Rehabilitation centers after hip replacement. Rehabilitation centers after hip arthroplasty

Endoprosthetics is a serious operation. Nevertheless, today the replacement of joints with prostheses has turned from a miracle into a commonplace: the popularity of such operations is very high. However, it is very important to understand that the main risks of such operations come after they are completed: absolutely EVERYONE who underwent arthroplasty, rehabilitation needed.

The most difficult thing is to convince a person that the new joint is now his, and it's time to forget that there is something in his body that was not there a couple of years ago. Absolutely everyone who has undergone such an intervention avoids using the operated leg: leaning on it, moving it. As a result, all powerful muscles, due to which a person had a full range of motion when walking before the operation - quadriceps, pear-shaped, gluteal - sag, and eventually atrophy. Trophic disturbances begin, which entails new troubles. At the same time, an unhealthy load of the spinal muscles occurs, from which the spine suffers ... Problems accumulate like a snowball.

If you or someone close to you has undergone arthroplasty, you need to remember: you have little time to return to normal life. If you do not use it, the situation will worsen every day: as a rule, in a year after the operation, the changes will become irreversible and no one will undertake to restore your ability to fully move.

And so that you do not have illusions that a year is a rather long time, we will clarify: the ideal time to start rehabilitation after arthroplasty is the SECOND day after the SURGERY. First, the exercise therapy specialist begins to engage in small joints, muscles in a passive mode. On the 7th day, it is already allowed to partially step on the foot. After 21 days, the main drugs are stopped, and the full rehabilitation of the patient can begin.

• 14 years work experience
• 3896 cured patient
• 4286 installed joint prostheses
• 3506 operations performed free of charge within the VMP
• 99 % able to return to normal life

Rehabilitation periods after arthroplasty surgery

The program of motor rehabilitation of patients who underwent joint arthroplasty is conditionally divided into 3 periods:

1. Rehabilitation in the early postoperative period up to 10 days;
2. Rehabilitation in the late postoperative period from 10 days to 3 months;
3. Rehabilitation in the late postoperative period of more than three months.

Rehabilitation in the early postoperative period aimed at preventing complications after surgery from the cardiovascular and respiratory systems and involves the use of exercise therapy methods. Prevention includes activation of blood circulation in the lower extremities, breathing exercises with general postoperative activation of the patient.

The task of the late recovery period is to strengthen the muscles of the lower extremities, mastering the skills of walking when descending and ascending stairs. The task of rehabilitation in the late postoperative period is adaptation to daily physical activity and strengthening of the muscles of the lower extremities.

The rehabilitation period in a hospital

Endoprosthetics of the hip joint is a complex operation for the patient and the doctor. During the first few days after surgery, patients are usually weak. However, from the first days of sick special exercises are recommended aimed at preventing congestive complications from the cardiovascular and respiratory systems.

Pain treatment in the postoperative period plays an important role in the speedy recovery of the patient. After surgery, the presence of pain is quite understandable phenomenon, but the pain must be controlled, which is achieved with the help of painkillers.

In addition to painkillers, patients receive antibiotics to prevent infectious complications, anticoagulants to prevent the formation of blood clots (thrombi) in the veins of the thigh and leg. In the postoperative period, there may be a decrease in appetite or a feeling of nausea. In some patients, stool disorder is observed for several days. These are common reactions.

The stay of the patient after the operation in the hospital, as a rule, is 10-12 days. During this period, the patient must be activated, trained in physiotherapy exercises and walking with additional means of support. The wound heals, and the stitches are usually removed by this period.

Homecoming

Some helpful tips for patients undergoing total hip arthroplasty:

• Place frequently used items within easy reach so that you don't have to reach or bend down for them;
• Move the furniture in the room in such a way that you have plenty of room to move freely and safely with crutches;
• It is better to sit in a chair with a higher and firmer seat, it is safer and more comfortable than low, soft chairs;
• Remove any carpets or rugs that may cause slipping;
• Securely fasten electrical wires around the perimeter of the room;
• Install in shower rails;
• Install a special nozzle on the toilet, which will allow you to avoid a low seat;
• Use aids for dressing shoes, such as a spoon with a long handle,

Return to normal life

Once the patient has returned home, they must remain active - this is " the key to success”, but the main thing is not to overdo it.

Rehabilitation in our center

Experienced doctors-specialists of our rehabilitation center are always happy to assist you and carry out the necessary complex of rehabilitation treatment.

The duration of the rehabilitation course, as well as the choice of treatment method, largely depend on the patient's condition and the method of hip replacement.

The rehabilitation program usually includes:

• Massage;
• Passive exercises to develop joints;
• Myostimulation;
• Special gymnastics (LFK).

Rehabilitation treatment courses included in the rehabilitation program relieve pain, help reduce swelling and inflammation, improve tissue metabolism, and also stimulate bone tissue restoration and limb muscle strengthening after surgery.

