on a chair, it should be high. A regular chair should be cushioned to increase its height. Low, soft seats (armchairs) should be avoided.
In some patients with an advanced process, certain difficulties persist 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 clip sold in prosthetic and orthopedic enterprises.
Wear shoes with a long-handled horn, try to purchase shoes without laces
Place the blanket next to you or use a blanket stretcher.
Shower on a non-slip mat using a long-handled washcloth and flexible shower.
Dedicate most of your free time to exercise therapy.
The first goal of physical therapy is to improve blood circulation in the operated leg. It is very important to prevent blood stagnation, reduce swelling, and accelerate the healing of postoperative wounds. The next important task of physiotherapy exercises is to restore the strength of the muscles of the operated limb and restore the normal range of motion in the joints, the support of the entire leg. Remember that the frictional force in the operated joint is minimal. It is a hinge joint with perfect glide, so all problems with limiting the range of motion in the joint are solved not by passively developing it by swinging, but by actively training the muscles surrounding the joint.
In the first days after the operation, physiotherapy exercises are carried out while lying in bed. All exercises should be performed smoothly, slowly, avoiding sudden movements and excessive muscle tension. During physical therapy, proper breathing is important - inhalation usually coincides with muscle tension, exhalation - with their relaxation.
The first exercise is for the calf muscles. You have already used this exercise on the day of surgery. Bend your feet with slight tension towards yourself and away from yourself. The exercise should be performed with both legs for several minutes up to 4-5 times during an hour.
Ankle rotation: Rotate the foot of the operated leg first clockwise, then in the opposite direction. Rotation is carried out only at the expense of the ankle joint, not the knee! Repeat the exercise 5 times in each direction. 
Exercise for the quadriceps muscle of the thigh: Tighten the muscle on the front of the thigh, try to straighten the knee, pressing the back of the leg against the bed. Hold in tension for 5 to 10 seconds. 
Repeat this exercise 10 times for each leg (not just the operated leg) 
Knee flexion with heel support: Move your heel towards the buttocks, bending the knee and touching the heel to the bed surface. Don't let your knee pivot towards the other leg or bend 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 the operation, then you can postpone it. If difficulties arise later, you can use a tape or rolled sheet to help tighten your foot.
Contractions of the buttocks: Contract the muscles of the buttocks and keep them tense for 5 seconds. Repeat the exercise at least 10 times.
Abduction exercise: Move the operated leg to the side as much as possible and bring it back. Repeat this exercise 10 times. If at first it is difficult for you to perform this exercise on the first day after the operation, then you can postpone it. Very often this exercise fails in the first days after the operation. 
Raising a straightened leg: Tighten your thigh muscles so that your knee on the bed is fully extended. Then lift 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 the operation, then you can postpone it. Like the previous one, very often this exercise fails in the first days after the operation.
Continue all these exercises later, in the next second, third, and so on days after the hip replacement surgery.
The first steps
In the first days after surgery, you must learn to get out of bed, stand, sit and walk so that you can do it safely yourself. We hope that our simple tips will help you with this.
Immediately you must remember that before sitting down or getting up, you must bandage your legs with elastic bandages or wear special elastic stockings to prevent vein thrombosis of the lower extremities !!!
How to get out of bed
As a rule, they are allowed to get up on the third day after the operation. For the first time, a physical therapy instructor or attending physician will help you to get back on your feet. At this time, you still feel weak, so during the first days someone must definitely help you, supporting you. You may feel a little dizzy, but try to rely on yourself as much as possible. Remember, the faster you get up, the faster you will begin to walk on your own. The medical staff can only help you, but no more. Progress is entirely up to you. 
So, getting out of bed should be towards the operated leg. Sit on the edge of the bed with your operated leg straight and in front. Before getting up, check that the floor is not slippery. Place both feet on the floor. You can also stand to 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 the midline of the body. Using crutches and your non-operated leg, try to stand up.
If you want to go to bed, all actions are performed in the reverse order: first you need to put your healthy leg on the bed, then the operated one.
