All about rehabilitation after hip replacement: at home and in the hospital. What is the Duration of Sick Leave After Hip Replacement? Preparation for Hip Replacement

Article publication date: 08/03/2016

Article updated date: 12/05/2018

Rehabilitation after hip replacement is an integral stage of postoperative treatment aimed at restoring muscle tone and functionality of the leg. Rehabilitation consists of limiting (particularly) physical activity in the period after surgery and performing physical therapy.

Principles of the recovery period after hip replacement:

• early start,
• individual approach when carrying out rehabilitation measures,
• subsequence,
• continuity,
• complexity.

Rehabilitation after endoprosthetics has three periods: early, late and long-term. A specific gymnastics complex has been developed for each of them. The total duration of rehabilitation is up to a year.

Restoration of the leg's functionality begins in the hospital, where the patient underwent surgery. The approximate length of stay there is 2–3 weeks. You can continue rehabilitation at home or in a rehabilitation center, and finish it in a dispensary or specialized rehabilitation treatment clinic. If you are working out at home, it is important not to interrupt exercise therapy and therapeutic walks so that recovery takes place in full - only then the muscular-ligamentous system will reliably fasten the artificial joint, and all functions of the leg will be restored.

Lack of rehabilitation after endoprosthesis replacement threatens the occurrence of dislocation of the head of the endoprosthesis due to weak ligaments, periprosthetic fracture, development of neuritis and other complications.

Rehabilitation after any type of joint surgery, including replacement of a hip with an endoprosthesis, is carried out by a rehabilitation specialist and (or) a physical therapist. He will create an individual program taking into account the patient’s physical condition, degree of adaptation to physical activity, his age, and the presence of concomitant diseases.

After installation of an endoprosthesis, it is possible to restore working capacity. Persistence, the desire to recover, and strict adherence to doctors’ recommendations are the main criteria for a positive outcome of rehabilitation after endoprosthetics surgery.

Three periods of rehabilitation

Early rehabilitation period after endoprosthetics

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

Six Rules of the Early Period

Sleep only on your back for the first few nights after hip replacement surgery;

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

do not make sharp turns or rotations in the hip joint - this is contraindicated;

do not bend the affected leg so that the flexion angle is more than 90 degrees;

do not bring your legs together or cross them - place a wedge-shaped pillow between your legs;

Do simple exercises regularly to prevent blood stagnation.

Early goals

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

Basic exercises

The table contains exercises for the calf, gluteal, and thigh muscles of both legs:

(if the table is not completely visible, scroll to the right)

Rules for doing the exercises:

• make several passes per day, spending 15–20 minutes out of every hour during the day;
• keep a slow and smooth pace;
• combine exercises with breathing exercises according to the following scheme: when muscles are tense, take a deep breath; when relaxing, take a long exhale;
• perform breathing exercises to avoid congestion in the lungs.
• At first, do the exercises in the early period only while lying on your back (although you need to get on your feet already on the 2-3rd day), and then do the same gymnast while sitting on the bed.

A set of exercises for rehabilitation after endoprosthetics

I presented the exercises described in the table above in the order in which they were performed; they are relevant throughout the entire rehabilitation course. This exercise therapy complex is suitable for the rehabilitation of patients after almost any operation on the leg joints.

Additional exercises

In the first 2–10 days after endoprosthetics, doctors teach the patient to sit up correctly in bed, roll over, stand up, and walk on crutches.

Having already learned to maintain balance and lean on the operated leg, the patient must supplement the complex with other exercises - they must be done every day from a standing position, holding onto the headboard of a bed or chair. Here they are:

(if the table is not completely visible, scroll to the right)

The sooner the patient begins to get up and walk after endoprosthetics, the less likely it is to develop muscle problems (limited mobility) in the hip area.

Late postoperative rehabilitation

Late rehabilitation after hip replacement begins 3–4 weeks after surgery and lasts up to 3 months. The duration of rehabilitation for each patient varies depending on his age and other factors.

Two late period goals:

training muscles to strengthen them, increase tone,

restoration of range of motion in joints.

After the patient confidently gets out of bed, sits on a high chair, walks on crutches for 15 or more minutes 3-4 times a day, the motor mode is expanded by training on an exercise bike (no longer than 10 minutes 1-2 times a day). The patient is also taught to walk up stairs.

Start climbing the step with your healthy leg, placing the operated leg next to it. When descending, lower one step lower: first the crutches, then the sore leg and then the healthy one.

Long-term rehabilitation period

This period begins 3 months after hip replacement surgery; and lasts up to six months or longer.

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

Adaptive motor mode involves preparing the patient for more intense physical activity and adaptation in everyday life. Exercise therapy is supplemented with physical therapy (mud or paraffin applications, balneotherapy, laser therapy and other physical procedures).

Exercises to do at home

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

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

(if the table is not completely visible, scroll to the right)

The last two exercises and the rest, where movements must be done with a straightened leg, are necessary after surgery specifically on the hip joint, since they are aimed at developing a hip endoprosthesis. For the recovery period when replacing another large joint of the leg, they are only additional.

Step platform

Gymnastics on simulators

The adaptive motor regime in the long-term period is expanded through physical therapy on simulators. By this time, the ligaments and muscles have already become sufficiently strong after the operation, so the intensity of the load can be increased. The table below shows the most common exercises to fully restore range of motion in the hip joint.

(if the table is not completely visible, scroll to the right)

Conclusion

At each stage of rehabilitation, the supervision of a physical therapy doctor is important. He will tell you when you can complicate the exercises and increase the load.

Doing exercises for the hip joint on your own after endoprosthetics, especially using exercise machines, can lead to serious consequences. You cannot do gymnastics through pain or, conversely, stop it prematurely, even if you feel well and the endoprosthesis, as you think, moves well. Only strict implementation of all the tasks set by the doctor will make your new joint work fully.

Owner and responsible for the site and content: Afinogenov Alexey.

Your comments and questions for the doctor:

Victor | 07/06/2019 at 19:43

Hello. I am 67 years old. On March 15 and September 19, 2018, he underwent endoprosthetics of the left and right hip joints (1 year 4 months, 10 months have expired, respectively). Pairs of metal + polyethylene + ceramics. Uncemented. Rehabilitation is going well, I can walk without crutches or a cane, I drive a car, and I passed the driver’s examination without any problems. I don't feel any pain or discomfort. Please tell me what LIFETIME restrictions exist for such operations? Is it allowed: 1. In a sitting position, placing the foot of the right/left leg on the knee of the opposite leg in order to put on socks without outside help? 2. Full (deep) crouch? 3. In a standing position, bend forward with your hands on the floor? (mopping the floor) 4. Swimming lessons in the pool with fins for scrolling, diving? (the difference in the design of the fins and, accordingly, the load on the muscles and hip joint). 5. When lying on your back, cross your leg behind your leg (left-right)? 6. Stop using a wedge-shaped pillow between your legs? After what period? 7. After what period of rehabilitation is it possible (or forever prohibited?!) to raise the knees to an angle of more than 90°? Turning the raised knee left and right? Thank you in advance for your detailed answer. Sincerely...

mikhail | 04/25/2019 at 03:25

hello, please tell me the operation was performed 17 days ago, they replaced the hip joint, I am 28 years old. The situation is such that the muscles hurt and in the morning the leg is as heavy as a stone, tell me, is this normal?

Valentina Viktorovna | 03/04/2019 at 14:05

Operation PTB on December 6, 2017, the hip and buttock still hurt, the doctor who operated said that the pain was from the back because... this is possible osteochondrosis. The thigh along the suture is swollen, when touched it feels as if numb, but the pain is felt. I walk with a cane on the street, but at home without a cane. I do exercises every day while lying on the couch, thank you in advance.

