Crutches after endoprosthetics: how to walk correctly, flat surface and steps

The use of crutches or special walkers is necessary for every person who has undergone endoprosthetics of any large joint of the lower limb. Walking with the help of support devices is an important part of rehabilitation. It helps patients maintain good physical shape in the postoperative period so they can recover faster and return to their normal lifestyle.

After replacing the TBS.

Many doctors recommend that patients purchase crutches in advance and learn to walk on them. Moreover, in many private clinics, specialists select the most suitable means of support for patients and teach them how to use them. All this allows you to avoid troubles and complications during the rehabilitation period.

After surgery, get out of bed only with the permission of your doctor. Use them exactly as much as he says. Don't give up walking with them ahead of time. Such amateur activities can have unpleasant consequences.

Why are crutches needed?

Endoprosthetics of the hip or knee joint is a surgical intervention during which not only the bones, but also the soft tissues of the leg are damaged. After surgery, patients regain the anatomical integrity of the joint, but not the function of the lower limb. It takes a lot of time for the patient to begin to move independently. During this period he needs to use walking aids.

The main purposes of their use:

1. Protect a person from falling. In the first days after surgery, the patient is often bothered by general weakness and dizziness. The operated leg is usually weakened and non-functional, with swelling and pain. At this time, they serve as an excellent support that he can rely on at the right time. When a person begins to move around a lot, they support him during breaks. The patient can walk as long as necessary without the risk of falling, because they provide two additional points of support.
2. Reduce the load on the sore leg. When walking with crutches, the patient only leans slightly on the operated limb. Partial load allows you to limit leg trauma as much as possible, not overload recently implanted elements and create good conditions for postoperative wound healing. Thanks to this, the rehabilitation period is more favorable, and leg functions are restored faster. And bone tissue can grow into the pores of the endoprosthesis without stress.

Please note that only persons with well-developed muscles of the torso, shoulder girdle and upper limbs can use crutches. They must have enough strength to support their body in the correct position for walking. As for older, weaker and sick people, they do not always have the opportunity to use the devices. As a rule, doctors recommend that such patients walk with a walker.

Rehabilitation methods used in the recovery process

• Drug therapy - antibiotics to prevent infection in the early period, painkillers, anti-inflammatory drugs. After this - vitamin complexes, calcium supplements, immunostimulating drugs.
• Physiotherapy – techniques for improving blood circulation, stimulating metabolic processes, reducing pain and increasing muscle tone.
• Hydrokinesitherapy – water exercises to develop the joint, speed up recovery and reduce the risk of complications.
• Cryotherapy is cold therapy. Special forms filled with hydrogel are cooled and applied to the location of the endoprosthesis for 15 minutes. This relieves pain and relieves swelling.
• Magnetotherapy is a hardware technique for stimulating microcirculation in tissues and accelerating healing.
• Electrical stimulation - tissues are exposed to alternating weak current, due to which the muscles maintain tone even with limited physical activity. Lymph and blood flow improves.
• Laser therapy for anti-inflammatory effect, pain relief and swelling.
• The use of orthoses if the joint needs to be further stabilized. The orthosis (bandage) is selected by an orthopedic traumatologist. This device fixes the joint, relieves it and corrects the function of the leg. The load is redistributed to healthy areas, treatment time is reduced.
• Kinesitherapy is a set of exercises that is selected taking into account the patient’s medical history, condition and a number of other factors. The load gradually increases, using walkers, crutches, and exercise equipment. This technique allows you to restore motor function.
• Exercise therapy, which is best done under the supervision of a trainer. But in the long term, the practiced exercises can be done at home.
• Massage is indicated in the absence of acute pain. It is carried out in order to increase blood flow and saturate tissues with oxygen for better regeneration.

How to walk on crutches correctly

The principle is very simple, its essence is that the “sick” leg should always be between two crutches.

1. When we take a step with the “healthy” leg, the “sick” leg remains in place along with the crutches on the same line.
2. When we take a step with the affected leg, the entire weight of the body is transferred to the healthy leg, and the sick leg, together with two crutches on the same line, takes a step.

Over time, you will switch to a cross step; it completely coincides with walking without crutches, when you step with your left foot, your right hand moves forward, when you step with your right foot, your left hand moves forward. This is an innate gait stereotype, so no additional comments are required, it will come on its own.

The sore leg is indicated in black; note that it is always between two crutches.

Another example.

Precautions when sitting and walking

When sitting on a bed or chair, you need to remember the main thing: the affected leg should not bend at the hip joint more than 90 degrees. Otherwise, there is a high risk of endoprosthesis dislocation.

Therefore, for 8-12 weeks after endoprosthetics, experts recommend sitting on high bar stools. If there is no such furniture at home, then you can use ordinary stools. However, before this, they should be placed on high, firm pillows. It is extremely important that when sitting, the pelvis is at least 10 centimeters above the level of the knees.

At the same time, the patient is prohibited from sitting on:

• soft sofas;
• low chairs;
• armchairs;
• “sinking” mattresses.

As for the toilet, you need to attach a special elevation to its seat. It will be possible to sit on it only after this.

Toilet nozzle.