How to use crutches correctly
It is necessary to stand up and put the crutches forward a step length and towards the toes. With your elbow slightly bent, keep your hips as straight as possible. Hold the crutch handles firmly as you walk. When walking, touch the floor with the operated leg. Then increase the load on your leg by trying to step on it with a force equal to the weight of your leg or 20% of your body weight. You can determine the load using ordinary weights, 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 palms, not armpits!
If you are allowed to use only one crutch, then the crutch must be on the side of your good leg. 
How to properly sit down and get up
To sit down, go to the chair with your back turned until you feel its edge. Move both crutches to the side of your good leg. Sit in a chair with the armrests in place and your operated leg extended.
Bend your legs at a slight angle and sit up straight. Slide forward to get out of the chair. Grasp the armrests of the chair with your hands to stand on your healthy leg, slightly stretching the still operated leg. Then, grab the crutches with both hands to stand on the 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 UP AND DOWN THE STAIRS
Attention: do not take your first steps up the stairs yourself!
In 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 it should be avoided if possible until complete 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 a ladder, you may need someone else's help. Always use the opposite hand opposite the operated joint on the railing when climbing stairs and take one step at a time.
Climbing stairs:
1. Step up with your good leg. 
2. Then move the operated leg up one notch.
3. Finally, place your crutch and / or cane on the same rung.
Descending the stairs, everything is in reverse order:
1. Place your crutch and / or cane on the step below.
2. Step down with the operated leg.
3. Finally, move your good leg down.
Remember the basic rule: A HEALTHY LEG IS ALWAYS ABOVE THE SICK!
When you learn to get up and stand steadily, you can expand the complex of physiotherapy exercises. While doing these exercises while standing, hold onto a secure support (headboard, table, wall, or sturdy chair). Repeat each exercise 10 times during each session 3 times a day.
Raising the knee while standing: Raise the knee of the operated leg. Do not raise your knee above waist level. Hold your leg for two seconds, for the count of three, lower it. 
Straightening in the hip joint in a standing position: Slowly pull the operated leg back. Try to keep your back straight. Hold your leg for 2 or 3 seconds, then bring it back to the floor. 
Abduction of the leg in a standing position: Make sure your hip, knee, and foot are pointing straight ahead... Keep your body straight. Making sure that the knee is directed forward at all times, move the leg to the side. Then slowly lower your leg back so that the foot is back on the floor. 
AFTER DISCHARGE
Your compliance with the instructions of the attending physician is very important for a speedy recovery:
If you use a walker or crutches while walking, ask your doctor how much weight you can use on the operated leg. Do not forget that, most likely, you will get tired faster than before. You should allow for 30 to 60 minute rest periods throughout the day.
It is easier and safer to sit down and get up from a chair, putting most of the weight on your hands. It is unacceptable to sit on low and soft chairs or beds. Cushions or sleeping pillows can be used to sit at a sufficient height.
A sufficiently high toilet seat will help reduce stress on the hip and knee joints when standing up and sitting on the toilet.
A shelf that is screwed in at chest level in the shower avoids the need to bend down to retrieve toiletries when showering.
The seat (bench) in the bathroom will allow you to safely and comfortably take a bath in a sitting position.
Use a long-handled washcloth to wash the lower parts of your feet. For women to shave their legs, use a special razor extension.
Do not sweep, mop or vacuum the floor. You can use a long-handled mop to wash high or low items.
Driving by car is not prohibited, but instructions must be followed when getting in and out of the vehicle. You can place a cushion on the seat to increase the height of the seat. When traveling, try to push the seat back as much as possible, taking the half-reclined position.
Your doctor will most likely prescribe pain relievers for you. Be sure to follow your doctor's instructions for taking these medications.
A slight swelling of the tissues around the postoperative wound is not a deviation. Therefore, comfortable and loose clothing should be worn to prevent pressure on the wound. Ask your doctor or other qualified healthcare professional about how you should handle your surgical wound.
All this is needed in order to move from crutches to canes and then begin to walk completely on your own. It is impossible to give up crutches earlier, when the muscles are not yet able to fully hold the joint and even more so to react to possible non-standard situations (for example, a sharp turn).
