In the article, we will consider how rehabilitation after arthroplasty goes.
These concepts are closely related. It is rightly believed that it is the recovery period after surgery that can provide half the success of the case.
Rehabilitation after hip replacement
Arthroplasty is the most complicated operation to replace the entire joint or part of it with an anatomical implant, which is made of a hypoallergenic and wear-resistant material with good survival rate. The result of such an intervention should be an absolute restoration of joint functions. And although the procedure itself is not very complicated, the rehabilitation course is quite long and often painful. Especially when it comes to an older person.
Rehabilitation after arthroplasty is designed to eliminate pain, preventing possiblecomplication, improving well-being and preparing the patient's limbs for the necessary loads. When developing a recovery program, doctors take into account factors such as muscle tone, general he alth, the complexity of the operation, the body's response to surgery, and at the same time age, and so on. The attending physician, prescribing a program, will tell you where to undergo rehabilitation after arthroplasty.
Muscle tone affects primary load. It is very important that its increase occurs gradually. Training that begins at times when the patient's body is not yet ready enough can disrupt the healing process of postoperative wounds. To assess the general condition, a urine and blood test is performed, which may indicate an inflammatory and allergic reaction that occurs against the background of rejection of implants by the body.
Possible consequences may also include:
- The appearance of an infectious disease of the joints.
- Loosening of the prosthesis along with its displacement or loss of functional property.
- Wound infection.
It is worth noting that the percentage of complications is usually small. Especially if the rehabilitation after hip arthroplasty is well done.
According to available statistics, only one percent of patients develop negative consequences. Whatever rehabilitation program the patient is assigned to, there are general recommendations for all people who have undergone arthroplasty:
- Excessive traction is strictly prohibitedjoint.
- Possible impact, swing and other dangerous movements should be avoided.
- It is necessary to bandage the limb for three months after the operation.
- Don't go to the baths for the first few months.
- Not recommended for self-driving.
- It is forbidden to wear shoes with heels.
Do not neglect the doctor's instructions, as rehabilitation after knee arthroplasty, like any other, is very important. Restoring the working condition of the operated organ is directly related to the quality of human life.
Post Knee Replacement
The postoperative period following knee replacement is conditionally divided into three periods:
- Early stage - up to ten days.
- Late - the period of time is from ten days to three months.
- Delayed stage - more than three months.
The tasks of the early period of rehabilitation after knee arthroplasty include the prevention of various postoperative complications of the respiratory and cardiac systems by the methods of exercise therapy. As part of this stage, it is important to activate blood circulation in the lower extremities along with improving the mobility of the artificial joint. In addition, a general recovery of the patient is carried out. We are talking about learning to sit, walk, stand up, perform certain gymnastic exercises.
The tasks of the late stage include strengthening the muscles of the limbs along with the developmentclimbing and descending stairs, restoring proper walking, and the like.
Further strengthening of the lower extremities in combination with adaptation to working daily motor activity is considered to be the tasks of the remote period. Now let's look at how the recovery period occurs and where rehabilitation can take place after arthroplasty.
Recovery period in the center
Usually, postoperative rehabilitation of patients begins some time after surgery. Classes are carried out with isometric exercises, which consist in the tension of the thigh muscles in the absence of leg movement. Such exercises must be done several times a day.
The first goal of rehabilitation is the development of an injured organ after surgery. In addition, experts recommend moving the foot in various directions in order to strengthen the ankle joints.
In addition to everything else, in the rehabilitation center after arthroplasty, walking is practiced with dosed loads on the operated limb with additional supports (crutches, arena). This can be done from the third day. Stitches are removed on the tenth - twelfth day.
Discharge from the rehabilitation center after hip or knee arthroplasty is made twelve days after the operation. Limitation of physical activity on the reconstructed limbs must be observed for eight weeks after the intervention. Throughout this time, it is recommendedapplication of additional support.
Rehabilitation stage after surgery
Rehabilitation after knee or hip arthroplasty is usually twelve months. During this period, with a successfully performed surgical manipulation and adequate motor activity, the patient almost completely recovers absolutely all previously disturbed functions.
To continue certain rehabilitation measures should be in strict observance of all available recommendations from the operating surgeon. In most situations, recovery within the hospital is required only in the first period. Further therapy (exercise therapy along with electromyostimulation), as well as observation, are possible in sanatoriums, as well as at home.
Rehabilitation after arthroplasty in simple cases can be carried out outside the hospital.
Restoring from home
Due to organizational factors, most surgical hospitals that deal with arthroplasty do not have the opportunity to conduct a full-fledged postoperative recovery event. And here the patient comes to the aid of rehabilitation after arthroplasty at home, which today is quite feasible.
It should be taken into account that during the development of the disease, in addition to the destruction of the articular elements, there are also changes in the functions of the surrounding muscles. Simultaneously with the development of contracture, strength muscle characteristics also decrease due toconvergence of their points of attachment.
In this situation, CPM-therapy can be an indispensable assistant, the essence of which is to develop an organ using a special device that does not require active contraction of the periarticular muscle. Such rehabilitation allows the patient to quickly get on his feet without any pain and discomfort. CPM treatment is carried out at home using the Artromot device, which can be rented.