How long to use crutches

The minimum period for using crutches after endoprosthetics is 6 weeks. If complications arise during surgery or in the postoperative period, you will most likely have to walk with them a little longer. This applies to cases where, during surgery, doctors replaced both knee or hip joints at once.

Contraindications to early refusal:

• the presence of osteoporosis or obvious bone tissue defects;
• intraoperative bone fractures;
• reconstructive operations requiring bone grafting or the use of additional fixing devices;
• implantation of a femoral component with proximal fixation, which is attached to the cancellous bone of the trochanteric region;
• large body weight of the patient.

In different clinics, endoprosthesis replacement is performed using different methods. For example, in hospitals in the Russian Federation, hip joints are replaced by first making a large incision in the soft tissue of the thigh. In European clinics, the operation is performed using a minimally invasive technique. During surgery, surgeons do not cut the muscles, but only spread them apart. Naturally, in the second case, rehabilitation will be easier, and the person will be able to give up crutches much earlier.

Fact! During the normal course of the rehabilitation period, a person begins to walk a little without support within 4-5 weeks. At first he is allowed to walk 5-10 meters on his own, then 20-30 meters.

Precautions for bathing and swimming

To prevent slipping in the bathroom, rubber mats should be placed on the floor. They should also be used to cover the bottom of the bathtub. And so that the operated person can easily climb into it, special steps need to be installed nearby. These, as well as grab bars, chairs and other bathroom fixtures, can be found in specialty stores or online stores.

Taking a bath is often a problem.

Why is it so important to put off crutches in time?

Early activation of the patient with full weight bearing on the operated leg speeds up rehabilitation and contributes to the rapid restoration of limb function. Therefore, doctors make sure that patients begin to sit up, get out of bed and walk as early as possible. After all, the more a person moves and engages in physical therapy, the faster he will return to his usual lifestyle.

At a certain stage of rehabilitation, crutches begin to interfere with the patient’s ability to move; physically the patient is ready to walk without them, but mentally he is not. In this situation, it is better for a person to completely abandon their use. Otherwise, it will “cling” to additional means of support, which will negatively affect the condition of the muscles and slow down recovery.

Many patients are initially afraid to move independently. In most cases, their fears are unfounded and only hinder them, forcing them to walk with a cane for several months, although there is no need for this. As a result, they waste time and hinder rehabilitation with their own hands.

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Possible complications of the postoperative period

Having figured out how long rehabilitation lasts after knee replacement, it is necessary to talk about the problems that may arise during this process. After knee replacement, there is a risk that the prosthesis will become dislodged or blood clots will form in the veins. During rehabilitation, joint mobility is also sometimes limited. This problem occurs because scar tissue forms. In addition, inflammatory processes develop at this stage. Moreover, sometimes they can arise as a result of infection.

Using a cane after endoprosthetics

In many sources you can find information that after giving up crutches, patients should still walk with a cane for several weeks. This is not entirely true. Only frail elderly people and patients with complications need a cane. Everyone else does not need to use this device.

The unnecessary use of additional means of support leads to the fact that patients become “emotionally attached to the cane.” It would seem that the timing after the operation and their physical condition allow them to move independently, but they cannot do this. To prevent this from happening to you, you need to give up walkers, crutches and canes as early as possible. Naturally, do this only with the permission of your doctor.

What not to do with a seam

Before the stitches are removed from the postoperative wound, it should not be wetted or washed with running water. Therefore, in the first 10-14 days after surgery, it is not recommended to take long showers and baths. And you should wash so that water does not get on the bandage. If it gets wet, it must be changed immediately. Remember that a wet bandage can become a source of infection and cause the wound to fester.

Surgical suture.

You can start bathing in the shower only two to three days after the stitches are removed. And take a bath after a few more weeks. Before starting water procedures, you should check with your doctor whether this is possible.

Please note that the postoperative scar cannot be rubbed with a washcloth until it has completely healed. After all, the skin here is very thin and sensitive, and it is undesirable to injure it.

Useful tips

• For winter, it is better to purchase attachments with spikes or crutches with a built-in retractable spike.
• Adjustable models - constantly check for quality of fixation.
• If it is difficult to maintain balance, then crutches (axillary models) should be pressed closer to the chest.
• Tips should be inspected regularly. If they wear out, you may slip and fall.
• To avoid falling on a slippery surface, you need to take small steps.
• Models with multiple support points allow for better balance and are optimal for older people.

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Selection reminder

Obviously, when choosing crutches, in addition to the rehabilitation and physical training stage, you need to take into account key anthropometric parameters - height and weight. When selecting axillary models, you also need to measure the distance from the floor to the armpit (the patient should be wearing normal shoes).

Approximate ratio of height and distance from floor to armpit

If you are not choosing crutches for yourself and there is no way to measure the patient, subtract 40 cm from his height (this is a very approximate calculation and you should try not to resort to it).

When selecting “Canadian crutches” with emphasis on the forearm, there is no need to take anatomical measurements - these crutches are universal.

Using the formula “height minus 40 cm” you can choose crutches for a child. If it is possible to take measurements, choose models with a crossbar height of -4 cm from the armpit.