Hip joint prosthetics: rehabilitation

All about rehabilitation after hip arthroplasty: at home and in the hospital

articles:

Rehabilitation after hip arthroplasty is an integral stage of postoperative treatment, aimed at restoring muscle tone and leg functionality.Rehabilitation consists in limiting (especially) physical exertion during the postoperative period and in performing exercise therapy.

Principles of the recovery period after hip arthroplasty:

• early start,
• individual approach to the implementation of rehabilitation measures,
• sequence,
• continuity,
• complexity.

In rehabilitation after endoprosthetics there are three periods: early, late and distant. For each of them a certain complex of gymnastics is developed. The total duration of rehabilitation is up to a year.

Restoration of the working capacity of the foot begins in the hospital, where the patient was operated. The approximate period of stay there is 2-3 weeks.

Continue rehabilitation can be at home or in a rehabilitation center, and finish - in a dispensary or a specialized clinic for restorative treatment.

The lack of rehabilitation after endoprosthetics threatens the dislocation of the endoprosthesis head due to weakness of the ligaments, periprosthetic fracture, development of neuritis and other complications.

Rehabilitation after any type of operation on the joints, including the replacement of the hip on the endoprosthesis, is performed by a rehabilitation physician and / or a physician of physiotherapy.

He will make 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.

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Further in the article I will describe in more detail the periods of rehabilitation, the duration of each of them; I will list what exercises for the hip joint are performed at home, and what - in the gym.

Three periods of rehabilitation

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Early rehabilitation period after endoprosthetics

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

Six rules of the early period

1. Sleep the first few nights after the operation of endoprosthetics only on the back;

2. turn on a healthy side can be with the help of a nurse at the end of the first day after surgery, on the stomach - after 5-8 days;

3. Do not make sharp turns or rotations in the hip joint - this is contraindicated;

4. Do not bend the diseased leg so that the bending angle is greater than 90 degrees;

5. do not draw or cross your legs - put a wedge-shaped pillow between your legs;

6. Regularly perform simple exercises to prevent blood stagnation.

Recommended position for sleep and rest

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

In the table - exercises for the calf, gluteal, hip muscles of both legs:

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Rules for doing the exercises:

• Do a few visits per day, spending 15-20 minutes from every hour during the day;
• Observe a slow and smooth pace;
• combine exercises with respiratory gymnastics according to the following scheme: with muscle strain - in-depth inspiration, with relaxation - a prolonged exhalation;
• perform respiratory gymnastics to avoid stagnation in the lungs.
• first exercise in the early period, do only lying on your back (although you need to get up on your feet for 2-3 days already), and then do the same gymnast sitting on the bed.

Complex of exercises for rehabilitation after endoprosthetics

Described in the table above, I presented the exercises in order of priority, they are relevant throughout the rehabilitation course. This complex 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 properly on the bed, turn over, get up on their feet, walk on crutches.

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

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The earlier the patient starts to get up and walk after endoprosthetics - the less likely the development of muscle contractures (mobility restrictions) in the hip area.

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 its age and other factors.

Two goals of the late period:

1. training muscles to strengthen them, improve their tone,

2. restoration of the volume of movements in the joints.

After the patient is 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 mode is expanded by training on a stationary bike (not longer than 10 minutes 1-2 times in day). Also, the patient is taught to walk the stairs.

Remote rehabilitation period

This period begins 3 months after the operation of hip arthroplasty; and lasts up to six months and longer.

Objectives:

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

Adaptive motor mode involves preparing the patient for more intensive physical exertion and adaptation in everyday life. LFK supplemented with physiotherapy (mud or paraffin baths, balneotherapy, laser therapy and other physiotherapy procedures).

Exercises for doing house

Later the above gymnastics of the early period after endoprosthetics is supplemented by more complex exercises.

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

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The last two exercises and the rest, where the movements should be done by straightening the leg, are necessary after the operation on the hip joint,

they are aimed at developing the hip endoprosthesis.

