Rehabilitation after endoprosthetics at home

General principles of rehabilitation

The goals of rehabilitation are:

complete elimination of pain and inflammation that are a consequence of surgical procedures;
ensuring strong fusion of the endoprosthesis components with the bones, which occurs gradually during the process of regeneration and renewal of bone tissue;
normalization of the function of the muscular-ligamentous apparatus, which sets the articular bones in motion;
prevention of side effects and complications.

Rehabilitation after endoprosthetics includes the following treatment methods:

1. Drug therapy. The patient is prescribed medications:

antibiotics (to prevent infection of the operated area);
NSAIDs (for inflammation and pain);
anticoagulant drugs (to avoid the formation of blood clots);
gastroprotectors, diuretics;
calcium and protein supplements (to accelerate the recovery of muscle and bone tissue).

2. Physiotherapy. Includes procedures such as electrophoresis, electromyostimulation, UHF, balneotherapy, laser treatment, mud therapy, massage after knee replacement at home.

Physiotherapeutic procedures have the following effects:

quickly relieve swelling and pain;
eliminate muscle spasms;
strengthen ligaments, increase muscle tone;
increase the speed of lymph flow and blood flow in the injured leg, which accelerates the flow of nutrients and promotes rapid regeneration;

The rehabilitation period after hip, knee, or ankle replacement is a rather labor-intensive and lengthy process. To endure it normally, the patient and his loved ones need patience and strength.

If the rehabilitation process is organized correctly, the patient’s ability to work returns by the end of the tenth week. If during the recovery process after surgery to replace a hip, knee, or ankle joint with an artificial analogue, side effects and complications arise, then the rehabilitation process can be very prolonged.

Possible complications after endoprosthetics

After the hip joint is noticeable, complications of various types are observed in 4.3% of cases. Risks can be minimized by ensuring the stability of the prosthesis, observing the rules of asepsis and antisepsis, as well as early prediction and prevention of common postoperative complications. The latter include the following conditions:

deep vein thrombosis of the legs;
thrombophlebitis of the superficial veins of the legs;
bedsores;
embolism – accompanied by a high risk of death;
pneumonia, bronchitis, pleurisy.

Local complications from the postoperative wound include:

suppuration;
formation of inflammatory infiltrate, hematoma;
bleeding;
divergence of the edges of the wound (suture failure).

During surgery for hip replacement, purulent-inflammatory (1.5-6.0% of cases) and thromboembolic complications (9.3-20.7%) often develop [3]. Aseptic instability of implant components, dislocation of the endoprosthetic head, periprosthetic fractures, and postoperative neuritis may also occur.

If total hip replacement is performed after previous operations in this area, the risk of complications increases significantly. The likelihood of their development also increases with the patient’s age, in the presence of obesity[4], and concomitant severe diseases.

Stages of rehabilitation

There are three main stages of recovery:

1. Early. Includes the first 14 days after surgery. The patient is in a hospital, under round-the-clock supervision of specialists and masters basic skills (learns to stand up independently, walk on crutches, perform simple exercises, lie down correctly on the bed and place his legs in such a way as not to damage them).

2. Late. Lasts 1-2 months. During this period, the patient independently, at home, performs the exercises recommended by the attending physician, and also attends exercise therapy training in his clinic. The main efforts at this stage of recovery are focused on adapting the body to the new state, as well as on developing muscles. In addition, a person masters basic skills in solving everyday problems, taking into account the changes that have occurred to him.

3. Remote. This stage continues for six months after the operation. At this time, the patient is doing gymnastics after hip replacement at home, visiting a rehabilitation doctor, and learning to walk without crutches.

If it is decided that the patient will recover after knee, hip or ankle replacement at home, then close people need to prepare the apartment in advance.

So, in the bathroom you need to install handrails on which a person will lean while bathing, put a bench, and put a non-slip mat. At first, when carrying out hygienic procedures, relatives should accompany the patient, help him get into and out of the bath, holding the handrails with both hands.
Carpets, wires, and other obstacles must be removed from the path of human movement. It is necessary to increase the height of the kitchen chair by placing a folded blanket under it. You also need to raise the bed by placing a second mattress. The bed should be in a convenient place so that a person can easily approach it and lie down.
A small table or cabinet is placed next to the bed, on which essential items will be located (glasses, water, table lamp, flashlight, phone with charger, and so on).
It is necessary to organize optimal lighting in the apartment so that the light is not too bright and not too dim.
In addition, the attending physician will advise you on what exercise equipment you need to purchase so that recovery proceeds as quickly as possible. The recovery period after joint replacement is faster and easier for people with normal weight.
If there are extra pounds, the patient is advised to follow a diet. To accelerate the regeneration of bone tissue, it is useful to include in the diet foods rich in protein, calcium, collagen (lean meats, fish, milk, fruit jelly, jellied meat and others).
It is extremely important to choose the right comfortable shoes. It is desirable that it be orthopedic and have no laces. You also need to purchase crutches or a four-legged walker. If the rehabilitation process goes well, the patient will be able to begin walking with a cane approximately two months after surgery (this period is usually longer for older people).

