The post-discharge check-up is carried out regularly by the operating physician, including an X-ray examination.
This is followed by a gradual increase in the load on the operated limb. Usual checks are soon after discharge home, and then at regular intervals according to the surgeon. Annual checks are advisable. A spa stay focusing on improving range of motion, muscle strength, exercise on the exercise bike and in the pool is possible.
Rehabilitation after total hip replacement is usually divided into three phases in relation to the surgery itself.
1) Preoperative rehabilitation
Pre-operative rehabilitation is the ideal preparation for a patient who comes to surgery with stereotypes already learned, proficient in walking on crutches and familiar with post-operative exercises. Therefore, he or she can respond to rehabilitation procedures after surgery and cooperate better, which also allows for a shorter hospital stay.
2) Post-operative rehabilitation during hospitalisation
Postoperative rehabilitation during hospitalization is usually very well developed in every orthopaedic department that performs TEP surgery, with minor variations according to the preferences of different departments. The aim is to train independent walking and self-care.
3) Rehabilitation programme after discharge to home treatment
Outpatient rehabilitation is an essential part of post-operative care at home, as it helps to maintain correct movement stereotypes and improve the movement of the operated limb. After 6 months, the patient is normally able to return to everyday life. He or she can begin to fully exercise and engage in lighter recreational sports. Throughout the rehabilitation period, the principle that the load on the operated lower limb is determined by the surgeon applies.
degenerative joint changes (arthritic) - these are the most common and are manifested by pain, limitation of movement, tremors, swelling or changes in joint configuration. The affected joint is deformed, deprived of quality cartilage and growths (osteophytes) are present.
rheumatoid arthritis - is a similar change to the previous example, but in more severe cases it significantly restricts the patient's movement and therefore leads to the indication of total replacement.
post-traumatic changes - occur after poorly healed fractures most often in the hip and knee area, they must be treated with total joint replacement. In some cases, even a fresh splinter-type fracture is indicated for total replacement.
Congenital defects - initially cause little difficulty to patients. These are mainly imperfect roofs of the femoral head and shape changes of the upper end of the femur. Degenerative changes in these patients proceed rapidly and eventually lead to surgical resolution.
oncological diseases - only in exceptional cases
Allergic reactions can occur mainly with materials containing the following metals: cobalt (Co), chromium (Cr), molybdenum (Mo), nickel (Ni) and others. Endoprostheses are made from the three basic groups of materials listed below.
- Stainless steel
- Stainless steel - nitrogen
- Titanium alloy
- Cobalt-chromium-molybdenum alloy for ISO casting
- Cobalt-chromium-molybdenum alloy for forging ISO
- BIOLOX delta ceramic is imported (Germany) and is mainly used for the production of the acetabular head.
- ultra-high molecular weight polyethylene
- crosslinked ultra-high molecular weight polyethylene
- Polyethylene (UHWMPE) is designed for PE wells, PE liners in metal acetabular sheaths. For total knee replacements as an insert between the femoral and tibial components.
- Polymethylmethacrylate (PMMA)
The patient is placed in the ICU after surgery. The following day he is transferred to the inpatient ward where very gentle muscle re-education, mainly with healthy limbs, begins under the supervision of RHB staff. Moderate movement is also allowed to the operated limb under supervision. On the second or third day at the latest, the patient stands on both lower limbs at the bedside.
From this point onwards, training in walking on crutches with moderate weight-bearing into pain begins. The patient is also allowed independent hygiene under the supervision of a nurse. The operated limb is actively and passively warmed up to the pain. Practice of walking up stairs is also necessary.
Some patients are discharged from the hospital bed directly to the RHB ward, where they usually stay for 2 - 3 weeks depending on the motor improvement.
Walking with underarm crutches is now changed to walking on French crutches. The patient is continuously checked by the surgeon. Rehabilitation treatment lasts at least three months. After X-ray control at this time, the patient begins to fully load with the removal of crutches. Spa treatment after this time may also be appropriate.
Ten guidelines for patients after hip surgery
Exercise - several times a day with hip movements. Exercise the back and abdominal muscles, gluteal muscles and upper limbs.
Lie and sleep - on a flat, firm bed. When lying on your side, lie on the non-operated side with a pillow inserted between your knees and shins.