Step platform

Gymnastics on the simulators

The adaptive motor regime in the long-term period is expanded due to therapeutic physical training on simulators.

By this time, the ligaments and muscles are already sufficiently strong after the operation, so the intensity of the loads can be increased.

In the table below, the most common exercises for complete recovery of the amplitude of movements in the hip joint.

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Conclusion

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

Self-fulfillment of exercises for the hip joint after endoprosthetics, especially with the use of simulators, can lead to serious consequences.

You can not do gymnastics through pain or, on the contrary, stop it before the time, even if you feel well and the endoprosthesis, as you think, moves well.

Only a clear performance of all tasks set by the doctor will make your new joint work fully.

Nadezhda Martynova

A source: http://SustavZdorov.ru/raznoe/reabilitaciya-posle-ehndoprotezirovaniya-tazobedrennogo-297.html

Rehabilitation at home after hip replacement: how to properly perform gymnastics and exercise therapy

A patient who has recently been placed with an endoprosthesis needs special care and assistance. It is important to help him in the shortest possible time to restore the motor functions at home. To do this, daily perform therapeutic gymnastics and adhere to a number of rules to avoid complications.

Rehabilitation after hip replacement

An operation is scheduled to replace the hip joint with a hip fracture, coxarthrosis, osteonecrosis, rheumatoid arthritis.

If earlier these diseases meant disability, now thanks to successfully conducted treatment the patient can restore the functional activity of the joints.

To accelerate the rehabilitation period at home after hip replacement, all the recommendations of the doctor should be followed and regular special physical exercises for the legs should be performed regularly. Each recovery period requires compliance with certain rules.

Early period

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Immediately after surgery for hip replacement, the patient will be under the supervision of a doctor. During this period, it is important to monitor the body temperature systematically, change bandages on time, observe the work of the respiratory and cardiovascular systems.

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The edema from the leg is removed with the help of an ice pack. If necessary, the doctor can prescribe blood transfusion and medication with blood thinning medications (this helps prevent thrombosis).

To prevent the development of complications on the second day after the operation, antibiotics are prescribed.

Pain occurs after the artificial joint is established. However, it is a normal consequence of the operation.

The duration of the use of painkillers and the dosage of medication is adjusted by the doctor.

During the first 24 hours after hip replacement, patients are in a recumbent position. To avoid dislocation, do not bend the leg with the prosthesis more than 90 degrees.

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To avoid injury, patients are placed between the lower limbs of a special roller. In addition, immediately after surgery, the patient in a supine position is recommended to withdraw the operated leg slightly to the side.

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The first time of rehabilitation is categorically forbidden to take a blanket lying on the lower part of the bed.

Late period

After an early rehabilitation, there is a longer late recovery period for the patient, which stretches for several months. At this time, you should gradually increase the length of walking with the support.

At the same time, you need to keep your back straight and look in front of you. The daily maximum is 30 minutes walk. Only speed and distance can be increased.

Within 2 months after endoprosthetics of the hip joint, you can not climb the ladder higher than 1 flight.

Sleeping is on a rigid orthopedic mattress, the height of the bed should be at least to the knees. Dressing during rehabilitation is better sitting on a chair and with the help of a loved one.

It is forbidden to wear socks or to wear shoes on your own - this leads to excessive bending of the hip joint.

Functional recovery period

Rehabilitation after hip replacement ends after three months, however, functional restoration of the leg should continue.

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If the specified period has passed, and the pain in the leg does not pass or there is discomfort when walking, it is worth using a cane.

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Despite the fact that a person can already return to work and drive a car, it is only after 8-12 months that he is allowed to actively participate in sports.

Term rehabilitation of the house in some may increase the doctor. This decision is affected by age, patient's history, systemic pathologies, hypersensitivity to medication.

To accelerate recovery after endoprosthetics of the hip joint at home, it is necessary to perform exercise therapy prescribed by the doctor. In addition, therapeutic massage and kinesitherapy are excellent.

