Recovery after endoprosthetics

Any surgical operation requires the body strength and time to recover. Doctors call this recovery period rehabilitation. Such a complex operation as hip arthroplasty is no exception. It also has a recovery period, when there is a renewal of the functions of the joints of the leg and the work of the tissues of the joints. After all, the result of the operation is affected not only by the operation itself, but also by the factor of the normal course of the rehabilitation period. You should know: the process of rehabilitation after arthroplasty lasts quite a long time and consists of several phases. In each phase, the rehabilitation procedures are very different.

Recovery after arthroplasty: stage zero

Rehabilitation after arthroplasty depends on how hard or easy the patient underwent the operation. The main goal of this period is to restore blood circulation and movement in the joint. During this period of time, doctors offer mandatory special exercises that help simultaneously reduce pain symptoms. The initial rehabilitation phase begins from the first day after the prosthetics operation and lasts about five days. The first procedures and gymnastics often depend on what led to such an operation and the absence of pain.

It is recommended to start exercising immediately after recovering from anesthesia. If anesthesia was performed with an injection into the spine, then within 4-6 hours after it, the patient will not be able to move his legs. After restoring sensitivity, you need to start moving very carefully, but always every day, even if nothing comes out at first.

During the initial restorative treatment, the patient may attempt to gently sit up. But for now, he is prohibited from crossing his legs, lying on the operated side, strong bending of the leg operated on at the hip joint.

From the course of therapeutic exercises, you can do the following exercises:

• lie down, turning your back down, and carefully move your foot up and then down;
• lying in the same position, slowly make rotational movements of the feet (the leg should not come off the bed);
• lift each leg in turn for a couple of seconds up, and then gently lower it back onto the bed;
• without changing position, carefully raise your knees in turn, without taking your feet off the bed;
• without changing position, relax, and then strain the muscles of the buttocks for a short time (repeat this exercise about a dozen times);
• without changing position, position your legs evenly, smoothly move them to the sides, moving along the bed, and smoothly return back at the same speed.

The first rehabilitation phase after arthroplasty

This period is a rehabilitation stage, when, under the supervision of a doctor, the patient begins to learn how to manage a new joint: get out of bed on his own, sit back or on a chair, lie down and move around, helping himself with crutches or with the help of special walkers. There can be no single system of gymnastics and rehabilitation measures here. Each patient has his own set of exercises, depending on the pathologies that led to endoprosthetics. It is useful to add the following to the exercises already learned at the zero stage after the operation:

• walk carefully with the use of auxiliary means (about 100 m must be overcome already on the fourth day);
• stand against the wall and, holding on to it, bend each leg in turn at the same time at the knee and hip;
•  Without changing position, take each leg back one by one, keeping them straight.

At this stage, a small load on the prosthetic joint is already given, which will gradually need to be increased. It is easy to see that rehabilitation physical education at this step combines the strengthening of muscles and joints weakened by the operation in all positions. But we must not forget about caution so as not to dislocate the newly received joint. Recovery of working capacity after arthroplasty implies not only physiotherapy exercises. Several rules should also be observed to help the patient return to their previous way of life without complications.

The first of them states that it is unacceptable to bend the leg, the joint of which has been operated on, more than at a right angle. Sitting cross-legged and squatting down is also prohibited. Moreover, this condition must be observed during sleep. In order not to violate this rule, a couple of pillows are placed between the legs before going to bed.

Next: lying down in bed or sitting on a chair, the operated leg should be slightly moved away from the healthy one, and slightly straightened. This will help relax the muscles that fell under the surgeon's knife during the operation.

It is unacceptable to try to get a blanket or other items that are on the bed at the feet. It is also impossible to put on shoes, bending over strongly. For this, it is better to use a spoon.

You can only sleep on the side that has not undergone surgery. Between the knees, you need to put a small roller or pillow to help relax the muscles of the buttocks. But when lying on your back, you should not constantly keep a roller under your knee. The joint will not bend well in the future.

Second phase of recovery

This phase lasts from the 5th to the 21st day and is often called the late phase by doctors. The main goal is to increase the intensity of movements. At this step, rehabilitation after joint arthroplasty is complicated by moving up the stairs. They walk up the stairs very carefully, observing the following conditions:

• in one session, do not “travel” in this way for more than half an hour;
• the healthy leg should be the supporting one (it is placed on the new step first, and then the one that was operated on);
• crutches must be used when walking.

During this rehabilitation period, orthopedists, in addition to walking up the stairs, recommend adding the following gymnastic exercises:

• lie on your back, bend your legs, directing your heels to the buttock (you can do it alternately, or you can do it with both legs together);
• from the same position, raise your legs up, straining the muscles of the buttocks.

These exercises are performed in combination with those that have already been introduced into the rehabilitation course.

Third rehabilitation phase

This stage of recovery after arthroplasty is called remote by orthopedists. It usually begins 2-3 months after surgery. The patient is already invited to perform all the proposed procedures and exercises himself at home, periodically coming to the doctor for control. By this time, the joint had taken root, the tissues and articular ligaments damaged during the operation had strengthened. According to doctors, the patient can switch to a system of intense physical activity. The load on the joint at this time should be stronger, and three-hour walks. Walking at speed is already acceptable, however, it should not be too big. It is still impossible for such a patient to run, regardless of the causes of the joint disease. When conducting classes, it is allowed to use an elastic bandage, one end of which is attached to a door or furniture, and the other is tied around the ankle area.

The stage of rehabilitation of hip arthroplasty at this stage implies the inclusion, for example, of such a set of exercises with the participation of an elastic band:

1. Having fixed the elastic bandage, as mentioned earlier, stand near the object where the bandage is fixed, turn your back. Then lift the operated leg forward, trying not to bend the knee. Return slowly.
2. Turn sideways to the place where the end of the bandage is attached. Take the injured leg to the side and slowly return it back.
3. Use the exercise bike with the seat positioned so that straightened legs do not reach the pedals. In addition, the first movements on the simulator must be performed backwards. The load increases gradually. For example, for the first time it is allowed to pedal for 10 minutes. Gradually, the lesson time is brought to half an hour.
4. At this stage, you can already lie on your healthy side. Then raise the injured leg smoothly up, slightly bending it at the knee.
5. You can do exercises to restore a sense of balance. To do this, you need to stand for some time on one leg, leaning on a support or holding on to a wall.
6. The thigh muscles can already be trained by slightly squatting.

With a tape, you can perform strengthening exercises and lying on your back. In this case, it is fixed in the same way, and then, lying down, bend the leg, pulling the tape. It is necessary at this stage of rehabilitation to learn to walk backwards and move to the side.

After 3-4 months, the operated patient will be able to lead a healthy life. Although doctors recommend being careful with heavy loads on the modified joint and taking breaks in its physical work. Recommended sports include skiing and cycling, as well as swimming.

Conclusion

It should be remembered that each stage of rehabilitation should take place under the supervision of a specialist in physiotherapy exercises. He can tell the patient when a transition to a new complication of exercises and an increase in the load on the joint is possible.

Self-changing a set of exercises to develop a joint, especially with simulators, can lead to serious complications. Exercises with pain are unacceptable. Even when you feel good, and there is no pain, only a doctor should prescribe a load on the joint.

Rehabilitation after arthroplasty - video