Video reviews about rehabilitation after hip arthroplasty

Khrenov S.N. - endoprosthesis replacement of the joint on two legs

Kirova Lyudmila, 76 years old - prosthetics of the femoral neck

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User questions about rehabilitation after hip arthroplasty

I have a fracture of the humerus of the lower third / diaphysis. Like. 24 01 2019. We put the plate. Today is 07 04 2019. They said to walk for 3 months. After the first

The picture grows together like! When. Rehabilitate a little???? the biceps are already numb, I'm afraid the plate will leave the hand

Doctor's answer:
Start rehabilitation under the supervision of an exercise therapy instructor.

Tell me if you have a rehabilitation program immediately after arthroplasty with a stay in the hospital. How much would one day cost

On October 10, I had an operation for p-halyus valgus in another clinic. I understand that the minimum -rehabilitation period is 3.5-

month. But problems have been outlined, which, ideally, should not be. On one leg, it looks like Morton's neuroma (2-3 fingers), on the other (in the presence of initially lymphostasis in the zone of 1-3 fingers), the second and third fingers bend down and when put on shoes "weakly wrap themselves in a ring." Taping attempts, injections with d-iprospan did not help. I am 62 years old, there are certainly age-related problems with arthrosis, but I would like to correct what I have listed. Is it possible for you to consult on such issues and see if you have real solutions for such problems? Sincerely, - Vera Ivanovna-

Doctor's answer:
Yes, a consultation is possible in our hospital. Call the phone numbers listed on the site.

My father broke his femoral neck as a result of burning, an operation was performed, screws were screwed in. He was in the hospital for a month, now it's over

rehabilitation at home, after the hospital a month lay at home. Then he slowly began to get up on crutches, walk around the house. Now he walks on crutches. 2 months have passed since the operation, they took a picture, the doctor said that his screw had shifted, said that this was due to the fact that he allowed to step on his foot. We are very worried, after his remark, he stopped completely stepping on his foot. I ask you to help with advice. Is it possible to walk at all and could the displacement of the screw be due to the fact that he sits down, almost always sits. Thanks in advance for your help!

Doctor's answer:
Of course, you began to put a load on the operated leg early. It is necessary to observe, make control radiographs.

My mother (68 years old) is preparing for a planned hip arthroplasty. I would like to receive information about the possibility of undergoing a rehabilitation course

in your clinic (only interested in hospital): duration, list of services/procedures, cost…

Doctor's answer:
These questions will be answered by your doctor during a face-to-face consultation.

Deforming arthrosis, which results in the destruction of the cartilaginous tissue of the joints, not only deprives a person of comfort, but also breaks his usual way of life, makes it impossible to fully move, causes discomfort and pain. And this problem inevitably leads a person to a doctor. In the early stages, treatment of arthrosis can be conservative. In this case, intraarticular injections are used. Physiotherapy can also be used in the early stages of the disease. However, as practice shows, in most cases, the optimal treatment for arthrosis of the joints is the operation of arthroplasty.

Operations for total lower limb joint arthroplasty (TLJA) are today the most modern way to restore a person's ability to move without pain, lead a normal life, and not feel helpless and dependent. Therefore, the treatment of knee arthrosis (gonarthrosis) or the treatment of arthrosis of the hip joint (coxarthrosis) is extremely important for any patient.

LRC has many years of experience in knee and hip replacement surgeries. Every year, the Center's orthopedic surgeons perform more than 4,000 such interventions. However, the healing process does not end there. Joint development is a major part of the patient's postoperative recovery.

Highly effective modern comprehensive rehabilitation after surgery on a joint (hip or knee) will allow each patient to significantly improve their quality of life, forget about the not always effective conservative treatment of arthrosis.

Like no one else, we know how important rehabilitation after joint replacement is, and for more than 7 years we have been successfully implementing specially designed programs in practice.

STAGES OF REHABILITATION after TESNK operations

I stage early postoperative (5 - 21 days after surgery)

Stage II late postoperative (3-4 months after surgery)

Stage III residual (training) - the stage of preparing patients for amateur sports activities (6 - 8 months after surgery)

We offer a variety of rehabilitation options to our patients. Depending on the state of health, family circumstances, the place of residence of the patient, rehabilitation can be carried out:

• in the LRC hospital
• outpatient (at the Center for Restorative Medicine and Rehabilitation of the LRC)
• remotely (a unique system of on-line rehabilitation)*

*if the patient has a computer, wired Internet and a webcam at home

REHABILITATION AFTER JOINT SURGERY

At each stage of postoperative rehabilitation, we offer the patient a comprehensive training program, tailored to the characteristics of each stage of recovery.

To increase the effectiveness of training in the process of rehabilitation, a number of goals are set for the patient and specialists, on which each stage of training is focused.

I stage

Rehabilitation goals: reduction of postoperative pain and swelling, muscle training and strengthening, teaching the patient to transfer and single-support walking, developing a physiological walking stereotype, mobilization and development of the knee joint after surgery. We use the same approach for patients who have undergone hip arthroplasty. The development of the hip joints is an important part of the rehabilitation process of recovery, which restores the ability of patients to move normally.