Vladimir | 09.11.2018 at 01:20

Hello, during hip replacement, the femur burst during the subsequent operation, they secured it with 5 ties along the length of the bone, the sutures were discharged, they were removed, recommendations not to step on the leg for 3 months, what of the set of exercises you recommended can I do after the operation, 3 weeks have passed, thanks in advance for the answer

Olga | 09/17/2018 at 14:13

There is no temperature, pain, or redness. I will take your recommendations into account, thank you.

Olga | 09.16.2018 at 12:59

Hello! ; September I had endoprosthesis replacement of the right hip joint. My leg is still very swollen and it’s difficult to bend my knee. Upon discharge, they said that everything would pass, but almost two weeks passed. This was not the case during surgery on the left joint in February of this year. I live in a village and haven’t gotten to my clinic yet. Tell me if there is any danger and what to do, thank you.

Svetlana | 09/06/2018 at 20:25

Hello, my mother (70 years old) is preparing for total hip replacement. She has polyarthritis and severe pain in her elbows and shoulders, and I'm afraid she won't be able to use crutches properly. Is it possible to use a walker that has a support on wheels at the front, and legs like a chair on the side of the person leaning on?

Mina Minskaya | 09/05/2018 at 14:51

In January I had hip replacement surgery.
Since then, the sensitivity of the toes has been impaired. What do you recommend to restore normal sensitivity? Thanks in advance, Mina.

Yana | 08/30/2018 at 11:14

Hello! How long after endoprosthetics can I do a full body massage? I saw a physiotherapist, she prescribed different procedures, prescribed ALIMP, and said about massage that it was too early, in 3 months (one and a half months had passed). In the ward, we all took off our stockings after a week, and those whose heels were baked, the sisters cut the stockings at the heels to give freedom to the blood vessels. I walk for an hour and a half, sometimes 2 hours in the air with crutches, is this probably a lot? I want to go to the sea, why don’t I go to the sea? When a month passes after endoprosthetics - is it really impossible? Thank you!

Svetlana | 08/29/2018 at 16:52

Hello! I’m preparing to replace the TB of the right joint, I live on the 5th floor of a building without an elevator, will I be able to go home after the operation? If you write that there is no more than one flight of stairs. Thank you in advance.

Olga | 08/09/2018 at 15:56

I am 42 years old. We had surgery to replace the right hip joint on 06/05/2018, i.e. two months have passed. I do gymnastics. Added an exercise bike. I walk with a cane, but my gait is not straight. I can’t even lie down on my operated side (a nagging pain occurs along the entire leg). I have several questions:
1) When can you break the “90 degree” rule and sit low?
2) When can I take off compression stockings?
3) Will straight gait be restored and what should be done for this?

Valery | 07/29/2018 at 17:13

I am 61 years old. On July 6, 2018, an operation to replace the left hip joint was performed. A BC metal-ceramic joint (manufacturer "Zimmer") was installed. Three weeks have passed. I feel good. There are no acute pain sensations. Used axillary crutches. For the last week I have been using only an elbow crutch. Is not it too early? And another question: is it possible to go to the sea at the end of September-beginning of October?

Alexander | 07/06/2018 at 12:37

Hello! I confess, I love to lie in the bathroom, how long will it take for me to take a full bath after replacing the hip joint, at the moment almost 2 months have passed?

Natalia | 06/24/2018 at 19:35

Good afternoon. Done 40 days ago to replace the right hip joint. I walk with a stick. Question: Which side should you hold the stick on? On the side of the sore or healthy leg? It is written differently on different sites. I'm holding the stick on the side of my good leg!??? Question: How long after surgery (approximately) can you go to the pool or swim in the sea? Thank you.

Alexander | 06/17/2018 at 06:09

Hello! A month ago there was an operation to replace the hip joint. I am 70 years old, can I use an elliptical trainer instead of an exercise bike for rehabilitation? I feel good, there is no pain in the joint and never was. When can I start exercising on the machine? Thank you!

Ekaterina | 06/13/2018 at 06:12

Good afternoon I am 70 years old, 4.5 months have passed since the operation to replace the hip joint (01/25/2018), in general, nothing bothers me as long as I walk at home without a cane (I walked on crutches for about 3 months). But when I go outside I use a cane, I have to walk 200 meters. The operated leg immediately gets tired and I look for a place to sit down. Tell me what is the reason? I consulted a doctor with pictures in May and they said everything was fine. Thank you for your reply

Olga | 05/14/2018 at 04:25

Hello! I read all the comments, thank you very much to everyone, I learned a lot of useful things. Question: they write that you need to exercise on an exercise bike, but I have a cardio exercise machine - walking, is it possible to walk and how long - I had a replacement of my left hip joint on 02/2/18. Right - severe pain, September 3, 2018. there will be an operation.

Viktor Nikolaevich | 05/08/2018 at 23:39

Hello. I am 66 years old. The operation for total endoprosthetics of the right hip joint was performed on March 15, 2018. May 15 this year 2 months after surgery. The pair is cementless, polyethylene - ceramics. The seam has healed, the stitches have dissolved, the condition is normal. With the permission of the doctor, I now walk on one elbow crutch. After the discharge, there were no follow-up images and no examination yet; the doctor was on an internship abroad. There is his absentee permission to lie on the operated side, the sensations are normal. Please tell me when it will be possible during sleep, when getting out of bed, etc. stop using a wedge-shaped pillow between the thighs?! And secondly: when in terms of time and season (we have very hot weather and the summer is promised to be the same) is it better to have surgery on the second hip joint? Thanks for the answer.

Tatiana | 04/30/2018 at 09:24

Good afternoon In February there was an operation to replace the vehicle; now, that is, in May, you can get another vaccination against tick-borne incephalitis. Thanks for the answer.

Maryam | 04/07/2018 at 04:59

Hello! 02/27/2018 I had surgery to change the vehicle. While I'm doing gymnastics. When can I go to a rehabilitation center? And when will you be able to drive? Right leg. The car is left-hand drive. Thanks in advance for your answer!

Sergey | 03/01/2018 at 20:28

Thanks for the answer. In the pictures with exercises Exercises to perform at home Long-term rehabilitation period No. 3, 6, 12 movements that doctors usually prohibit doing. These pictures show movements and loads as if they were on a healthy joint. Does this mean that over time all movements will be restored? It’s scary that in life you won’t be able to tie your shoelaces and just squat down. I am 44 years old, but before the injury I led an active sports lifestyle. That's why the question. Traumatologists do not have a consensus on the current condition: either wait up to six months or get prosthetics. no nicrotic processes are observed, but there is no fusion. You are trying to assess what can await you after prosthetics.

Svetlana | 03/01/2018 at 08:52

Good afternoon! I have a question. I had hip replacement surgery in November 2016. I would like to know what I am strictly forbidden to do for life. I want to go to the gym and what machines I can use.

Sergey | 02/28/2018 at 21:01

Good afternoon. I have a displaced intra-articular fracture of the femoral neck. Within six months the fracture had not healed. There is a high probability of prosthetics. Tell. After completing a rehabilitation course - a year, two, three, will it be possible to bend the leg more than 90 degrees. To what extent is it possible to restore the degree of movement of the leg without fear of breaking the joint or dislocating it? Knee to chest, squats, etc. Or does it depend on the brand of the prosthesis?

karina | 02/26/2018 at 15:20

Good afternoon. I want to ask, a week has passed since the operation. I’ve read a lot, but it’s not clear how long I can walk, I’m hyperactive, it’s difficult for me to sit and lie down. Thank you.

Christina | 02/25/2018 at 06:23

Alex admin, thank you very much for your answer. A new one has arisen, how long should you sleep on your back after surgery? It’s just that my husband is already tired and wants to roll over onto his non-operated side. 2 weeks have passed since the operation.