Exercises with elastic band (with resistance). These exercises should be done 10 times in the morning, afternoon and evening. Attach one end of the elastic band around the ankle of the operated leg, and the other end to a locked door, heavy furniture, or wall bars. To maintain balance, it is worth holding on to a chair or headboard. 
Resistance hip flexion: stand with your back against a wall or heavy object to which the elastic band is attached, with your operated leg slightly to the side. Raise your leg forward, keeping your knee straight. Then slowly return the leg to its original position.
Resistance hip extension: Stand facing a wall or heavy object to which the elastic band is attached, with your operated leg slightly to the side. Extend your leg at the hip joint, keeping the knee straight. Then slowly return the leg to its original position. 
Abduction of the leg with resistance in a standing position: stand with your healthy side against a door or a heavy object to which a rubber tube is attached, and take the operated leg to the side. Slowly return your leg to its original position. 
Walking: Use the cane until you are confident in your balance. At first, walk for 5-10 minutes 3-4 times a day. When 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 walking for 20-30 minutes 3-4 times a week to maintain the muscle strength achieved. Use the cane only on the side of your good leg.
ADVICE FOR THE FUTURE
Approximately 6-8 weeks after your surgery, your doctor may allow you to drive and tell you about driving habits. If your car is not equipped with an automatic transmission, talk to your doctor about the resulting driving restrictions. Before entering the road, you should make sure that braking the vehicle does not cause you discomfort.
Constipation is common in patients after surgery. It is caused by low mobility and pain medication. Talk to your doctor about your diet. If the doctor has no objection, then the menu should include fresh fruits and vegetables, and also drink eight full glasses of liquid every day.
Watch your weight - every extra kilogram will accelerate the wear and tear of your joint. Remember, there are no special diets for hip replacement patients. Your food should be rich in vitamins, all essential proteins, and mineral salts. None of the food groups has priority over the others, and only all together can they provide the body with complete healthy food.
Your artificial joint is a complex structure made of metal, plastic, and ceramics, so if you are going to travel by plane, take care of obtaining a certificate of the operation performed, because this can be useful when going through airport control. On long trips, take your endoprosthesis passport with you.
Remember that your joint contains metal, so deep heating is undesirable, as well as UHF therapy on the area of the operated joint using the transverse technique.
Usually, when the function of the limb is fully restored, patients have a desire to continue playing their favorite sports. But, given the peculiarities of the biomechanics of the artificial joint, it is advisable to avoid those types of sports activities that are associated with lifting or carrying weights, sharp blows to the operated limb. Therefore, we do not recommend horse riding, running, jumping, weightlifting, etc. Walking (normal and Scandinavian), swimming, leisurely cycling and skiing are recommended.
Avoid colds, chronic infections, hypothermia - your artificial joint can become the very "weak point" that undergoes inflammation.
Outpatient rehabilitation
Each patient needs an individual program, taking into account the concomitant pathology. The goal of rehabilitation is to form a correct gait and eliminate muscle imbalance.
Physiotherapy:
Magnetic therapy of the hip joint and lower limb area
Calcium electrophoresis in the area of the hip joint
Electrical stimulation of the gluteal, quadriceps muscles of the thigh (DDT, SMT, Miorhythm, IFT)
Phonophoresis of heparin 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 the removal of postoperative stitches).
Physiotherapy
Continue with the exercises you did before.
Special gymnastics lying on the side (non-operated), on the stomach, standing with support.
Cycling
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, one should not constantly think about the inevitability of a second operation (especially since most patients manage to avoid it). Your new joint "loves" an attentive, tidy attitude. It is very important that you remember this, stay in good physical shape and on your feet all the time. Given some of the caveats we talked about above, you can fully recover and return to a normal active life, to your favorite job or hobby.
WE WISH YOU HEALTH!
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,
- subsequence,
- 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 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 ligamentous 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 physical condition of the patient, the degree of adaptation to physical activity, his age, the presence of concomitant diseases.