Program composition:

1. Passive mechanotherapy
2. Instruction and Patient School
3. Electromuscular stimulation
4. Walking stereotype training using biofeedback methods (BFB-video reconstruction) or robotic training
5. Symptomatic hardware physiotherapy
6. Massage

II stage

Rehabilitation goals: stimulation and training of muscles, teaching and training of the patient to the stereotype of walking without support

Program composition:

1. Therapeutic gymnastics with an instructor
2. Hydrokinesiotherapy
3. Hardware mobilization of the operated joint and muscle strengthening on the arthrological complex
4. Training methods
5. Massage
6. biofeedback-associated techniques
7. Physiotherapy procedures of a stimulating nature

Stage III

The goals of rehabilitation are to prepare the patient for life in an active motor mode, including sports.

At this stage of recovery, a comprehensive motor rehabilitation is carried out in a mode individually selected for each patient. Rehabilitation programs are also developed individually.

Rehabilitation after knee arthroplasty is necessary after a surgical operation, as a result of which the part that was destroyed by the disease is replaced with an artificial one.

• Indications for joint replacement
• Most Common Cases
• The benefits of arthroplasty
• Endoprosthesis risk
• Endoprosthesis service life
• Postoperative period
• A set of exercises
• Contraindications for endoprosthetics

Joint arthroplasty has been practiced since the early 80s of the last century. In America, more than four hundred thousand such operations are performed annually. The modern level of development of medicine has made it possible to improve endoprostheses, which are now complex technical structures designed to improve joint mobility, as well as eliminate pain.

Endoprosthetics has a long history. Attempts to replace the affected articular surfaces were made back in the nineteenth century, but due to the development of medicine at that time, they could not be successful. To date, the situation has changed and now arthroplasty helps to achieve the most successful results for ten to fifteen, or even twenty years. Around 800,000 such surgeries are performed annually around the world, 90% of which are successful.

Indications for joint replacement

The knee joint is the largest joint in the human body. Its strength is provided by the thigh muscles. It consists of three bones, which are covered with articular cartilage, as well as a smooth substance. The latter allows the bones to move freely. All other surfaces of the joint are covered with a very thin and smooth tissue - the synovial membrane. It helps in releasing fluid that lubricates the joint and reduces friction to zero.

In various diseases of the joint, damage and destruction of the protective cartilage and curvature of the knee occur. The reason for this may be arthritis, trauma and arthrosis. Patients who suffer from such diseases are first prescribed conservative treatment, which is designed to improve the condition and nutrition of cartilage tissue, as well as reduce its inflammation.

However, this type of treatment helps only at the initial stages of the development of the disease; in advanced cases, it is already powerless and one has to resort to replacing the destroyed surfaces. During the endoprosthetics operation, the damaged parts are replaced with artificial implants made of plastic or metal.

Candidates for such an operation are patients with the following symptoms:

• daily severe pain that limits normal life activities;
• significant limitation of joint movement;
• severe deformity of the knee joint.

Most Common Cases

The most common cause of joint pain and subsequent loss of its functionality is arthritis, namely: osteoarthritis, polyarthritis and traumatic arthritis. Osteoarthritis is a frequent companion of people whose age has reached fifty years. The cartilage that covers the bones gradually wears out and becomes stiff, thereby causing pain.
Rheumatoid polyarthritis has a slightly different pattern. In this case, the synovial membrane thickens, increases in size and becomes inflamed. Too much fluid is produced, which over time begins to overflow the entire space around the joint, which subsequently leads to its destruction. Traumatic arthritis is also the culprit in the destruction of the knee joint and can occur after a serious injury: a fracture, torn ligaments, etc.

The benefits of arthroplasty

An endoprosthesis is not an exact copy of a healthy human joint, but it is a good replacement. The main purpose of the appointment of an arthroplasty operation is to reduce or completely get rid of pain for ten to twelve years. Moreover, after a successful operation, almost ninety percent of patients note that the range of motion of the joint increases markedly.

Many patients eventually return to an active lifestyle and even sports.

Endoprosthesis Risk

As after any other operation, some complications may occur after arthroplasty. The operation is traumatic and may be accompanied by blood loss, however, frequent complications are those caused by the exacerbation of various chronic diseases that every elderly person must have. Also occasionally, but still, the development of thrombosis of the veins of the lower extremities, infectious complications, as well as the development of urinary tract infections are noted. Fortunately, such problems are unlikely to occur.

The most severe scenario may be an infectious complication, the treatment of which is long, painful and expensive. Most often, the infection process can be stopped only by removing the implanted endoprosthesis.

There are also patients who have a higher risk of getting a postoperative infectious complication than others. These are overweight patients, as well as patients suffering from rheumatoid arthritis and forced to take hormonal drugs.