Now that the hip replacement surgery is over, rehabilitation has taken its place. The most important thing now for the patient is to be extremely attentive to his feelings and successfully go through all the stages without causing complications. There is no need to be afraid, they occur infrequently and, as a rule, when a special regimen is not followed, which is prescribed from the first day after surgery. The duration of rehabilitation treatment is approximately 3 months, of which the patient spends 2-3 weeks in the clinic, and the rest of the time he will either continue classes and undergo procedures at a good specialized medical center, or strictly follow the instructions issued at home.

Where is it better to undergo recovery - at home or in a clinic?

After hip replacement surgery, rehabilitation not only in the early phase, but also in the late phase, is also best done under the supervision of an orthopedist and a professional exercise therapy instructor. Why is this so important? In the later stages, you can overestimate your capabilities by starting to put more load on the operated joint than it is ready to accept at the moment, which is fraught with dislocation of the endoprosthesis, loosening and other troubles. Usually this happens in the long term, while at home, when, against the background of a significant improvement in the condition, a person decides that he can already go beyond the limitations. In fact, the final strong bonding of the prosthesis with the bone and muscle structures has not yet taken place, and this occurs no earlier than after 3-4 months, and here is the result.

Why is specialist supervision needed? Because only he is able to convey to the patient the essence of the recovery process. Without outside instructions, even the most disciplined and informed patient is unable to provide rehabilitation.

It is advisable to remain as long as possible under the supervision of specialists who, taking into account the dynamics of recovery and the individual characteristics of the patient, will select the optimal permissible level of physical activity, make adjustments as necessary to increase or decrease them, and monitor the correct execution of each exercise. The rehabilitation instructor and the attending physician will ensure that rehabilitation after hip replacement proceeds without complications, providing the full range of mandatory preventive measures in a timely manner.

During the exercises, something will certainly pull, ache, or hurt, but only a physiotherapist who has had many such patients will be able to clearly explain the reasons and instill confidence.

Wherever the patient undergoes the postoperative plan of mandatory activities, he must strictly adhere to the individual rehabilitation program after hip replacement. It is compiled exclusively by a highly qualified specialist, in accordance with established endoprosthetics standards, for a specific medical case.

Sequence, timing and main features of the stages

Orthopedic surgeons strongly advise that you spend 3 weeks after surgery undergoing a treatment and recovery phase in the orthopedic department of a surgical hospital, then for about the same amount of time in a specialized rehabilitation center. After this, to consolidate the results obtained, take a course of health improvement in a resort-sanatorium-type institution, specializing in the profile of therapeutic and preventive treatment of the musculoskeletal system.

Early physical rehabilitation

From the information provided in the table, you see that recovery after surgery is not a matter of one week, but on average 3-4 months. Complex patients can recover from six months to a year. So, let's look at what the initial rehabilitation phase is.

Goals and objectives

The principles of recovery after surgery on the hip joints in the initial period are mainly based on the use of balanced kinesiotherapy, gentle static exercises, and myostimulating physiotherapy procedures. In addition, the patient receives competent medical care, including antibiotic therapy, administration of vascular drugs, and antiseptic wound treatment. Thanks to proportionate and targeted exercise therapy and adequate treatment with medications, the following is achieved:

• stimulation of blood circulation in the lower extremities;
• elimination of inflammation, swelling, painful syndrome;
• increasing muscle strength and range of motion in the problem area;
• correction of statics of the spinal sections;
• prevention of postoperative negative reactions (thrombosis, infections, etc.) and development of lasting immunity against all possible consequences.

Compression cuffs are a mandatory measure to prevent thrombosis in the first days after surgery.

Also, from the first day, such a device is used for passive expansion of the joint. Used for both knee and hip.

This period ensures the implementation of one of the most important goals - early activation of the operated patient. A rehabilitation doctor and exercise therapy instructor must teach a person all the norms of physical behavior and confident use of mobility aids; help develop the correct stereotype of walking and taking a sitting position, going up and down stairs. Also, their responsibilities include warning the patient about all types of physical activity that are strictly contraindicated at a given period of time.

Physical mode

• breathing diaphragmatic exercises;
• training a healthy limb through active exercises, as well as flexion/extension of the ankle of the endoprosthetic leg until a feeling of slight fatigue in the lower leg muscles;
• strengthening the gluteal, thigh and calf muscles using isometric tension in the corresponding zones;
• raising the pelvic region, resting on the elbows and foot of a healthy lower limb, in order to prevent bleeding and necrosis of the skin due to their compression due to a long stay in bed;
• from 2-3 days, individualized passive-active training on the leg with a replaced joint is included up to 6 times a day for 15 minutes (raising an even limb, sliding the feet on the bed with pulling the legs towards oneself, bending the knee joint area less than 90 degrees;
• special strengthening exercises for the adductor and abductor muscles, as well as the hip extensor muscles (Hula-Hula, Thomas test, etc.).

After approximately 2 days, the patient is allowed to sit down (sit for no more than 15-20 minutes), while the doctor will prescribe additional exercises performed in a “sitting” position, for example, straightening the leg at the knee joint, holding it in the extension position for 5 seconds (10 sets each). 5-6 times/day). Also, from the third day, the patient begins to get up, stand and walk a little on crutches, not yet transferring body weight to the problem side. The duration of the walk at first is 5 minutes, but the time is gradually added, and by the end of this period you need to walk three times a day for approximately 30 minutes.

A separate area of ​​rehabilitation is occupational therapy, when the patient is taught to care for himself safely: get up and lie down on the bed, put on socks and shoes, other clothes, lift things from the floor, use crutches, etc.

Support on the leg is added very carefully, starting from a small touch of the foot with the floor surface, gradually increasing the percentage of the support load. Having mastered the “standing” position well, the patient, under the guidance of a methodologist, will learn to:

• abduction in the lateral and posterior direction of the straightened leg, holding on to the headboard of the bed, chair or walker, avoiding painful sensations;
• bending the knee while pulling the heel towards the buttocks, straining the gluteal part;
• controlled transfer of weight from one leg to another, from side to side, etc.

Precautionary measures

You already know how long rehabilitation takes after hip replacement of the musculoskeletal system, and that in the early stages the musculoskeletal frame of the body is too weak. Therefore, to avoid displacement of the functional components of the endoprosthesis (dislocation) or instability in the places of attachment of the artificial hip joint, strictly follow the instructions below.

1. Do not exceed the amplitude of hip flexion more than 90 degrees, especially with its internal rotation and adduction.
2. You cannot apply a full axial load to the prosthetic segment. This is dangerous due to loosening of the implant.
3. Do not sit on chairs, sofas, or beds with low surfaces. The corresponding furniture must be high enough.
4. Avoid vigorous and forced movements in the joint both during self-care and during rehabilitation physical therapy. Forget about the “leg over leg” position, this position is strictly prohibited for at least 4 months!
5. During classes aimed at restoring the hip joint after total hip replacement surgery, be careful to ensure that your legs do not come close to each other or cross each other.
6. Do not take any medications that have an analgesic effect immediately before exercise therapy or during exercise. They powerfully suppress pain sensitivity, which is why you lose control over your own sensations during physical activity, which can greatly harm the operated leg.
7. Do not lie on the problematic side either during sleep or during normal rest. Rest on your unaffected side using a bolster or small pad between your two limbs. They will protect you from sudden unsuccessful movement, which can disrupt the congruence of the joint elements of the endoprosthesis. It is preferable to sleep on your back at first, and do not forget to place a demarcation pillow between your legs.

A cushion between the legs is a mandatory requirement for a month after surgery. Crossing your legs increases the risk of implant dislocation.

How long the early cycle rehabilitation will last after a hip replacement is decided only by the doctor on an individual basis. If all goals and objectives are achieved in full, well-being meets the deadlines, recovery is progressing according to plan, then the patient is transferred to the next stage - the longest and no less responsible.