A person begins to walk on his own feet, without the use of a cane or other supports, after 6 months. At this time, it is recommended to start walking a little. The duration of walking should be no more than half an hour. It is forbidden to lift heavy objects or place heavy loads on the leg. If swelling, redness, pain or other unpleasant symptoms appear in the area of the operated joint, you should immediately consult a doctor.

Useful complex

photographer Vladimir Grigoriev tel., home phone

After recovery from anesthesia, it is recommended to perform light exercises:

You need to wiggle your toes.
Move your foot forward and backward.
Rotate your foot clockwise and then counterclockwise.

These movements help improve blood flow, reduce swelling and prevent blood clots. They need to be performed every 10 minutes.

On the second day, squats on the bed are recommended. But this must be done with the help of medical staff. Already on the third day you need to get up and walk several steps, but with support. On the fifth day you need to walk 100 meters.

In addition to physical activity, breathing exercises are performed. Rehabilitation should be continued at home. In this case, the complex is done several times a day for half an hour. While lying down, perform the following movements.

In this case, repeat each 7-15 times:

Bend your legs and move your knees to the sides at a distance of up to 20 cm.
Bend one leg and straighten the other. At the same time, lift your pelvis up a few centimeters. It is necessary to tense the muscles of the buttocks.
Turn onto your stomach and place a pillow under your navel. Raise your leg and reach your heel towards your buttock until you feel tension. Hold the position for 15-30 seconds. Do the same with the other leg.
In the same position, spread your legs and bend them, and bring your heels together. You need to stay in this position for 7 seconds. This exercise cannot be done if the incision is located on the front of the thigh.
Place a small bolster under your ankle and lift your hip until your knee straightens. Stay in this position for 7-8 seconds.

At this time, rehabilitation measures are aimed at restoring movement functions and improving muscle tone.

This complex is performed when the patient can stand up and move around with support on crutches. The following exercises can be used:

Bring your legs together and perform slow squats. In this case, you need to bend your hip joints and knees. You need to do five repetitions. First you need to perform movements with hand support.
Lean on the back of the bed and do leg raises with a bend at the knee.
Lean on the headboard and smoothly lift your leg into a straight position. In this case, while lifting, the limb must be fixed for several minutes.

During this period, it is worth practicing massage treatments.

After discharge, recovery is carried out independently. In this case, rehabilitation is aimed at rapid restoration of bone tissue, as well as improvement of muscles, ligaments and tendons. Here are the exercises that are performed in a lying position:

Lie on your back and bend your legs one at a time. Then pull them towards your stomach. In this case, you need to simulate riding a bicycle. 10-20 repetitions are done.
Turn onto your stomach and lift your leg straight. Take her aside. Repeat with the other leg. If it is too difficult to keep your leg straight, you can bend it slightly.
Lie on your side and place a bolster between your legs. Raise your leg and hold in this position for several seconds. Then do the same manipulations on the other side. In this case, the limb can be bent at the knee or straight.

In the later stages of the recovery period, motor function should be adapted.

In this case, you can do exercises on simulators:

On an exercise bike, all movements must first be carried out backwards, and when it becomes easy to do, then forwards.
Walking on a treadmill is performed at a slow pace.
A budget option is a step machine.

Three months after surgery, the exercises can be performed while sitting or standing. Before using a complex complex, you should consult a specialist.

Here are some effective exercises:

Stand with your shoulder to the wall on the side of your sore leg. Hold the back of the chair with your other hand. Raise the bent and operated limb along the surface of the wall. In this case, the bend angle should not be more than 90 degrees. Repeat the same, but with the other leg.
Stand with your back to the wall surface and lean on the back of a chair. As you do this, elevate your operated hip. Then the exercise can be performed without support.
In the same position, leaning on the chair, raise your leg to the side by 18-20 cm. In this case, the heel should slide along the wall. Hold the limb at the top point for 6 seconds.
While sitting on a chair with your legs extended, move your leg to the side and then do the same with the other limb.

In addition to gymnastics, it is recommended to walk every day. In this case, you can choose short distances.

You also need to go up and down stairs. When lifting, you need to put on the healthy leg first, and then the sore leg.

When descending, crutches are placed forward, then the sore limb and the healthy one.