Endoprosthesis service life

Most often, in most patients, the endoprosthesis lasts for twelve years, after which it needs to be replaced - re-endoprosthetics. After this period, some loosening of the implants is possible, which is associated with the destruction of bone cement or resorption of the bone to which it is fixed. During the first ten years, only ten to fifteen percent of patients experience loosening of the endoprosthesis. If the patient experiences pain, then a second operation is performed.

Postoperative period

In the first hours after the operation, the patient completely loses the sensitivity of the lower extremities. Since the operation is accompanied by blood loss, blood-substituting solutions are transfused, as well as the introduction of antibiotics and painkillers.

For several days, all vital signs are constantly monitored: pulse, pressure, electrocardiogram. Blood counts are monitored. If everything is normal, then the patient is transferred to a regular ward in one day.

Features of rehabilitation

The main factor in rehabilitation after knee arthroplasty is time. After the operation, about three months must pass before the patient is healthy. In some cases, much more time is required.

The main goals of the recovery period are:

• increasing the range of motion of the joint;
• increase in muscle power;
• prosthesis protection;
• return to the previous level of physical activity.

Doctors recommend gymnastic exercises that the patient must perform daily. For this, a special procedure for their implementation has been specially created. After being in a specialized clinic, the patient is sent to a rehabilitation center, where he should spend about three to four weeks.

Staged rehabilitation process

The first two months after the operation is the period that the patient must stay in the clinic and do the exercises that are indicated to him by the doctor. Their gradual build-up should lead to greater joint mobility and a return to the usual way of life. The patient may also be discharged home. Being engaged in simple household chores, the patient will be able to return to the previous workload faster.

After two to three months, yoga, swimming, cycling, and dancing will be useful. However, the patient should not be overworked, significant loads in this case are contraindicated.

A set of exercises

1. Flexion - extension of the ankle joint. It is better to start with five times, and then, increase the volume up to twelve times.
2. Tension of the anterior thigh muscles for three to five seconds.
3. Tension of the posterior thigh muscles for three to five seconds.
4. Straight leg raise.
5. Strain the gluteal muscle for three to five seconds.
6. Flexion - extension of the knee.
7. Abduction of the hip to the side.
8. Raising the straightened leg to an angle of 45 degrees and holding it in this position for up to five seconds.
9. Mahi with a straightened leg at an angle of 45 degrees and holding it in this position for up to five seconds.
10. Using the Dikul apparatus.

Contraindications for endoprosthetics

Contraindications are divided into two types: relative and absolute. In the first case it is:

• oncological diseases;
• liver failure;
• obesity of the second or third degree;
• patient's lack of motivation.

In the second case it is:

• complete lack of the possibility of independent movement;
• diseases of the cardiovascular system;
• thrombophlebitis (in the acute stage);
• serious pathologies of external respiration and chronic respiratory failure;
• the presence of an infection in the body;
• sepsis;
• polyallergy;
• neuromuscular disorders;
• mental disorders.

Varieties and existing variants

Endoprostheses are made from components that are designed to protect existing tissues. They are divided into:

• total;
• articular surface prostheses;
• single-pole;
• bipolar.

The most common total prostheses are replacements for the proximal portion of the femur and acetabulum. The prosthesis is tightly fixed to the bone and this is necessary for the implant to function normally. There are several ways to fix the prosthesis:

• hybrid;
• cement;
• cementless.

The materials used for prostheses are reliable, highly resistant and biocompatible. They are wear resistant and durable. For the manufacture of endoprostheses, the following materials are used:

• polyethylene;
• ceramics;
• metals and their various alloys;
• bone cement.

To date, there is no single standard of endoprosthesis that would be equally well suited to all patients. The question of what is better or worse in the case of a particular patient is still decided by the doctor, but every day the production of implants is getting better and more extensive.

Sergei Mikhailovich Bubnovsky is the author of books on the treatment of diseases of the joints and spine, the human musculoskeletal system and the general healing of the whole organism without the use of drugs. He is a doctor by education, doctor of medical sciences, professor. His method of kinesitherapy combined two methods - consultative assistance to patients and a set of special physical exercises. In fact, getting to the Bubnovsky center, after the examination, patients begin exercise therapy under the strict guidance of highly qualified specialists.

Be careful when contacting the Bubnovsky center without a preliminary examination. The technique gives excellent results in non-started cases. However, the chronicle is not always amenable to healing, despite the undoubted benefits of all the developed exercises.

Healthy lifestyle (HLS)

Instead of moving a lot, eating right, living actively and in harmony with ourselves, we spend the day at the computer, at work or watching TV, earning illness after illness. And only a small part of the population is trying to somehow monitor their joints and spine.

HLS (healthy lifestyle) in the understanding of a modern person is a gym, swimming pool, fitness or yoga, travel. However, what about those who have already begun to turn a sedentary lifestyle into a disabled person and for whom classic simulators are not suitable? The answer is quite simple and at the same time complicated - contact a specialist who knows kinesitherapy.

In the healthy lifestyle library (there is also such a messenger) there are many examples of how the Bubnovsky technique helped in the treatment of a particular disease. This suggests that it works and benefits patients. In addition, the healthy lifestyle bulletin participated in the publication of the book “Improvement of the spine and joints. Methodology of Dr. Bubnovsky”, which very quickly found its readers and became a desktop for many.