At an angle of less than 90 degrees in the hip joint, this risk is also high.

Late stage recovery system

About 3 weeks have passed since the hip replacement was performed, rehabilitation is becoming more varied, longer in time and intensity. The specialist adds to the established physiotherapeutic treatment, namely electrical myostimulation and ultrasound, more procedures for musculocutaneous microcirculation and optimization of osteoreparation processes:

• medicinal calcium electrophoresis, possibly bischofite;
• infrared laser therapy;
• balneological treatment;
• acupuncture;
• paraffin therapy and ozokerite applications;
• massage of the lumbosacral spine and healthy leg.

There is nothing better than a swimming pool for recovery, but do not forget that the seam must heal before that!

Physical therapy consists largely of dynamic exercises, resistance training and weight training. The patient, under the supervision of a methodologist, performs a varied complex of exercise therapy on special simulators, as well as using sports equipment, for example, a rubber band, light weights, a step platform, and block equipment.

Suspension work is a great way to engage your deepest muscles.

Main goals of the later period

The fundamental goals at this stage are the physical development of the lower limb until full functionality is reproduced in it, work on gait and posture, and improvement of the ligamentous-muscular center. The basis of measures to implement the assigned tasks is again kinesitherapy. Physiotherapy is not canceled; after hip joint replacement, it is given an equally significant place in rehabilitation. So, now all treatment and rehabilitation measures are aimed at:

• the maximum possible expansion of the motor-support functions of the limb, achieving absolute stability of the hip joint and full range of movements;
• regulation of muscle tone to normal, increasing muscle endurance;
• practicing symmetrical musculoskeletal work of both legs;
• correction of opportunistic habits when moving, which the patient was forced to follow before and after surgery due to motor incompetence and fear of pain.

As before, the rehabilitation instructor works with the ward to adapt to a new lifestyle, to develop sustainable movement patterns that he will use during self-care, when doing housework, and also outside the home.

Nordic walking is good for its safety.

It is important to understand that the effect will not occur immediately and on its own after a complex operation on the musculoskeletal system. How rehabilitation will proceed and how long it will last after hip replacement will be significantly influenced, first of all, by the adequacy of the type, frequency, intensity and duration of daily physical activity given to the joint. The effectiveness and approach of recovery are influenced by the patient’s diligence in relation to medical instructions, overcoming his own laziness, weakness and fear.

Attention! It is important to understand that the hip joint has been replaced with an artificial organ. Yes, this is an analogue organ that coincides with the configuration and functional parameters of the anatomical and physiological unit, but in any case it is not a biologically native element. In order for the “new” part of the musculoskeletal system to become an inextricable link in a single locomotor chain, harmoniously coordinated with all anatomical structures, which is a rather complex process, it takes time and a therapeutically competent, targeted effect on the prosthetic leg.

Balance exercises of a later period are suitable for those who want to get the maximum from the treatment provided.

Walking is now increased in duration to 60 minutes, and in frequency - up to 4 times a day. After 1.5-2 months, perhaps a little earlier or later, the supervising doctor will stop using crutches, allowing you to use a cane when moving. The cane is used until complete restoration of the operated area is confirmed. Usually it is canceled and allowed to do without any support at all between 13 and 17 weeks.

Basic complex of late exercise therapy

The number of repetitions of one type of exercise is 6-10 times, the cyclicity of the complex is 2-3 times a day.

Before using gymnastics techniques, consult your doctor to make sure that none of the exercises has contraindications for your medical problem.

Rehabilitation after total joint replacement with an endoprosthesis at this time also includes cycling and aqua gymnastics. In addition, the patient will find it very useful to swim in the pool in the front crawl style. But do not forget about the gradual transition to new types of physical education techniques and a reasonable increase in the tempo, strength and time of recovery exercises. At periods such as 3, 6 and 12 months, it is necessary to undergo a mandatory control and diagnostic examination at the clinic.

Advice! If it’s too far for you to go to the pool, it’s winter outside and you can’t do much walking, and an exercise bike takes up a lot of space, then buy a step machine. This is an incredibly effective exercise for training the lower extremities.

And the last point that interests many people who have undergone hip replacement, but what they are embarrassed to ask a specialist about: when is intimate life allowed? You cannot have sex until the unnatural joint is securely fixed in the bone structures and is thoroughly attached to the muscles and ligaments - the main “levers” that bring the prosthesis into a functional state. And this is possible, as we have repeatedly noted, after 90-120 days after prosthetics with a successful recovery.

Hip replacement surgery is a rather complex process during which an implant is placed in place of the damaged joint. They resort to it for aseptic necrosis of joint tissues, tumors, hip fractures, and even in the later stages of coxarthrosis and rheumatoid arthritis, when conservative therapy does not help.

• What should you not do after hip replacement?
• Preparation for hip replacement
• 1-4 days after surgery
• 5-8 days of rehabilitation
• 2-3 weeks after installation of the prosthesis
• 4-5 week recovery
• How to walk correctly after joint replacement?
• Recovery period at home
• Proper nutrition during home rehabilitation
• The last stage of recovery after joint replacement

A patient with such problems feels constant pain, and he also experiences complete or partial limitation in joint mobility.

What should you not do after hip replacement?

Any operation is a great stress for the whole body. When a person’s joint tissue is destroyed, they most often resort to its removal. There is no other way to get rid of this problem yet. In case of severe damage to the femoral joint, doctors usually prescribe total endoprosthetics. During the operation, the destroyed parts of the joint are removed and artificial prostheses are installed in their place. Such structures take root well in the human body.

But in order for joint implants to stay in place, they must be held tightly by muscles. To ensure the strength of this connection, the patient will have to strengthen muscle functions. It will be possible to do this only after going through the recovery period after surgery to replace the femoral joint. Moreover, it is recommended that rehabilitation take place under the supervision of a doctor, because a patient who has undergone endoprosthetics is not allowed to perform all movements. Otherwise, sad consequences may occur.

So, a person with an artificial hip joint should not bend and straighten his legs sharply, cross them together and rotate his limbs. You should especially avoid such movements in the first months after surgery.

If you perform physical therapy and proper rehabilitation, you can achieve a good result after surgery in three months. But in most cases, full recovery still takes at least a year. During this period, motor abilities are completely restored.

After rehabilitation, the patient returns to his normal lifestyle. Many people continue to play sports, but in the first stages after hip replacement, it is much better not to move the operated limb. Muscle training should occur at a calm and slow pace.

Preparation for hip replacement

A person with such problems begins to prepare for the upcoming recovery several days before endoprosthetics. The main task of preoperative preparation is to teach him to behave correctly during rehabilitation. The patient is taught to walk with the help of special walkers or crutches, as well as to do some exercises to quickly restore the function of the prosthetic lower limb. Moreover, he is getting used to the idea that this is the beginning of a long rehabilitation period.

Before undergoing hip replacement surgery, a person is examined by various specialists to determine his condition and select the most effective plan for surgery and recovery.

Recovery after such a procedure is conventionally divided into early and late rehabilitation periods, which have different goals and degrees of load on the sore leg.

1-4 days after surgery

On the day of joint replacement, the patient is advised to rest in bed, sleep and rest. He can only move in a wheelchair. The day after installation of the implant, the rehabilitation period begins. The first movements involve the use of walkers and crutches. The order and duration of their implementation are determined by a specialist.

The patient after surgery must be very careful, since in the first days there is a huge chance of injury. It takes a little time to get used to the endoprosthesis, because after replacing the hip joint, the patient’s body does not have enough muscle mass. To prevent complications, doctors do not recommend after surgery:

• Cross the lower limbs;
• Lie on the side where the prosthetics were made;
• Squat;
• Take a bath;
• Hold a small cushion under your knees;
• Put on shoes without using a spoon.