Regardless of whether the operation of hip arthroplasty was total or partial, a person must adhere to a number of rules for the early restoration of motor functions:

• sit down and get up you can on the second day after the operation (for this you need to use handrails);
• On the 5th day, climbing up several steps of the ladder is permissible, with the first step being done with a healthy leg (when you go down the other way);
• the physical load should be increased slowly, making sudden movements is forbidden;
• You can not sit at home on low chairs / chairs, lift items from the floor without the help of foreign devices;
• you need to keep your body weight as normal;
• allowed to sleep on the back or side with a roller between the knees;
• To drive a car is allowed at least 2 months after the rehabilitation of the house;
• it is necessary to adhere to a balanced diet (the amount of food with iron needs to be increased, drinking plenty of water);
• sexual relations can be resumed after 2 months after hip arthroplasty.

Recovery after hip arthroplasty

Since most of the rehabilitation takes place at home, it is worthwhile to know what aspects are important for the soon restoration of the motor function of the foot. An important place is therapeutic gymnastics.

If during training you feel pain or severe discomfort, it is better to interrupt the exercise and consult a doctor.

Every day during 3 months of home rehabilitation you need to bandage your operated limb with an elastic bandage - this will help to remove puffiness.

Moving at home is first allowed only with the help of crutches, later you can go to the cane. Doctors recommend using it for six months. In doing so, you should put the cane at the same time as the operated leg.

You can not lean forward while driving, and if it's otherwise difficult for you, slow down and step in small steps. Homework is allowed to perform. The only condition is that you can work if there is no burden on the sick limb.

Strictly prohibited during the rehabilitation of the house to lift any gravity.

How to walk on crutches

A few days after the endoprosthesis, the doctor allows you to get out of bed. The first time this happens with the help of the LFK instructor, who explains the rules of the patient's movement and use of crutches. The method of walking is:

• when climbing the stairs, the movement begins with a healthy leg;
• The movement is: lean on crutches and move a healthy limb to a step;
• then push the crutches off the floor and transfer the weight of the body to that leg;
• pull up the operated extremity, simultaneously having rearranged crutches on the top step;
• when moving down the stairs, everything happens the other way round - first place the crutches on the step;
• leaning on them, move down your aching leg, leaving the emphasis on the healthy;
• on the same level put a healthy leg and lean on it.

Effective complex of exercises after hip arthroplasty

Without curative physical education, rehabilitation of the home after endoprosthetics of the hip joint is impossible.

Universal exercises to restore the functionality of the limb is not: every period of rehabilitation involves performing different in complexity of movements.

The program of lessons is selected by the doctor. On the first day of rehabilitation, the patient is allowed to do such exercises at home:

• alternate pulling of the toe socks on themselves with elongated legs;
• circular movements of feet;
• squeezing / unclenching of the toes.

Later the exercises become more complicated and look like this:

• in the standing position, the prosthetic leg is forwarded by 25-30 cm and returns to its original position (10-15 repetitions);
• The leg rises with a bent knee at a height of 30 cm (10 times);
• the leg is maximally set aside and comes back, the patient is held by a chair or handrail, stands with a flat back (6-7 times);
• raising the leg up without bending the knee (up to 10 repetitions).

Learn also what to do if the neck has blown.

: rehabilitation after hip arthroplasty

A source: http://sovets.net/6953-reabilitatsiya-doma-posle-endoprotezirovaniya-tazobedrennogo-sustava.html

Rehabilitation after hip arthroplasty

Restoration of the health of the patient who underwent surgery on the joints is necessary after the first hours after awakening from anesthesia.

Rehabilitation after hip arthroplasty (TBS) is a complex of exercises, different for each period.It can also depend on the type of fixation of the prosthesis, the condition and age of the patient, the presence of concomitant diseases.

Rehabilitation should be carried out not only in the hospital, but also after discharge, in a specialized medical center or at home.