Kinesitherapy

This method is also known as "movement therapy". In this it differs from the traditional understanding of the problem of the joints and spine. Classical medicine has little in common with a healthy lifestyle (HLS), because in pain syndrome it almost always prescribes non-steroidal anti-inflammatory drugs and bed rest until it is completely eliminated. Kinesitherapy comes from the opposite - NSAIDs are completely excluded, classes begin at the time of acute pain, all painful places are worked out. The goal is to relax tight muscles, increase the mobility of the joints and spine, and release the strangulated nerve roots.

The main components of kinesitherapy according to Bubnovsky are:

• Classes on special simulators.
• Gymnastics (much more difficult than the usual shaping and aerobics) combined with proper breathing.
• Water procedures - sauna and ice bath (shower).

Bubnovsky's simulators are multifunctional. After exercising on them in the patient's body, the following are observed:

• regulation of central and peripheral blood circulation;
• microcirculation improves, as a result of which edema subsides and venous stasis decreases;
• metabolism and water-salt metabolism returns to normal;
• the muscular corset is strengthened, which removes part of the load from the joints and spine.

All gymnastic exercises, as well as work on simulators, are performed in decompression mode.

Exposure to cold has a pronounced analgesic effect. Immerse in an ice bath always for a short time.

Indications and contraindications

The problems that the Bubnovsky technique solves are specific and mainly relate to the musculoskeletal system and spine. Therefore, among the testimony (based on the official website of Dr. Bubnovsky):

• Acute pain syndrome of various etiologies, including after operations on the spine.
• Compression and ordinary fracture of the spine (rehabilitation).
• Fracture of the pelvis.
• Coxarthrosis (significant improvement of the condition in grades I and II, preparation for arthroplasty in grades III and IV).
• Scoliosis, flat feet, related comorbidities.
• Degenerative diseases of the joints and spine (Bekhterev's disease, rheumatoid arthritis).
• Other joint diseases and posture disorders.

Recovery of the spine with the help of kinesitherapy is indicated for Bechterew's disease, when the back gradually loses its flexibility, turning into an immovable stick. Such treatment is shown not only for diseases of the joints and spinal column, but also for other disorders in the body. The technique helps with:

• Chronic obstructive pulmonary disease.
• Bronchial asthma.
• Ischemic heart disease and myocardial infarction (rehabilitation period).
• Hypertension.
• Acute disorders of cerebral circulation (rehabilitation period).

The technique of Dr. Bubnovsky, despite its undeniable benefits for both a healthy body and a patient, has a number of contraindications. Some of them are absolute:

• Oncology.
• Hemorrhages and problems in the work of the hematopoietic system.
• The risk of heart attack, stroke (pre-infarction and pre-stroke conditions).
• Fractures of tubular bones. After their complete splicing, it is possible to undergo kinesitherapy treatment.

Relative contraindications include:

• Conditions after surgery on the spinal column, joints and ligaments.
• Rupture of muscles and tendons.
• Diseases of the cardiovascular, respiratory and other systems in the stage of decompensation.
• Benign neoplasms on the spine and joints.

You can not do kinesiotherapy if the body temperature is above normal!

Before starting classes, it is necessary to undergo a comprehensive examination of the body.

Terms

Numerous reviews prove the effectiveness of the technique, but there are also many such patients whose body reacted to the treatment with increased pain and a persistent deterioration in their condition. This happens for various reasons. If you need to improve the spine and joints, besides, there is a whole bunch of other diseases, remember that the effect of kinesitherapy is possible if only 4 conditions are met:

1. There are no contraindications. Pass the examination before contacting the Bubnovsky center.
2. There is a mood for a long and serious work with your body, a readiness for a short period of exacerbation at the beginning of classes.
3. Readiness for a delayed result. Kinesitherapy does not give an immediate effect. This is not a miracle pill for all diseases. Over time, the muscles become stronger, improvement occurs.
4. The desire to recover without the use of painkillers and trust in the doctor. This is a very important point, because without desire, any method is powerless, as well as without trust. If you doubt any method of treatment, nothing helps you, and the condition, despite all the efforts of the attending physicians, continues to worsen, contact a psychologist and figure out the reason. Trust and the desire to heal often play the role of a placebo. In this case, there are cases of so-called miraculous healing.

How is the treatment going?

1. Taking an anamnesis, examining the patient, studying the results of previous studies.
2. Myofascial diagnostics is a visual and manual assessment of the condition of muscles and joints. It is necessary to detect masked diseases (atypical symptoms or similar to another disease).
3. Trial lesson. It is called "testing on simulators." During a trial session, the capabilities of the whole organism are checked, an individual training scheme is selected - the frequency of visiting the gym, exercises and their complexity.
4. A course of treatment. Lasts 12–36 lessons. In addition to working on simulators, a sauna, contrast baths, stretching sessions and even a diet are individually prescribed.
5. Final examination and myofascial diagnosis with recommendations for further lifestyle. Then the doctor gives the patient a list of exercises that need to be done regularly at home.