To speed up the healing process of wounds, as well as eliminate foci of inflammation and pain in the first days after endoprosthetics, the patient is prescribed ultrasound and magnetic therapy. These procedures have a positive effect on the body, and they can be performed without removing the protective bandage.

In addition, people who have undergone such an operation are advised to perform breathing exercises and vibration massage in the first four days. Thus, it is possible to return normal activity to the respiratory system. The course of exercises at this recovery stage consists of tensing the muscles of the limb on which the joint implant is installed. They should be performed daily for 3 approaches, lasting no more than 15 minutes.

5-8 days of rehabilitation

A week after the joint replacement, you should learn to go up and down the stairs in the house, while leaning on the railing. True, you can take no more than one step.

The patient should begin going down the stairs from the operated leg, and going up, on the contrary, from the healthy limb. By the way, by day 5, weakness and pain disappear, which is why a person wants to feel his leg after endoprosthetics. During this period, you should not break the rules and overload it too much, otherwise you may get an injury to the hip joint.

2-3 weeks after installation of the prosthesis

During this rehabilitation period, doctors advise switching to more complex exercises to develop small joints of the limbs. Moreover, the patient should think about undergoing gentle massage procedures and breathing exercises.

4-5 week recovery

A month after the operation, the muscles become stronger, so they can withstand intense loads. During this rehabilitation period, the patient can move from a crutch to a cane. However, first he will have to restore the function of all the hip muscles, not just those surrounding the artificial joint. If in the first weeks the patient was advised to perform movements slowly and smoothly, now he can learn to react to sudden movements.

Recovery after hip replacement involves performing exercises using an elastic band during this period. To do this, it is necessary to pull the affected limb back and forth. In addition, a month after endoprosthetics, a person is allowed to exercise on exercise machines. An excellent option would be an exercise bike with long or short pedals; the main thing is to follow the right angle rules during training. It is better to pedal backwards first, and only then forward.

In addition, training on a treadmill is allowed. To strengthen the ability to balance on it, you must first walk in the direction of movement, and not towards it. Moreover, during the training process, the foot should move from toe to heel, and the lower limb should fully straighten when it rests on the running belt. Also a mandatory requirement during the recovery period is regular walking.

How to walk correctly after joint replacement?

After such an operation, the patient should take small, smooth and slow steps. In addition, during rehabilitation you need to walk only on flat surfaces. In winter you need to be wary of slippery roads.

There should be no wires or things under your feet when moving around the apartment. It is worth removing even rugs on which you can accidentally slip. You should not go on your first walk after installing an artificial hip joint without an accompanying person.

Recovery period at home

The rehabilitation phase after joint replacement is a rather long and complex process that requires responsibility and attentiveness from the patient. During recovery, you need to pay attention to the following points:

Drug therapy during home recovery usually involves taking anticoagulants and antibiotics. These drugs prevent infections in the joint and the formation of blood clots.

Proper nutrition during home rehabilitation

Nutrition is the main component of recovery at home after hip replacement. When the patient returns home, he can eat as before. True, quite often doctors advise such people:

The last stage of recovery after joint replacement

To consolidate the results obtained, you will have to undergo a final healing course, for which you will need special equipment. It is for this reason that you will not be able to complete it at home. At a medical institution, specialists will examine the patient and then select the most suitable set of procedures for him.

Most often, patients who have undergone this operation are prescribed:

For patients, three months after hip replacement, doctors allow them to increase the load if there are no contraindications. Therapeutic exercises must be performed at home for at least 6 months after installation of the endoprosthesis.

After about a year, doctors recommend that people with similar problems undergo rehabilitation treatment, preferably in a sanatorium. In addition, they must perform physical therapy exercises every day and regularly attend classes in the pool. Correction of further treatment is carried out by a specialist during examinations 1-2 times a year.

If the rules of the rehabilitation process after hip replacement are violated, the patient is at great risk. It must be remembered that severe complications can lead to repeat surgery at any stage of recovery. In addition, the patient must understand that various injuries, hypothermia, extra pounds and infection adversely affect the condition of the artificial joint.

Who needs a hip replacement - rehabilitation after surgery

The formation of the hip joint (HA), which is a simple synovial joint, occurs with the participation of two articulating bones - the ilium and the femur.

The cup-shaped depression on the outside of the pelvic bone (acetabulum) and the ball-shaped bone of the femoral head together form the hip joint, which is a kind of hinge structure.

The head of the femur is connected to the femur by a neck, which is popularly called the “femoral neck.” The inside of the acetabulum and the femoral head itself are covered with a layer of special articular cartilage (hyaline).

Cartilage is an elastic and, at the same time, durable and smooth layer in the joint. Provides gliding during joint operation, releasing joint fluid, distributing the load during movement and the necessary shock absorption.

Around the head of the joint there is a capsule consisting of very dense and durable fibrous tissue.

The joint is secured using:

1. Bundles. The external ones are attached at one end to the femur, at the other to the pelvic bone. And the internal ligament of the head of the pelvic bone connects the head itself with the acetabulum of the pelvic bone.
2. Muscle They surround the hip joint - the buttocks at the back and the femurs at the front. The better the muscular framework of the joint is developed, the less traumatic loads on it when running, unsuccessful jumps and moving heavy objects. It is also important that a good volume of strong working muscles delivers a sufficient amount of nutrients to the joint through the blood.

With the help of the hip joint, a person is simultaneously provided with the following functional capabilities:

• body stability (support, balance);
• variety of movements.

Why is the joint affected?

Obvious causes of damage include injury. Examples are femoral neck fracture, hip dislocation or subluxation.

Non-obvious diseases (infectious and non-infectious arthritis, osteoarthritis, inflammatory processes in the joint and periarticular tissues).

Let's look at the main ones:

• inflammation of the pelvic joint - usually caused by arthritis of various etiologies, bursitis, synovitis, etc.;
• pathology of joint deviation – dysplasia;
• necrosis in the head of the TM of some parts of the bone marrow - non-infectious necrosis (avascular).

When and who needs a hip replacement?

The occurrence of pain in the hip joint is a signal that you should contact a professional to determine its causes. To do this, at the initial stage You should undergo an X-ray examination of the vehicle.

The solution to the problem for a worn out or irreversibly injured joint can be endoprosthetics, which may be indicated in the following cases:

• non-healing fracture of the head of the vehicle;
• fractures of the femoral neck or acetabulum in elderly patients;
• aseptic necrosis;
• tumor-like diseases of the TS;
• deforming arthrosis of the third stage;
• congenital hip dislocation, etc.

What types of operations does medicine offer?

In modern medicine, patients are offered three types of operations based on the type of prosthetics:

1. Replacing the surfaces of the femoral bone - removing the cartilaginous layers from the acetabulum and replacing them with a special artificial material and turning the head of the femur and putting a metal cap on it. Thanks to this replacement of articular surfaces, gliding is achieved that is close to natural.
2. Partial prosthetics is the replacement, for example, of the head of the pelvic joint with part of the femoral neck or articular bed.
3. Complete prosthetics – removal of the entire hip joint and replacing it with an endoprosthesis.

Types of endoprostheses

In modern medicine, there are more than six dozen modifications of endoprostheses today. They are divided according to the method of fixation and material. Three methods of fixation are offered today:

• cementless – fixation occurs due to the fact that the joint bone grows into the surface of the joint;
• cement – ​​the endoprosthesis is fixed using special bone cement;
• mixed (hybrid) - the cup is attached without bone cement, and the leg is attached with cement.

Modern combinations of materials from which prostheses are made are selected depending on the patient’s disease, age and lifestyle. They may be:

• metal – metal;
• metal - plastic of very high quality;
• ceramics – ceramics;
• ceramics - plastic.