Sit - on a sufficiently high and firm chair. Do not put leg over leg and do not lean to one side. The angle between the trunk and the thigh must not exceed 90 degrees. It is advisable to use a toilet attachment on the toilet. When sitting in the car, it is advisable to use a cushion.
Walking - with the assistance of crutches to lighten the operated limb. Use sturdy shoes for walking. A long spoon, long hook for shoe zips and Velcro straps will make dressing easier. The amount of stress on the limb will be determined by the doctor depending on the type of endoprosthesis used and the patient's physical condition.
When bathing - it is best and easiest to use a shower, equipped with a handle and non-slip pad. In a bathroom with a conventional bathtub, it is advisable to equip it with a bath seat.
To prevent TEN (thromboembolic disease) - use elastic bandages or medical stockings for 6 weeks after surgery.
Driving in a car - as a passenger, it is advisable to sit in the back seat with the operated lower limb extended. Driving a motor vehicle is appropriate no sooner than 3 months after surgery.
Sexual activity - during the first 3 months after surgery, significant external rotation and hip flexion beyond 90 degrees should be avoided in all movements.
Return to work and sporting activities - return to work and sporting activities is usually possible within 6 months at the latest, but individual differences are great and are determined by the physical condition and motivation of each patient.
Sport and recreation - swimming, walking and cycling and exercise biking are suitable. More vigorous running, jumping, horse riding and contact sports should be avoided.
Guidelines for patients after knee surgery
flat, firm bed, one pillow under the head
spend every spare moment exercising the operated limb: extending and flexing the knee, strengthening the muscles and calf, lifting the extended limb
practise flexion of the operated limb several times a day, actively and passively using the heel of the healthy limb
comfortable soft footwear, elastic sole, heel no more than 3 cm
continue to lighten the operated limb with 2 French canes for a period of time determined by the doctor
do not overload the operated knee by prolonged standing
do not overload the knee by excessive prolonged walking
if pain occurs, sit down with the knee relaxed
maintaining an appropriate body weight, possibly reducing weight
when sitting, place the feet parallel and further apart to prevent knee twisting
avoid heavy physical exertion
after heavy walking or exercise, it is advisable to cool the knee for 1-2 hours with either ice packs or special gel packs
attend regular check-ups with an orthopaedic surgeon /Your attendance at regular check-ups is essential
A patient who has significant clinical and radiographic findings in a joint that can be replaced must meet a number of prerequisites.
In a patient with a hip joint damaged by advanced degenerative changes, conservative treatment is no longer effective. Therefore, total hip replacement surgery is necessary. Such surgery is a standard procedure in all orthopaedic departments and usually takes no longer than 90 minutes. After the operation, the patient can start practicing walking the very next day, of course with lightening, exercising the joints of the limbs and within six months returning to a full life.
What does a new hip joint mean?
For the patient, immediately after the operation, they must follow all the instructions they receive from the surgeon. After discharge from the hospital, he or she must be careful to lighten the operated limb - this means not a step without crutches. The limb can only be fully loaded by normal walking with the permission of the surgeon. Even in the following years, the endoprosthesis may fail. Wear and tear of the material may occur, which will result in increasing pain. The most common cause of failure, however, is loosening of the endoprosthesis, which is caused by overloading, especially with excessive body weight. The most serious complication is infection of the endoprosthesis. Any infectious disease must therefore be treated with special care.
Beznoska offers a solution
Modern medicine nowadays makes it possible to treat even severe degenerative diseases of various joints, including hip joints. In some cases, however, the damage to the joint is too extensive and it is necessary to replace the joint with an implant. These replacements can last for many years without major problems, but it is important that the patient understands that this is only a "joint replacement", not the creation of a healthy new joint !! Therefore, he must always keep in mind that the life of the replacement is also determined by the way it is loaded ( the more and at the same time inappropriately the artificial joint is loaded, the shorter its life will be ). As a manufacturer and supplier of joint replacements with many years of experience, we would like to present some recommendations to help you decide how to treat the implant. These recommendations are of general validity and apply to all types of hip replacements. Of course, patients must follow the instructions given to them by their treating physician in these cases.
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