Regularity and systematicity in classes are necessary. By following these conditions, you can achieve excellent results.

Advantages and disadvantages

The method of Dr. Bubnovsky has only 2 negative points - a delayed effect (not every patient is able to train hard to get a result in the form of lasting relief) and regimen (a gym must appear throughout the course).

Among the advantages:

• Versatility.
• Availability of a patent and all necessary documents for carrying out kinesitherapeutic activities.
• Safety.
• Healing effect for the whole organism.
• The ability to deal with people of any gender and age (individual approach to the patient).

Thus, kinesitherapy is a unique opportunity to improve the whole body and get rid of many diseases.

Hip arthroplasty: rehabilitation after replacement surgery at home, recovery reviews

Rehabilitation in the period after hip arthroplasty is needed to restore joint activity, remove pain, prevent complications, prepare the leg for stress and improve the patient's general well-being.

A successful rehabilitation process after hip arthroplasty is associated with many features. Restorative procedures begin the day after the operation, in which the prosthesis is replaced, and they can last from 2 to 3 weeks.

Sometimes, for example, if a person has weak immunity, the recovery period begins in the preoperative time. This is necessary so that the hip joints can be prepared as much as possible for the replacement of the prosthesis and to avoid disability.

Recovery procedures are based on the following principles:

• the strictest sequence;
• continuity of the course;
• systematic studies with a doctor and independently;
• individual approach.

Rehabilitation: what is it for?

Some recovery measures after arthroplasty need to be carried out at home, however, absolute self-treatment can be hazardous to health.

After all, the psychological peculiarity of a person is such that unpleasant painful sensations (a natural phenomenon in the postoperative period) will push him to instinctively keep his leg.

As you know, inadequate load leads to muscle hypotrophy and incorrect tonic redistribution. As a result, the likelihood of the formation of contractures increases, due to which deformity of the pelvic and femoral bones, complications when walking and compensatory scoliosis may develop.

Restorative measures after hip arthroplasty are carried out under the supervision of doctors in a special health resort. In such centers, doctors will control the load so that the muscle and joint tissues are developed correctly, muscle tone is restored and the pain syndrome is gone.

Initial preoperative recovery period

The zero rehabilitation phase consists of special exercises. They must be done before the operation at home or in the clinic. These workouts help:

1. improving blood circulation;
2. prevent stagnant formations;
3. activate tissue trophism;
4. improve the finishing of the cardiovascular and respiratory systems;
5. develop hip joints;
6. eliminate pain syndrome;
7. remove discomfort.

Note! The basic principle of the zero stage of rehabilitation is that each exercise should be done slowly and carefully.

Using the lower leg (not the knees), you need to make 5 circular movements against and clockwise.

It is necessary to press the previously straightened limb into the floor with force. The voltage must be maintained for at least 7 seconds. The exercise is repeated about 10 times.

Without removing the heel from the floor, it is necessary to bring it with a bent knee to the thigh. Then the leg should be returned to a level position by slowly moving the heel in the direction from the hip. The exercise is repeated 7 to 10 times.

The buttocks should be contracted and held in tension for about 8 seconds. You need to do at least 10 repetitions.

The straightened limbs are smoothly bred to the sides, while they are not torn off the surface. The exercise is repeated 10 times.

The straightened leg should be raised a few centimeters above the floor level, after which it should be slowly placed on the surface. You need to repeat the exercise no more than 10 times.

In order to achieve greater efficiency of rehabilitation together with exercise therapy, it is advisable to perform several procedures of electrical stimulation of the femoral and gluteal muscular system, and massage of the lower extremities before the start of the hip replacement surgery.

1-4 and 4-8 days

On the first day after the operation, the patient should observe bed rest, so he is transported using a stretcher. On the second day, you can gradually load the new joint with your own body weight using a walker or crutches. Sometimes the doctor prescribes a partial load.

The main tasks in the rehabilitation period are as follows:

• doing exercises;
• getting out of bed on your own
• walking with crutches or a walker;
• independent use of the toilet;
• the patient himself must sit down and get up from the chair.

To avoid the risk of complications in the first phase of recovery after surgery, it is not recommended to wear shoes without a spoon, cross your legs, squat and lie on the side on which the operation was performed. Also, do not take a hot bath before the patient plans to go to bed, raise the leg more than 90 degrees and constantly keep the roller under the knee joint.

In the first two days after hip replacement, the doctor prescribes magnetic therapy or UHF, during which a therapeutic effect of temperature and radiation is applied to the area where the suture was made.

Such procedures have an analgesic and anti-inflammatory effect. Moreover, they can be carried out without removing the bandage in the ward. If there are any contraindications to such procedures, UV irradiation of the wound is performed during the dressing process.

As a preventive measure, to avoid congestion in the lungs and prevent the development of pneumonia, the initial recovery includes breathing exercises and vibration massage of the chest.