Rehabilitation after the replacement of TBS is divided into early and late postoperative periods, in which there are different tasks and degrees of stress on the diseased limb. The recovery of each patient passes individually and is determined by many factors.

Recovery in the early postoperative period

Objectives of the early period:

• Prevent postoperative complications
• Master the exercises performed in the main lying
• Learn to sit down and get up
• Learn walking on crutches

Combating possible complications

The main worries, which occur at an early period after the replacement of the joint:

• Caring for the correct position of the sore leg
• Reduction of pain and swelling
• Wound dressing
• Maintaining a gentle diet
• Prevention of thrombosis

Requirements for the position of the legs and movements

• The first days are allowed to sleep only on the back
• In order for the patient's legs not to approach the unacceptable distance or to cross, a wedge-shaped cushion or roller is placed between the legs

• Turning to a healthy side can be done already eight hours after the operation, asking to help a nurse or nurse. The legs should be bent at the same time, pressing them with the ankle joints
• The amplitude of flexion of the diseased leg in the knee should not exceed 90 °
• Sharp turns of legs, rotation of TBS are inadmissible

Reduction of pain and swelling

It is impossible to avoid pain after surgery. Anesthesia goes by - and inevitable pain attacks begin, accompanied by swellings as well. Endure this already exhausted patient is difficult, and come to the rescue:

• Anesthetic therapy
• Drainage of accumulating fluid in the joint:
  • A drainage tube is inserted into the joint cavity, which opens onto the surface
  • The tube is removed as soon as the exudate ceases to accumulate in the cavity
• Lining the affected area with ice
• If the pain is accompanied by an infectious process, antibiotics should be used

Wound dressings

• The first dressing is usually performed on the second day after surgery
• The frequency of subsequent dressings is determined by the surgeon, with a frequency - at least one in two to three days
• Sutures are removed after 10 to 14 days:
  • the removal of the thread can occur earlier with a satisfactory wound condition
  • absorbable threads do not need to be removed

Meals and water intake

After the patient comes to, he may have a thirst and an appetite. This is a reaction to anesthesia. But a little drink and eat a little bit of crackers can only 6 hours after surgery.The usual meal is allowed the next day.

The first days you need to keep a diet, which includes:

• Meat broth, slightly salted, with mashed meat
• Oatmeal porridge, mashed potatoes
• Lactic Acid Products
• Fruit jelly, unsweetened tea

Then the usual diet or usual diet, corresponding to chronic diseases of the patient, is prescribed.

Prevention of thrombosis

After the operation, blood coagulability always increases - this is a natural reaction of the body, aimed at accelerating the healing of the wound. Therefore, during this period there is always a threat of thrombosis, and if the patient still has a history of venous insufficiency, the risk is doubled.

For the prevention of thrombosis, the following measures are used:

• Dressing of lower extremities with elastic bandage
• Admission of heparin, warfarin and other anticoagulants
• Special exercises for the limbs

Modes of loading on the operated side

• If the cement method of fixation is used when replacing the joint:
  • initial loads on the operated leg should already be in the early rehabilitation period, in the first postoperative days
  • full loads - in a later period
• With a cementless fixation method:
  • 10 - 15% of the full load - after 7-10 days
  • Half of the load - after 21 days
  • Full load - at the end of a two-month period
• Special clinical cases:
  • Stroke, diseases of internal organs, cancer, deep old age, etc. - in all These cases should be started as soon as possible after surgery, and in full load.
• With acute pain:
  • The limited-load regime is applied at any stage of rehabilitation

Artificial joint has an ideal mobility, but in itself it will not move: you need to "tie" it to the muscles. And this is possible only through active rehabilitation, strengthening the muscles.