It is important that during the rehabilitation period all classes are supervised by a doctor. It will help you choose the right load.

You can't do gymnastics through pain. Fear may be the reason why recovery is too slow. Older people may experience severe anxiety. The stages of recovery may vary from patient to patient. After all, rehabilitation may require different periods of time. It is important to adhere to the recommended time limits for putting pressure on the leg.

The set of rehabilitation measures is individual and selected by a doctor. The standard program takes from 10 weeks to 7-8 months.

To speed up recovery, you need to move regularly and follow useful medical recommendations.

By setting a goal and slowly moving towards it, you will definitely achieve success and begin a fulfilling life.

bending the legs at the hip and knee joints;

Features of application

Selected by height based on doctor's recommendations. The main requirement is the distance between the knees. The degree of rigidity depends on the patient’s preferences, depending on the material with which the product is filled.

You will have to use a pillow for a long time after hip surgery. Judging by the reviews on the forums, we can confidently say that most patients use them constantly, because without a roller they experience discomfort and fatigue in the morning. In this regard, you should immediately choose a high-quality model, test it in the store in all positions where a person likes to sleep, and clarify the features of caring for the product.

Remedy for joints SUSTAFAST

Additional Precautions

Everyone knows how dangerous it is to slip and fall in the early stages after arthroplasty. Everything can end in a fracture, dislocation and repeated surgery. But the easiest way to slip is in the bathroom.

How to prevent this?

It's actually simple. To prevent the floor in the room from being slippery, rubber mats should be placed on it. They are also recommended to cover the bottom of the bathtub. These simple precautions will help make bathing as enjoyable and safe as possible.

Safe body position in bed

Immediately after surgery, the person should lie on their back with their legs moderately apart. A wedge-shaped pillow is placed between his knees, which prevents his legs from moving, crossing or turning inward. Please note that the pillow should not be placed in the popliteal cavity, as this will interfere with normal blood circulation in the lower extremities.

The next day the patient still continues to lie on his back. He is prohibited from crossing or bending his limbs too much. Until the endoprosthesis takes root, the patient should not turn the feet more than 30 degrees and bend the limb at the hip joint more than 90 degrees.

A person is prohibited from bringing his legs together - bringing the operated limb beyond the midline (a line drawn through the center of the spine that divides the body into right and left halves).

When can you lie on your operated side and stomach?

A person is allowed to lie on the operated side and stomach no earlier than after a month. This can be done with the permission of the attending physician.

During sleep, in order to avoid excessive contraction of the legs, the patient is recommended to place a special cushion between them. This is a soft leg spacer that is installed between the knees. With its help it is very easy to fix the lower limbs in the desired position.

The roller can be purchased in stores and online stores. It must be ordered in advance, before the patient returns home. After being discharged from the hospital, he will be able to sleep immediately without unnecessary worries.

How to choose a bathing seat

People who only have a bathtub (and no shower) at home should buy a chair or seat designed specifically for it. Sitting in this device, you can take both a shower and a bath.

When making a purchase, it is better to give preference to plastic products, since they are the lightest and most ergonomic. They do not absorb moisture, are easy to clean, and removing them from the bathtub and putting them back is extremely easy. In addition to the chair/seat, it is recommended to equip the bathroom with steps and handrails.

What's the best way to get into the bath?

You must enter the bath using special steps. Their installation must be taken care of in advance, while preparing the house/apartment for the patient’s return. Such steps are sold in many shopping centers and online stores.

You should step into the bath itself with extreme caution so as not to slip. It is best to do this with the help of loved ones. When climbing the steps, the healthy leg should be lowered first, and only then the operated leg. This is necessary in order to prevent overloading of the sore leg.

In the bath itself you need to sit on a special seat or chair purchased in advance. It is recommended to get into it with the help of loved ones. If this is not possible, then the bathroom must be equipped in such a way that the patient can sit down and stand up independently. To do this, install special handrails.

You need to sit down in a chair slowly, holding your body firmly with your hands. You should sit in the device straight, keeping your legs together and avoiding skewing your pelvis.

Before using any chair, you must carefully read the instructions for it.

Results

In the first two to three weeks you cannot take a bath, and you can only wash in the shower.
During water procedures, the bandage must be removed, and after completion, replaced with a clean, sterile one.
Three to four weeks after endoprosthetics, provided the wound has completely healed, the patient is allowed to take a bath while sitting in a special chair/seat.
While swimming, you should sit upright, keeping your legs together and not allowing them to bend excessively at the hip joint (more than 90 degrees).
In addition to seating, it is recommended to equip the bathroom with steps, rubber mats, and handrails.
It is best for a patient to bathe with the help of loved ones and under their close supervision.