Also, at the beginning of recovery, the patient undergoes massage, exercise therapy and exercises for the joints. At the same time, he learns to do isometric exercises, which consist in tensing the muscles of the buttocks, lower leg and thigh.

Therapeutic exercises after arthroplasty are done every day for 15 minutes (from 3 to 5 visits). In this way, it is possible to enhance metabolic and trophic processes in the muscles and mobilize the central nervous system. This type of gymnastic exercises is effective in case of bilateral damage to the hip joints.

After 4 days of hip arthroplasty, you should start walking up the stairs with your hand on the railing, taking no more than one step at a time.

To shorten the recovery period in the field of joint replacement, the doctor prescribes a massage and a course of exercise therapy.

So, climbing the stairs should be done as follows:

1. put a healthy limb on the top step;
2. lift the leg with the prosthesis one step higher;
3. put a cane or crutch on the step below;
4. put the operated limb one step lower;
5. rearrange a healthy limb.

Climbing the stairs of the house in the postoperative period should always begin with a leg that is healthy, and you need to go down, relying on the operated limb. The fourth or fifth day is often referred to as the phase of "deceptive opportunities", because weakness and acute pain disappear on the 5th day of rehabilitation. Therefore, the person wants to regain leg sensation after prosthetics.

Important! At this stage, you can not ignore the recommendations and load the limb. Otherwise, everything can end with a dislocation of the hip joint.

2- 8 weeks

Rehabilitation in the period after hip arthroplasty at 2-3 weeks, when the stitches have already been removed, includes a painless massage of the joint, in which light massage movements are used. Also, patients are prescribed a special therapeutic and physical exercise complex:

• for small joints of the legs;
• sitting on the bed with the use of hands;
• for thoracic and diaphragmatic breathing.

Particular attention should be paid to laying and fixing with the help of special rollers of the leg after the operation to replace the prosthesis. Rollers are placed under the knee joint from the outside to prevent external rotation of the thigh.

During this period, the load on the muscles should increase. The operated leg should be trained to restore strength and restore motor balance. After that, the patient will be able to switch from crutches to a cane.

Recovery at 4-6 weeks in a sanatorium or at home must necessarily include a set of exercises aimed at developing the muscular system of the leg, in particular the hip joint.

The first recommended exercise is resistance (using an elastic band). You need to perform it 2 times a day in 3 sets. The ankle is wrapped with one end of the tape, the rest is attached to the leg of a chair or table.

The next exercise is hip flexion with resistance. To do this, you need to lean against the wall on which the elastic band is fixed, and put your foot to the side. The limb should be understood forward and the knee should be straightened. Next, you need to return to the starting position.

The third exercise is done in a standing position, it consists in abducting the limb to the side. To the attached tape, you need to stand with the healthy side of the leg, and then take the prosthetic leg aside and return to the starting position.

In the sanatorium, during the rehabilitation period after the operation to replace the prosthesis, it includes training on special simulators. And it is necessary to walk using a cane until the balance is fully restored. You need to move every day for at least 10 minutes three times a day, each time increasing the walking time so that the artificial hip joint takes root normally.

After hip arthroplasty, training should be lighter. And in order for the exercises to benefit and not harm, you need to consult a trainer or watch a special video.

The best option after the operation will be exercise on an exercise bike, which will help restore muscle tone and restore the mobility of the hip joint.

Initially, the pedals can only be turned backward, and then forward. In this case, the knees should not be raised high. After a month, the load can be increased. Also, before starting classes, the simulator must be adjusted for growth.

late stage

The main rehabilitation after the endoprosthesis surgery is the course of treatment in a sanatorium or health center, where there is special equipment.

The doctor selects the method of rehabilitation therapy individually, taking into account the stage and form of the disease of each patient. To return life to a healthy course, various restorative procedures are used in the sanatorium, for example, therapeutic massage.

The actions of a manual therapy specialist are aimed at resuming the muscular and ligamentous apparatus, relieving pain, activating blood circulation and eliminating pain.

Also, after the operation, during which total arthroplasty was performed, the doctor prescribes acupuncture for the fastest recovery of the patient. This procedure allows you to reduce pain, eliminating vasospasm and improving the nutrition of tissue cells.

Physiotherapy is a procedure in which temperature, electric current, laser and ultrasound are applied to the recovery area. During mud therapy, metabolism is activated, as a result of which tissue nutrition improves due to the healing properties of mud.

Hydrotherapy is also very useful in the postoperative period. In order to quickly return to your usual life, you need to do aqua aerobics, take coniferous and salt baths and do not forget about the sharko shower.

Total hip arthroplasty is a rather difficult operation, since the main category of patients who need it is the elderly. Therefore, it is necessary to replace a weak load with a heavier one no earlier than after 2-3 months. If such recommendations are not followed, then complications may arise.

• therapeutic exercises;
• special food;
• massage;
• drug therapy.

And do not forget that you need more sleep and rest.