The procedures included in the rehabilitation program after hip arthroplasty (including knee replacement) relieve pain along with swelling and inflammation, as well as improve tissue nutrition, stimulate restoration of the bone structure, and eliminate muscle weakness after surgery.
It is worth noting that physical therapy, along with mechanotherapy, electrical myostimulation and massage, is the main method of rehabilitation therapy after the process of endoprosthetics. A comprehensive program, which is selected by a competent specialist, will certainly restore mobility in the joints in order to be able to return the patient to their usual way of life as quickly as possible.
Rehabilitation at home after hip arthroplasty is not difficult at all. The main thing is to do it regularly.
Gymnastic exercises
Immediately after discharge, rehabilitation is continued at home, it is considered mandatory. It is extremely important to treatphysical education daily, doing several twenty-minute approaches a day. Homework should be combined, performing in various poses. In a lying position (any action is repeated six to fifteen times without overworking), you can perform the following exercises:
- Bend the legs, and then alternately move each knee to the side for a distance of no more than twenty centimeters.
- Bend one leg and keep the other straight, raise the pelvis a couple of centimeters, while straining the gluteal muscles.
- Roll over on stomach, put pillow under stomach, lift one leg and stretch heel towards buttocks until tension is felt. Maintain this position for fifteen to thirty seconds, and then repeat the exercise with the other limb.
- Lie on the stomach with a pillow under the navel, legs apart, knees bent and heels together. Remain in this position for six seconds (this exercise is strictly contraindicated if the surgical incision is located on the front of the thigh).
- In the same position (that is, on the stomach, when the pillow is under the navel), put a rolled towel under the ankle and lift the thigh until the knee is fully extended, hold for six seconds.
Advanced exercises
For rehabilitation after arthroplasty in the third month of the recovery period, while staying at home, you can already move on to more difficult exercises that must be performed standing or sitting(but this should be done after consulting a therapist):
- Stand shoulder to wall on good leg and use the back of a chair as a support for the other arm. Along the wall, bending at the knee, raise the operated limb, without exceeding an angle of ninety degrees. Repeat the same exercise while standing on the affected leg (while the he althy limb is against the wall).
- They stand with their backs to the wall and lean with their hands on the back of the chair, while lifting the operated hip (we must not forget that the angle should be less than ninety degrees). Then they gradually complicate the task and refuse support, arms crossed over their chest.
- They stand with their backs to the wall and lean on a chair, raise their sore leg to the side by fifteen to twenty centimeters. Slide the heel against the wall and hold the foot for six seconds.
- Sit on a chair with outstretched legs and move the affected leg to the side, then repeat the movement with a he althy limb.
Besides gymnastic exercises, it is important to walk every day. You can do this at home, choosing short distances, it is also useful to go up and down the stairs. In the last exercise, the he althy leg is placed first, and then the operated one, and at the end the crutches are raised.
During the descent, crutches are first put on the step, then the weak leg and the he althy limb closes the process. It is necessary to engage in therapeutic gymnastics after arthroplasty only after consulting a doctor. It should be noted that the rehabilitation course must be completed without failexclusively under the supervision of a medical professional.
Overview of sanatoriums
Let's look at where you can get rehabilitation after knee or hip arthroplasty.
The provision of qualified assistance in sanatoriums is carried out in all periods of rehabilitation, from the earliest to the last. Those who are only at the stage of making a decision about arthroplasty are offered specially designed programs that allow them to prepare for the operation and then perform the most comfortable recovery.
Let's look at some popular resorts:
- Zagorskiye Dali Rehabilitation Center. The cost of staying per day is 4000 rubles. The resort is located in the suburbs of Moscow.
- Center "Podmoskovye UDP". The cost of staying per day is from 4300 rubles. It is located on the Kashirskoye Highway, thirty kilometers from the Moscow Ring Road. This is the most demanded center today, offering more than twenty specialized programs designed to restore he alth in basic profiles. The presence of its own artesian well with therapeutic mineral water, a swimming pool and a balneological complex, along with an extensive diagnostic base and the latest physiotherapy equipment, noticeably distinguish this place from most rehabilitation centers located in the Moscow region.
- Patients speak equally well of the Pushkino sanatorium, which is also located in the Moscow region and has a largepark and scenic area. In their comments, people who have undergone rehabilitation here speak very positively about the level of treatment activities of this center.
Features of walking on crutches
In order for crutches to serve as a reliable support for a person when walking, it is very important not only to accurately select and adjust them according to their size, but also to learn how to walk correctly on them, go down stairs and rise, sit down and get up from a chair. For each type of these devices, there are a number of general rules that must be followed in order to achieve the maximum effect from the use of this orthopedic instrument.
In the event that the crutches are axillary, then during reliance on them, it is required to transfer the weight of the body to your hands, and not to the armpits, in order to avoid the negative consequences of their strong squeezing. Support posts should be kept as close to the chest as possible, and the tips should be placed at a distance of about ten centimeters from the foot.
Conclusion
It is very important during rehabilitation after hip or knee arthroplasty while walking, look forward, not under your feet, keeping your back straight and the knee of a he althy limb slightly bent.
When the crutches are located under the elbows, then during movement you should make sure that the handle (that is, the support under the hand) looks straight ahead with its free end, and the cuff securely wraps around the forearm (nothing is squeezed, but at the same time does not hang out).