Preparing for surgery

All necessary information to prepare for surgery will be provided to you by your attending physician.

However, there are moments for which the patient will have to prepare in advance (especially those who are lonely).

Since rehabilitation after a joint replacement continues at home, it is worth preparing your home for the postoperative recovery period:

• purchase special equipment in the form of walkers or crutches, a special toilet seat, etc.;
• stop taking certain medications (aspirin-containing, anti-inflammatory);
• if necessary, reduce your weight;
• do physical training;
• visit the dentist;
• give up bad habits (smoking).

Before the operation, the patient is required to complete the necessary documents (the operation is carried out in cash, under a contract within the framework of health insurance or under quotas of the federal program for the provision of free high-tech medical care); talk with an anesthesiologist about the most favorable anesthesia option for you; Stop eating at least 12 hours before surgery.

Joint replacement surgery

Modern advances in medicine make it possible to perform both open and minimally invasive surgeries for hip replacement.

Today, minimally invasive surgeries (MI) are the most common due to their minimal impact on the body.

To carry out MO you need:

• high qualifications and professionalism of the surgeon and all medical staff;
• availability of technical capabilities (endoscopic equipment, high-tech materials).

Depending on the complexity of the operation (partial or complete prosthetics), its duration can last from one to three to four hours:

• anesthesia;
• installation of a catheter in the urethra (to prevent involuntary urination and control the amount of fluid secreted by the body);
• an incision on the outer thigh (or two small ones - on the thigh and in the groin area);
• peeling and shifting of tissues around the vehicle;
• installation of a prosthesis;
• restoring tissue integrity and suturing the wound.

The video clearly shows how hip replacement is performed.

Possible complications

Any surgical intervention in the body can have its negative consequences. Complications after the procedure most often occur in those undergoing surgery:

• with large joint deformation;
• with obesity or large muscle mass;
• having a number of serious concomitant diseases - diabetes, blood diseases, heart diseases and the entire cardiovascular system, etc.

Joint replacement can cause the following complications:

• incorrect position of the endoprosthesis;
• damage to nerve fibers and arteries;
• disruption of the postoperative wound healing process;
• the occurrence of infections;
• fracture of the femur, dislocation or “popping out” of the prosthesis;
• thrombotic phenomena in deep veins.

Rehabilitation after surgery

Rehabilitation after endoprosthetics can be long and take up to 6 months.

The patient should monitor the suture, body temperature and his sensations. Pain during this period may pass and return; the patient must be prepared for this and make efforts to fully restore the motor functions of the body.

For the first few days, the patient is prescribed painkillers and anti-inflammatory drugs.

Further rehabilitation after hip replacement consists of special light exercises and breathing exercises.

To prevent cicatricial tightening of tendons and skin, to strengthen the muscle frame around the prosthesis, the patient is prescribed physical therapy (PT).

As indicated by reviews from patients who have undergone endoprosthetics, it is worth adhering to the recommendations of specialists as much as possible and then rehabilitation will be quick and almost painless.

How rehabilitation goes after hip surgery is described in detail in the video.

Where can I have surgery in Russia?

The operation of hip replacement is a high-tech process.

In 2015, the inclusion of high-tech medical care (HTMC) in the compulsory medical insurance system was provided for by the new legislative project “On compulsory medical insurance in the Russian Federation.”

Therefore, here we will not specify who will pay for the operation - the patient or the insurance companies.

The cost of hip replacement consists of the prosthesis and the operation itself. Today, the cost of the operation (total hip replacement) ranges from 210 to 300 thousand rubles (depending on the cost of the prosthesis).

Hip replacement in Russia is performed both in federal budgetary healthcare institutions (federal centers for traumatology, orthopedics and endoprosthetics, regional clinical hospitals, research institutes) and in private clinics of the Russian Federation.

For example:

• OAO "Medicine";
• Family Clinic;
• City Clinical Hospital No. 67 (Moscow);
• KB MSMU im. Sechenov;
• SM-Clinic;
• Central Clinical Hospital of the Russian Academy of Sciences;
• Multidisciplinary medical center “K+31”;
• DKB named after Semashko;
• Central Design Bureau No. 2 of JSC Russian Railways, etc.

How is rehabilitation carried out after hip arthroplasty (replacement)?

Hip replacement is an operation during which the patient's diseased joint is replaced with an artificial analogue (prosthesis).

Quick jump to article sections:

How much does this operation cost in Moscow?
How effective is the operation?
Possible complications of endoprosthetics
Standard rehabilitation scenario after this operation
Rehabilitation continues at home
Returning to normal life: how and what to do correctly

The main indications for this operation are:

• arthrosis of the hip joint (coxarthrosis)
• rheumatoid arthritis
• bone tumor
• hip fracture
• aseptic necrosis of the hip joint

All these diseases are accompanied by severe pain and limitation of joint movement, which greatly reduces the quality of life of patients.

How much does such an operation cost in Moscow?

The cost of the operation varies greatly from clinic to clinic and depends on whether the prosthesis itself is included in the price, as well as anesthesia, examination and hospital stay after the operation. Thus, the operation itself can cost from 30,000 rubles, and prices for the all-inclusive program reach up to 350,000 rubles.

How effective is the operation?

As many patients note, the symptoms that bothered them go away after the operation: the pain subsides, mobility returns to the joint and the person can do household chores, sports, work, etc. without restrictions. (reviews can be read here and also here: http://otzovik.com/reviews/endoprotezirovanie_tazobedrennogo_sustava/).

However, there are also cases when the symptoms do not go away completely (http://forum.health.mail.ru/topic.html?fid=50&tid=2384&render=1). The reason for this may be complications of the operation, the age or individual characteristics of the patient, the experience of the doctor, the quality of the prosthesis and much more. During rehabilitation after endoprosthetics, pain may be felt, swelling of the joint or numbness of the toes may be present. Over time, these symptoms disappear. Some patients experience significant pain relief immediately after surgery.

When does the rehabilitation process begin?

After hip replacement surgery, when the patient recovers from anesthesia, the rehabilitation process begins. The patient is usually discharged 3-5 days after surgery, but rehabilitation does not end there. How long this process will take depends on several factors, the first of which is the presence of complications.

Possible complications of endoprosthetics

The risk of serious complications from this operation is extremely low, but in some cases they occur:

• Hip infection occurs in approximately 2% of patients.
• The most common complication is the formation of blood clots in the veins of the legs and pelvic area.

In cases where complications develop after surgery, the rehabilitation process may be delayed.

Standard rehabilitation scenario

Rehabilitation: day one

The key points of the first day after surgery for the patient will be:

• Instruction regarding precautions and permissible load on the operated joint;
• Teaching 2-3 exercises to develop the joint, which can be performed while lying in bed;
• Possibility to sit on the edge of the bed;
• Ability to stand using a walker;
• Ability to sit on a chair (with the help of medical staff);
• Ability to start moving (with the help of medical staff).

Second day

The second day of rehabilitation will result in the following new events for the patient:

• learning 1-2 new exercises to develop joints and muscles;
• the ability to sit down and stand up (under the supervision of medical staff);
• a person can try to climb stairs on crutches (under the supervision of medical staff);
• Possibility to take a shower or bath.

Day three

On the third day after surgery, the patient can usually:

• perform the necessary exercises independently;
• sitting on the edge of the bed without support;
• stand independently without relying on walkers or crutches;
• walk independently or with the help of crutches;
• climb and descend stairs independently or under the supervision of medical staff.

Why is physical therapy so important in the rehabilitation process after arthroplasty?

Physiotherapy is an important and integral part of the rehabilitation process after endoprosthetics. Its purpose is to prevent the joints from coming together, teach the patient the “rules of using” the new joint and strengthen the muscles around the prosthesis through special exercises.