Early postoperative exercise

Goals of exercise therapy in the early postoperative period

After the replacement of the hip joint at the very beginning of rehabilitation, the following goals are set:

• Prevent blood stasis, accelerate wound healing and reduce puffiness
• To restore the supporting function of the diseased leg and the total amplitude of the movements

The complex of elementary gymnastics is very simple, but there are certain requirements:

• Exercises are often performed throughout the day:
  • intensity - up to five to six times per hour for several minutes (obtained on average per hour for therapeutic gymnastics takes 15 - 20 minutes)
• The nature and pace of the exercises is smooth and slow
• All exercises are combined with breathing, approximately according to this pattern:
  • at a muscular effort we inhale
  • with exhalation we exhale

The complex includes exercises for the gastrocnemius, femoral and gluteal muscles of both extremities.

On the first postoperative day:

• Alternate reciprocal movements of feet: the foot goes to itself, the right one goes away from itself, then vice versa

• Clamping and unclenching of fingers on both legs

On the second day after the operation:

• Static exercises:
  • Pressing the back of the knee for five to seven seconds to the bed, followed by relaxation - this way, training of the femoral muscles takes place
  • Similar pressing of heels - the muscles of the lower leg and the hind muscles of the thigh are trained
  • Slipping sick leg to the side and back, without breaking off the surface of the bed
• Slip with bending of the foot:
  • We slip the patient with his foot on the sheet, bending the leg in the joints no more than 90 °
  • We return the foot in the same way to its original position (First you can make it easier with an elastic band or a regular towel)
• Straightening with lifting
  • This exercise is performed using a roller height of no more than 10 - 12 cm, placed under the knee
  • Slowly straining the femoral muscle, straighten the leg and hold it in this position for five six seconds. Then, just as slowly lower it

These exercises need to alternate with each other:

In one hour we do one thing, in the second one another, and so on.

How to sit down correctly

It is necessary to sit down carefully on the second day. How it's done?

• You need to lean on your elbows or hold on to the frame above the bed
• Sitting should be in the direction of a healthy leg, lowering it to the floor at first, and then pulling to it (it is possible and with the help of elastic bandage) operated limb
• Roller between legs must be sure
• The legs must first be bandaged with elastic bandages
• When planting, observe the straight position of the trunk and do not turn the foot outwards

From the second day mechanotherapy of the hip joint also begins.

The period of circulation after the replacement of TBS

It can also be called "walking on the agony too little time has passed since the operation, the wound still hurts, and the doctor, despite the pain, already orders to stand on the crutches literally the next day. And this is not a surgeon's whim:

All the difficulties of walking on crutches are described in detail in our article Rehabilitation after knee replacement, so we will only focus on the stresses and walking on crutches on the stairs

Load on a sick leg

• During the first postoperative week, you only need to touch the floor with your foot
• Then we go to the 20% load on the aching leg: this is equivalent to transferring to it your own weight without the weight of the whole body, that is, standing on your foot without leaning on it

Increase the load with bringing it to half should be carried out for each patient individually:
If the pain and swelling in the leg is not gone, then the increase in the load is premature.

What they say lasting pain and swelling

In any case, the reasons must be understood by the surgeon.

Walking on crutches on the stairs

The method of walking is determined by the direction of movement - up or down:

• When climbing up the stairs, the movement starts from the unoperated limb:
  • We rely on crutches and transfer to the step a healthy leg
  • Pushing crutches and transferring the weight of the body to it
  • We tighten the operated leg, while moving the crutches to the top step, or we carry the crutches after the painful leg
• When descending from the stairs, all movements occur in the reverse order:
  • First, crutches are transferred to the lower step
  • Leaning on crutches, we put down without a stop the sick leg
  • We transfer the healthy leg to the same level and rely on it

Exercise therapy on the tenth day after surgery

Exercises in a standing position

• When performing them, you must hold on to the handrails, the back of the bed or chair

• Each exercise should be repeated up to 15 times up to 10 times a day
• Examples of exercises:
  • Retracting the operated leg forward, sideways, backward by 20 - 30 cm
  • Raising the leg with a bent knee to a small height

Exercises in a horizontal position

• Repetition of all isometric exercises with pressing the muscles of the leg, knee extensors and gluteus muscles alternately to the floor:
  • Static tension is achieved by straining the abdominal muscles and stretching the toe socks towards themselves
  • Isometric relaxation follows at the moment of relaxation
• Flexion and retraction of the diseased leg to the side by sliding
• Lifting of the sick leg to an angle of not more than 90 ° C by keeping it on the weight and slowly lowering
• Leaving the sick leg to the side with the position on the side:
  between the legs you need to place a pillow
• Flexion-extension of the legs in the supine position

The whole complex of exercise therapy should be continued at home.