The progress of medical science leads not only to the emergence of new drugs and methods of treatment, but to the fact that the worldview of the doctor and patient is changing. A striking example of such a change is the emergence of the hip arthroplasty technique. 10-15 years ago, when meeting a patient with complaints of pain in the hip joint, a doctor with longing (if he is not professional enough) or ostentatious enthusiasm (if he is understanding and competent) was preparing for a long battle with pain with a predetermined result - the steady progression of the disease, mountains medications and, as a result, complete immobility of the patient. Now the picture has completely changed. A good doctor clearly knows the limits and possibilities of conservative treatment. When they are exhausted, it is necessary to start preparing the patient for surgery. Only this way guarantees a high quality of life and an optimistic prognosis.

So, the patient, together with the doctor, went from the onset of the disease to a radical endoprosthetics surgery, which eliminated the very cause of the disease. And here, it would seem, it is necessary to put an end to it, but rather an exclamation point! But even a brilliantly performed operation and the most modern prosthesis do not at all guarantee a return to the life that a person led before he fell ill. Without a recovery phase, all the results of treatment can be reduced to zero. The path to full recovery leads through properly organized and persistently carried out rehabilitation work. It is for this purpose that a branch of the Scientific and Practical Rehabilitation Center for the Disabled was created in the picturesque corner of "Switzerland near Moscow" - the Ruzsky district.

When creating a branch, important advantages were laid down that will help a patient in need of rehabilitation after surgery to make the right choice.

• The location is ideally suited for the implementation of climate treatment: around the coniferous forest - a year-round source of natural phytoncides and the purest air. The Moscow River flows nearby - optimal air humidity and protection from dust. A large green and well-groomed area is a place to continue treatment and unhurried rest. Peace and quiet - set up medical professionals and patients for active joint work on rehabilitation.
• The capacity of the branch, which simultaneously accepts up to 150 people for rehabilitation, guarantees an individual approach to each patient.
• Own artesian well allows you to use the best water for drinking, cooking and procedures, and water, as you know, is the source of life.
• Accommodation in comfortable conditions, fully adapted for patients with disabilities.
• Implementation of the principle "all in one place" accommodation, meals, procedures in one low-rise building.
• A rational combination of the use of modern rehabilitation equipment and methods of non-apparatus treatment.
• The presence of a private indoor pool, equipped for persons with disabilities.
• Location of the branch within a 2-hour transport accessibility from Moscow.
• The possibility of living with relatives and friends with the patient.
• A reasonable combination of price and quality of services provided.
• A qualified, competent and friendly team of professionals who have undergone special training on the basis of the best clinics in Russia.

The rehabilitation program includes the following activities

• Program composition
  1. Accommodation in a double room
  2. Three meals a day, taking into account concomitant diseases
  3. Round-the-clock supervision of qualified medical personnel
  4. 24/7 emergency medical care
• Survey
  1. Clinical blood test
  2. General urine analysis
  3. Biochemical blood test (6 indicators)
  4. Blood sugar test
  5. ECG with computer interpretation
  6. Blood pressure measurement
• Consultation of medical specialists
  1. Therapist
  2. Neurologist
  3. Traumatologist
  4. Rehabilitologist
  5. Dermatologist
  6. Surgeon
  7. Dentist
• Healing procedures
  1. Medical therapy
  2. Manual massage of one area
  3. Mechanical massage
  4. Passive traction of the spine on the Detensor device
  5. Pneumomassage
  6. Whirlpool bath**
  7. Pearl bath**
  8. Whirlpool bath for legs and feet
  9. Whirlpool bath for hands and forearms
  10. Exercise therapy in the pool group classes
  11. Exercise therapy in the pool individual lessons
  12. Additional access to the pool
  13. Shower circular
  14. Rising shower
  15. Therapeutic exercise in the hall
  16. Mechanotherapy
  17. Laser reflexotherapy with the apparatus "Milta"
  18. Thermal treatment with tourmaline crystals local and general
  19. Mechanical massage
  20. Psychologist's consultation
  21. Individual session with a psychologist
  22. Group psychotherapy
• Other services
  1. Custom menu
  2. Bicycle, ski rental
  3. Library
  4. Karaoke
  5. Table tennis
  6. Socio-legal
  7. Transport services
  8. Cultural and leisure activities
  9. Our care and attention

* — Additional service not included in the rehabilitation program. Available for an additional charge.
** Hot tub and bubble bath can be used at the same time

Basic and additional services are provided only in the absence of medical contraindications. The volume of treatment and the number of procedures are determined by the attending physician, based on the state of health and the presence of individual indications / contraindications.

Procedures are issued daily, except for weekends and holidays. ATTENTION! The patient must submit a discharge summary, a certificate from a dermatologist, fluorography data, test results for AIDS, hepatitis B and C, syphilis, diphtheria and dysentery!

Dear patients, as well as their relatives and friends! If you are faced with the choice of a place for rehabilitation, we extend a helping hand to you and are ready to go through a difficult but necessary part of the path to recovery together with you!