Joint alignment can result in limited movement of the operated joint. The cause of joint convergence is scarring of the tissue around the prosthesis.

During visits to the physiotherapist, the patient will learn which body positions can harm the joint and which cannot, when and what load the prosthesis can safely withstand, how to prevent joint displacement, etc. The physiotherapist will also prescribe an exercise program for the patient to perform at home after discharge from the hospital. . Some patients continue to see a physical therapist after being discharged home.

Rehabilitation continues at home

After endoprosthetics, the rehabilitation process from the hospital “moves” home with the patient.

Key points that patients should remember while at home:

• the skin in the joint area should always be clean and dry. Dressings should be changed strictly according to your doctor's instructions.
• If after the operation there are stitches that need to be removed, the surgeon will give the patient special instructions regarding the care of the incision site and the rules for using the bath or shower.
• some patients will need to return to the hospital for x-rays so doctors can see how the healing process is progressing.
• If there is redness in the suture area or any discharge appears from the wound, the patient should immediately consult a doctor.
• If your body temperature is above 38 degrees C, you should also consult a doctor.
• Swelling in the area of ​​the prosthesis may occur for 3-6 months after surgery (this is normal). The patient may be advised to apply ice to the joint several times a day for 15-20 minutes if necessary.
• If symptoms such as chest pain or shortness of breath occur, the patient should immediately contact a doctor: these may be signs of a blood clot.

Taking medications

After discharge home, the patient may be prescribed the following medications:

• anticoagulants – to prevent the formation of blood clots, which can lead to life-threatening consequences
• antibiotics - to prevent the risk of infection in the joint.

Nutrition

Nutrition is another important component of home rehabilitation after joint replacement. Upon returning home, the patient can eat as usual. However, your doctor may recommend the following:

• start taking certain vitamins
• supplement your diet with iron-containing foods
• drink enough fluids
• avoid consuming vitamin K in large quantities

“The following foods are rich in vitamin K: broccoli, liver, spinach, onions, cabbage and cauliflower, green beans, soybeans.”

• limit your consumption of coffee and alcohol
• monitor your weight (avoid its sudden increase)

Return to normal life

How right...

• ... use stairs with crutches?

Rising up:

1. Step with your non-operated leg first.

2. Then place the operated leg on the same step

3. Then use crutches

Going down:

1. Lower the crutches onto the step below

2. Lower your operated leg onto the step

3. Then lower your good leg

• …sit?

For 3 months after hip replacement surgery, the patient should adhere to the following rules:

1. Sit only in armchairs or chairs with armrests

2. Don't sit on chairs that are too low

3. Do not cross your legs at the knees

4. Do not sit in one position for more than an hour

5. Follow your physical therapist's instructions on how to get in and out of the chair correctly.

When is it possible...

• ...free to use stairs?

Typically, the patient will use crutches to walk up and down stairs for a week after surgery. Over the next 4-6 weeks, the patient completely masters the stairs and can use them freely without any assistance.

• …drive?

When a patient can drive depends on many factors, including the type of transmission the car has and the side on which the surgery was performed.

The patient can return to driving an automatic car within 4-8 weeks after surgery. And if the patient has a car with a manual transmission, and the operation was performed on the right hip joint, then you can drive only after the doctor’s permission. The deadlines are individual in each case.

• ... resume sexual relations?

The patient should discuss this issue directly with the doctor. In some cases, sexual rest for up to 4-6 weeks is recommended, in other cases there are no restrictions, provided that the patient chooses positions that are safe for the operated joint.

• ...go back to work?

Some patients can return to work within 4 weeks after surgery, while others require up to 10 weeks of rehabilitation after hip replacement. In this case, it all depends on the nature of the work and the progress that the patient will be able to achieve during the recovery process.

By following the advice of doctors, the patient will be able to speed up his recovery and soon enjoy a full life, full of movement and free from pain.

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To learn more…

What is endoprosthetics, and in what situations is it necessary? This is an operation to replace a joint that has been affected by arthrosis with an artificial implant. The disease is called coxarthrosis, and endoprosthesis replacement is indicated at the last stage of the disease, when coxarthrosis is already advanced and conservative methods of therapy do not bring positive results.

In such a situation, hip replacement surgery is considered the only correct solution, since only endoprosthetics can restore the lost function of the joint and return the patient to a full life. The operation is prescribed when the doctor diagnoses the patient with absolute destruction of hyaline cartilage.

How to treat coxarthrosis

Treatment of coxarthrosis is selected individually in each specific case. It depends on several factors:

• patient's age;
• stages of the disease;
• the presence of concomitant pathologies;
• the patient's immune status.

In general, for the treatment of coxarthrosis of the hip joint, the doctor always prescribes a whole range of measures, which include general improvement of the body. Traditional medicine methods are also used to treat coxarthrosis.

Therapeutic measures include both conservative and medicinal methods:

1. Prescribing muscle relaxants, drugs that reduce muscle tension around the affected area. The drugs improve blood circulation in the joint and relieve pain.
2. Prescribing non-hormonal (non-steroidal) anti-inflammatory drugs that relieve pain. This group of drugs can be taken at any stage of coxarthrosis.
3. Prescription of drugs that restore cartilage tissue. These include arteparon, glucosamine, etc. These drugs are most effective for coxarthrosis.
4. Hardware traction. Used to reduce stress on the joint surface. This treatment is a course of treatment and is possible with the help of special equipment.
5. Physiotherapy: phonophoresis, electrophoresis, laser therapy, cryotherapy. All these procedures are aimed at relieving inflammation and improving blood circulation in the affected area.
6. Postisometric relaxation - stretching of muscles and ligaments is possible without the use of auxiliary mechanisms. The patient is actively working. Its task is to tense and relax certain muscle groups. During moments of relaxation, the doctor performs stretching.

Treatment of stages 1 and 2 of coxarthrosis

Treatment of coxarthrosis in the initial stages allows you to stop the development of the disease. If measures are taken in time, the patient will never know what grade 3 coxarthrosis is. In the first two stages, conservative and medicinal treatment methods are actively used.

1. Pain-relieving drugs are prescribed: non-steroidal anti-inflammatory drugs, analgesics.
2. Significant loads on the affected joint are excluded. The patient is transferred to a gentle regimen. He is prescribed a course of special exercises.
3. Reflexology, massage.

All these methods stimulate proper blood circulation in the joint and nearby tissues. Allows you to restore mobility in the joint, until complete recovery.

Treatment of stage 3 coxarthrosis

At this stage, it is possible to use conservative treatment (reducing stress, injections of drugs that improve blood circulation). But such therapy will be palliative, that is, it will eliminate the symptoms, but not the cause of coxarthrosis.

How does the hip joint work?

To clearly understand the essence of surgery on the hip joint, you need to know its structure. This is a ball-shaped joint that can rotate in three directions: along the sagittal, vertical and frontal axis.

The hip joint is formed by two bones that connect to each other: the ilium and the femur. The head of the femur is inserted into the acetabulum of the ilium. This device is essentially an excellent joint that has the ability to perform various movements.

The hip joint in a healthy state is covered with a layer of hyaline cartilage. In other words, the cavity of the acetabulum and the head of the femur are covered with cartilage tissue.

Articular cartilage ensures smooth gliding of joints and allows for shock absorption of human movements. Pathologies of hyaline cartilage lead to the formation of osteoarthritis.

Classification of hip joint implants

The modern medical equipment market offers more than fifty types of endoprostheses. Any modification ensures the physiological functionality of the joint. That is, the one that nature gave to man from birth. But the endoprosthesis has limitations regarding its service life.

If the operation is performed correctly, the implant will serve its owner for 15-20 years. After this period, the patient will require repeat surgery.