Late rehabilitation of the hip joint

And now, after the operation, two months have passed, however, TBS is still rather constrained, and you step on the operated leg uncertainly. It means - full restoration has not occurred and it is necessary to continue rehabilitation:

• At home, perform previous exercises plus gymnastics with the support of a sick leg
• To work on simulators

Exercise bike for the hip joint

The exercise bike is an effective method of strengthening absolutely all muscles connected to the joint.

However, you do not need to overdo it:

• Use the simulator in low speed mode
• Adjust the height of the seat so that the hip joint bends no more than 90 °, and when the knee is straightened, the foot hardly touches the pedals of the exercise bike

: Rehabilitation of TBS after joint replacement

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A source: https://ZaSpiny.ru/hirurgiya/reabilitaciya-posle-zameni-tbs.html

Rehabilitation after hip arthroplasty: what you need to know

Restoration of motor function of the hip joint

Each patient who replaces the "native" joint with an artificial prosthesis knows that after the operation a long and necessary recovery period follows. Its duration depends on the complexity of the surgical operation, the age of the patient and even on his desire for early independent movement.

So, rehabilitation after hip arthroplasty is a complex of measures aimed at re-teaching the patient to fully walk.

What is the operation for?

For today, diseases of the joints, including the hip joints, are quite common and bring a lot of inconvenience to the patient. A person suffers from severe pain, often loses efficiency.

Sometimes the removal of the joint, for example, with necrosis or oncology, is a necessary, urgent and at the same time vital operation.

Carrying out of operation on replacement of a joint

Previously, such surgical interventions led to serious disability. Now medicine is far advanced: the bone bone joint can be replaced in many large orthopedic clinics.

"Are joints aching? Does the spine "crunch"? "

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Pain - a harbinger of terrible pathologies, which for a year or two can seat in a stroller and make you disabled. Bubnovsky: completely restore the joints and spine simply, most importantly ...

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On average, rehabilitation after hip arthroplasty takes about six months and during this time period of the patient daily (for several visits) should perform a set of exercises that are assigned to the treating doctor. The price that clinics "expose" for putting the patient on their feet varies from 200 to 1000 euros per month.

Early recovery period

Doctor visits a patient after surgery

It starts from the first hours after the operation and lasts for about two weeks. This sparing period with a smooth tonic transition, the patient at this time is recommended to perform a minimal load.

On the part of medical personnel the following activities are carried out:

1. Maintenance of an operating wound. In the course of the surgical incision, in the wound area, under the skin there may be staples or sutures. The material is removed by the doctor in the second week after surgery. Before removal, it is recommended to avoid getting moisture on the surgical wound. If friction occurs on clothing or compression linen, then the postoperative bandage is worn.
2. Food.Since the surgery is not performed on the abdominal organs, the patient it is allowed to eat everything that he wants (at the same time it is recommended to adhere to an easy diet first three days). Many patients often feel a decrease in appetite, so they refuse to eat. Nevertheless, doctors recommend eating well in the early period, because the body needs great strength for recovery. Food should be rich in vitamins, trace elements and proteins (fresh fruits and vegetables, meat, cereals, rye bread).
3. Prevention of thrombosis.Deep vein thrombosis on the legs can lead to a dangerous and fatal complication - pulmonary embolism. As a preventive measure, it is recommended to use elastic knee socks or stockings, as well as variable pneumocompression. Without fail, doctors prescribe anticoagulant therapy, disaggregants, unfractionated or low molecular weight heparin. Do not use medication yourself, even if the instruction enclosed in the box details the treatment scheme!