After the installation of the endoprosthesis, 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;
turn on a healthy side with the help of a nurse at the end of the first day after the operation, on the 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 up 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 title | Description |
|---|---|
|
Wiggling toes |
Flex and unbend the toes of both the healthy leg and the operated leg. |
|
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. Lower it. 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. |
|
Straightened Leg Raise |
Alternately lift your straight leg 10 times a few centimeters. |
Exercise rules:
- do several runs a 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: with muscle tension - deep inhalation, with relaxation - prolonged exhalation;
- do breathing exercises to avoid lung congestion.
- first, do exercises in the early period only lying on your back (although you need to get up on your feet already on days 2-3), 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)
| Starting 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. |
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Leaning on one leg, take 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 earlier the patient starts to get up and walk after the 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 or more minutes 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 a step lower: first crutches, then the sore leg and then the 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)
| Starting 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 in this position 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 straight sore leg 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 title | Sequence of execution |
|---|---|
|
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 when 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 to 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 endoprosthetics of the left and right hip joint (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 stitches were discharged, the recommendations not to step on the foot 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 your recommendations into consideration, thank you.
Olga | 16.09.2018 at 12:59
Hello! ; September had an 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 it was 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 the 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? Thanks.
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 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 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 seam is tightened, the seams have resolved, the condition is normal. With the permission of the treating person, I now use one crutch on my arm. After the discharge of control images and examination, there were no yet, the 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 time and season (we have very hot weather and the summer is promised 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 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 will it be possible to drive? 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 accretion. Here you are trying to assess what you can expect after prosthetics.
Svetlana | 01.03.2018 at 08:52
Good afternoon! I have such a question. Hip arthroplasty was performed in November 2016. I would like to know what I am strictly prohibited from doing 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 displaced hip fracture, 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.
Rules to follow after hip arthroplasty:
- In the first days after the operation, you can only sleep on your back; you are allowed to turn on your side after 3 days under the supervision of a medical staff and on your unoperated side. You can sleep on your unoperated side two weeks after the endoprosthetics.
- In the early days, a large range of motion should be avoided: do not move abruptly, turn your leg, etc.
- When sitting on a chair or toilet, make sure that the operated joint does not bend more than 90 degrees, do not bend over, squat, cross your legs and throw them one on top of the other. It is advisable to sleep on a high bed, chairs should also be high (like bar ones)
- For the first six weeks after surgery, try to avoid hot baths, preferring warm showers. It is strictly forbidden to visit baths or saunas during the first 1.5 - 3 months of the postoperative period (in order to avoid thromboembolic complications).
- You need to do physical therapy on a regular basis.
- Sexual relations are allowed 1.5-2 months after the operation
- Sports such as horse riding, running, jumping, weightlifting are best eliminated, giving preference to swimming and walking.
Nutrition after hip replacement
After discharge and return home, the patient should have a balanced diet. In this case, on the advice of a doctor, it is desirable:
- take certain vitamins;
- monitor weight;
- replenish the diet with iron-containing foods;
- limit your intake of coffee, alcohol and excessive intake of vitamin K.
When should I see a doctor after joint replacement surgery?
Alarming symptoms indicating possible inflammation and complications of the rehabilitation period may be: high temperature (above 38 degrees), redness of the skin around the seam, discharge from the wound, chest pain, shortness of breath, increased joint pain, swelling. If these alarms occur, you should immediately contact your doctor.
In some cases, the patient after hip arthroplasty is recommended to periodically take x-rays, urine and blood tests so that doctors can follow the healing process.
The first control examination, as a rule, is carried out 3 months after the operation. During it, it becomes clear how the joint is "standing" and whether the leg can be fully loaded. The next control examination is after 6 months. The purpose of this exam is to find out if you have osteoporosis or other bone abnormalities. 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. Usually, the prosthesis lasts 15 years, sometimes 20-25, after which it is recommended to replace it.
Factors that accelerate the wear of the joint and lead to complications:
- hypothermia, colds leading to the inflammatory process;
- 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, unhealthy diet;
- carrying heavy weights, sudden movements and jumping on the operated leg.
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