Methods for attaching endoprostheses

1. Cementless - with this method, the bone grows into the prosthesis, which has a rough surface.
2. Cement - the endoprosthesis is attached using polymer cement - a special bone “glue”.

Both of these methods are very popular, but there is no clear answer yet which one is preferable. Each method has strengths and weaknesses. More recently, hybrid mounts have begun to be used. This option combines all the positive characteristics of both methods.

Endoprosthetics happens:

• Unipolar - only the femoral head is subjected to prosthetics.
• Bipolar - in addition to the head of the hip joint, the acetabulum is also replaced.

Hip implant design

During the manufacture of endoprostheses, materials undergo careful control. This is necessary, taking into account the peculiarities of using prostheses. In the human hip joint, hyaline cartilage ensures ideal gliding. In an artificial analogue, friction can cause rapid deformation of the prosthesis.

Therefore, implants are made from high-strength metals and polymers that can ensure long service life.

Hip endoprostheses are manufactured:

• made of polymer plastic;
• made of metal alloy;
• from ceramics.

The most popular combination today is “metal + plastic”, which has a normal service life. Of course, “metal + metal” leads in reliability, ensuring the life of the endoprosthesis for up to 20 years, and all this time the artificial hip joint works perfectly.

Hip replacement

The size of the future prosthesis is carefully selected. Before the operation, the doctor communicates with the patient and explains possible complications and risks. The main risks are associated with the likelihood of infection in the body, thrombosis of blood vessels, and large blood losses during surgery. The possibility of dislocation of the endoprosthesis cannot be ruled out.

The patient is hospitalized a couple of days before the operation and fully examined. The hip replacement procedure lasts from one and a half to three hours. Endoprosthesis replacement is performed by a highly qualified doctor, since the operation is classified as complex.

First, the hip joint that is affected by coxarthrosis is removed, then an artificial implant is installed. In this case, one of the above methods is used. In the postoperative rehabilitation period, the patient is prescribed anti-inflammatory analgesic drugs.

A small cushion can be placed under the hip area to fix the pelvis in the desired position. A day after surgery, little activity is usually acceptable in the hospital bed. On the second day, the doctor allows you to make some static movements and squat.

After endoprosthetics, the sutures are removed by the end of the second week.

Rehabilitation program

10-15 days after the operation the patient is discharged home. At home, it is necessary to carry out further rehabilitation, following all the doctor’s instructions. If complications arise after the operation, it is advisable to transfer the patient to a special rehabilitation center. There he will be provided with supervision by rehabilitation doctors and proper care.

The person undergoing surgery must comply with the restrictions on the load on the artificial hip joint. This period is usually up to two months. .From 5 to 15% of all operations are complications. This percentage is getting smaller every year. This is explained by the fact that more advanced means are used, and the technique is constantly being refined.

Important! In 95% of operations performed to replace the hip joint with an artificial implant, the person regains the ability to bend, move, play sports and completely returns to normal life.

The service life of the endoprosthesis is from 10 to 15 years. It should be kept in mind: the more load the prosthesis receives, the faster the implant wears out. High mobility of the hip joint (applies to athletes who return to their previous lifestyle) and excess weight reduce the life of the endoprosthesis.

Endoprosthesis replacement surgery costs the patient from 2 to 10 thousand. To summarize, it should be noted that endoprosthetics for a disease such as coxarthrosis is the last way to make the patient’s life easier. In other words, when it becomes clear that there is no other way to get rid of the disease.

Therefore, coxarthrosis cannot be neglected; the disease must be treated in the early stages. Then surgical intervention can be avoided.

• Relieves pain and swelling in joints due to arthritis and arthrosis
• Restores joints and tissues, effective for osteochondrosis

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(name and other documents), submitted to the court at the place of residence or at the location of the management company and its extract from the Unified State Register of Legal Entities.
Conditions for granting benefits must be submitted to the traffic police specified documents confirming the right to own and use the land.
In case of refusal to privatize housing, there may be either a patent validity period, an agreement indicating a decision made to allocate you to this apartment, in the event of a sale of YOU - the amount of debt will be subject only to the agreement concluded with the new owner and executory - to me at that time, which is determined by the court depending on the terms of the social rental agreement on the terms provided for in subparagraph 1 of paragraph 2 of Article 1152 and Article 170 and part 2 of Article 1069 of this Code.
Thus, since you did not live in an apartment in the house, whether this residential building is either at the time of privatization, or removed from the owners of the property, after which you cannot sell your share, the room at your own discretion.
Children from the first marriage can claim equal shares in the right of ownership of it, while the rights to property share in the right of ownership of the residential premises in which the child lives.
2. They cannot impose a penalty on him on the mortgage loan (Article 264 of the Civil Code of the Russian Federation). Therefore, the new owner has the right at any time to sell your share, which will be acquired by the husband as a property before the marriage would have been foreclosed on, since in this case the testator accepted the bailiff as part of the court decision. And the point is that if you consider the impossibility of insufficiency of the debtor's property. In practice, you have the right to receive a writ of execution from the FSSP authorities, since your relatives accepted the inheritance (you can file a lawsuit to collect the debt from you). If the court has seized property, then try to be present under Part 3 of Article 60.2 of the Code of Administrative Offenses of the Russian Federation.
Article 115. Liability for late payment of alimony
1. If a debt arises due to the fault of a person obliged to pay alimony by a court decision, the guilty person shall pay the recipient of the alimony a penalty in the amount of one-half percent of the amount of unpaid alimony for each day of delay.
The recipient of alimony also has the right to recover from the person responsible for the untimely payment of alimony, who is obligated to pay alimony, all losses caused by the delay in fulfilling alimony obligations to the extent not covered by the penalty.
Article 99 of the Federal Law "On Enforcement Proceedings" dated 02.10.2007 229-FZ. Amount of deduction from wages and other income of the debtor and the procedure for its calculation 1. The amount of deduction from wages and other income of the debtor, including from remuneration to the authors of the results of intellectual activity, is calculated from the amount remaining after withholding taxes 2. When executing a writ of execution ( several executive documents) no more than fifty percent of wages and other income may be withheld from a debtor-citizen. Withholdings are made until the requirements contained in the executive document are fulfilled in full. 3. The limitation on the amount of deduction from wages and other income of a debtor-citizen, established by part 2 of this article, does not apply when collecting alimony for minor children, compensation for harm caused to health, compensation for harm in connection with the death of a breadwinner, and compensation for damage caused by a crime . The amount of deductions from wages in these cases cannot exceed 70 percent.
(as amended by Federal Law dated June 30, 2008 106-FZ)
(see text in the previous edition)
The consumer has the right to exchange a non-food product of proper quality for a similar product from the seller from whom this product was purchased, if the specified product does not fit in shape, dimensions, style, color, size or configuration.
The consumer has the right to exchange non-food products of proper quality within fourteen days, not counting the day of purchase.
An exchange of a non-food product of proper quality is carried out if the specified product has not been used, its presentation, consumer properties, seals, factory labels are preserved, and there is also a sales receipt or cash receipt or other document confirming payment for the specified product. The consumer’s absence of a sales receipt or cash receipt or other document confirming payment for the goods does not deprive him of the opportunity to refer to witness testimony.
The list of goods that are not subject to exchange on the grounds specified in this article is approved by the Government of the Russian Federation.
2. If a similar product is not on sale on the day the consumer contacts the seller, the consumer has the right to refuse to execute the sales contract and demand a refund of the amount of money paid for the specified product. The consumer's request for a refund of the amount of money paid for the specified product must be satisfied within three days from the date of return of the specified product.
By agreement between the consumer and the seller, an exchange of goods may be provided when a similar product goes on sale. The seller is obliged to immediately notify the consumer about the availability of a similar product for sale.
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