Signs that should attract serious attention are pain in the calf muscles, redness of the shin, puffiness of any part of the lower limb.

There are certain rules that the patient must perform in the early period:

• in the first few days after surgery, sleep only on the back;
• on a healthy side only with the help of medical personnel, lying on the stomach is allowed in the second week after the surgical procedure;
• any load on the artificial joint is contraindicated;
• Do not bend the leg more than 90 degrees in the knee joint;
• also it is forbidden to bring your legs together and cross - for the obstacle it is recommended to place a pillow or a small soft roller between the legs;
• be sure to perform the movements that the doctor appointed.

The main goals that must be achieved in the early period are improvement of blood microcirculation, healing of the scar and reduction of edema. The patient must also learn how to sit and stand properly.

Recommended Exercises

It is necessary to perform movements slowly and smoothly. On the day it is recommended to make up to five visits, the duration of each must be at least 15-20 minutes.

Restorative measures after artificial joint placement

Table. Rehabilitation after total hip arthroplasty.

Description of exercises:

Fingers of the feet	Bend and unbend the fingers of both feet.
Pumping the pump with your foot	Exercises can be done on the day of surgery. Pull up the stack up and down, bending and bending at the ankle joint.
Rotation of the foot	Stretch the toe slightly forward, make a circular motion with the foot.
Strain of quadriceps femoris	Gymnastics on a sick leg should not be held earlier than on the 7th day. Lying on his back to straighten his leg and try to squeeze the inner side of the knee cavity as tightly as possible to the bed.
Reduction of gluteal muscles	Strain muscles of the buttocks alternately, then together.
Flexion of the leg in the knee joint	Slightly to bend a leg or foot in a knee and to tighten on itself (it is necessary to tear off a little from a surface from a surface).
Straightening aside the leg	Without bending the knee and raising your foot up, you need to take it to the side, then return it to its original position.
Straightening of the leg	Place the popliteal fossa on a small cushion so that the leg is in a semi-bent position. Straighten the leg and return to the starting position.

It is also recommended to monitor your breathing - you need to strain the muscle with an inspiration, relax - with an exhalation. This is necessary in order to saturate the tissue with oxygen.

In addition to exercising on your feet, you should do respiratory gymnastics. The easiest way is to inflate a balloon.

In addition, it is possible to take the maximum amount of air into the lungs through the nasal passages, hold it for eight seconds and exhale through the mouth.

In the first and second weeks after the operational implementation, specially trained medical personnel teach the patient correctly move to a sitting position on the bed, roll over, and also climb to your feet and enjoy crutches. The task for the patient is to fully comprehend the information, follow all the recommendations and in no case to commit harsh and unauthorized actions.

Once the patient has learned to keep his balance and can step on the operated limb, he is recommended additional exercises:

• Lean on the table or the headboard. Perform stepper movements in place at the support.
• Standing to take his foot to the side: first healthy, then - operated.
• Retracting the leg back, with the knee joint slightly bent.

The patient should not "regret" herself, but perform all movements, despite the severe pain.

If the time is not begun to develop a limb, then the development of muscle contractures (pathological change in structure of tendon muscles, vessels, subcutaneous fat), which leads to a limitation of mobility of the hip the joint.

Late postoperative period

The late period after operational introduction is divided into two stages - early recovery (terms of rehabilitation after endoprosthetics hip joint - begin about the second week and end in the second month) and the late restorative (from the second month to the third respectively). The goal that must be achieved is to strengthen the muscles and completely restore the joint function by performing an increased load.

Remedies for hip replacement

In the early recovery phase, the patient should already be confidently getting out of bed and sitting on a chair on his own. Now he learns to walk on crutches - the recommended load is fifteen minutes three times a day. Gradually introduces an exercise bike (ten minutes twice a day).

The hardest part is learning to walk the stairs; the patient must adhere to the following recommendations (see photo below):

• To put on the step an intact leg, then pull up the operated;
• After both limbs have risen on a step, it is necessary to put a crutch;
• if the patient goes down, then he needs to put a crutch on the bottom step, then a sick leg and only then - healthy.

At the end of this period, there is a significant strengthening of muscles, soreness passes. However, this does not mean that therapeutic gymnastics can be stopped - in fact, it's just the middle of the work.

Remote recovery period

This is the final and the longest stage. The rehabilitation period after hip arthroplasty starts from the third month and lasts until the sixth, sometimes up to the twelfth (it is established strictly individually).

At this stage, the crutches are replaced with canes. Approximately a month later the patient is taught to walk alone, that is, all means of rehabilitation after arthroplasty of the hip (all means are meant to maintain equilibrium during the step motion).

Also, the patient is trained to stand on one leg and pull it back (exercises are done without support).

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At this stage, short-term (up to ten minutes three times a day) walks are shown - first on the simulator, and later on - on the street.

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Gradually, the duration of walking is increased, depending on the general condition of the patient.

Recommended set of exercises

At this stage, physical therapy becomes more complicated. As a rule, the patient is already rather tired of daily exercises (especially if he has already been discharged home from a medical facility), but they must be performed through "I can not" and "do not want to."

Exercises to facilitate early recovery

Examples of exercises (for more details, see the video in this article):

1. On the back. Put your hands under your waist. Imitate the bicycle, pressing one and the other leg, bent at the knee, alternately to the stomach.
2. Following this exercise - hand to pull the legs to the stomach as hard as possible.
3. Lie for a "healthy" side. The operated leg should be pulled upward, holding it in this position for a minute or more. Repeat five times.
4. Lie on your stomach. Bend and unbend legs in the knee joints.
5. Exercise standing. Holding on to the support, do half-squats - fifteen times.
6. In the same position. Put on your feet a tight elastic band. Sick one's leg aside, stretching it.
7. Stand on all fours. We balance the body - straighten the left arm and right leg, then vice versa - the right arm and the left leg.
8. Step-exercises. To do this, you need an elevation (platform) in the form of a step. You can make it yourself from wood, you can also use a strong box or a bar, about fifteen centimeters high. Step with a healthy leg, then the patient rises, fall in the same sequence.

It is necessary to include training on simulators. You can start with a bicycle - the average load is twenty minutes twice a day. It is recommended that the pedals be turned back first, and then forward.

You should also use a treadmill. The pace should be included the most minimal - one or two kilometers per hour. Walking should also be in two directions - forward and backward.

In addition, the rehabilitation center recommends the following treatment and prevention activities:

1. Massages and manual lymphatic drainage. Procedures are conducted to prevent stagnation of blood and lymph, improve local circulation, reduce swelling, strengthen muscle tone and ligament apparatus.
2. Mineral mud wrap. Balneotherapy has an anti-inflammatory effect, also saturates the bone structure with important trace elements - bromine, magnesium, iron, etc.
3. Water procedures. Very diverse, include a wet wrap, medical douche, water massage and salt baths. Measures help to relieve the pressure from the vessels and muscles of the legs, improve blood flow, strengthen the vascular walls.
4. Paraffinotherapy. This is a painless and pleasant procedure, the main purpose of which is to reduce joint soreness, relax muscles, relieve spasm, and accelerate metabolic reactions.

Each patient should remember that rehabilitation after hip replacement surgery is an important healing moment.

In medical practice, cases when it was necessary to do a re-operation due to late or incorrect performance of measures to restore the motor function are not uncommon.

To avoid unpleasant moments, you should completely trust your doctor and fully follow his recommendations.

A source: https://vash-ortoped.ru/lechenie/reabilitaciya/reabilitaciya-posle-endoprotezirovaniya-tazobedrennogo-sustava-126