Dislocation of the hip joint endoprosthesis

With severe arthrosis of the hip joint, conservative treatment does not give the desired result. The only way to relieve a patient of pain and return him to normal physical activity is hip replacement surgery.

As with any other surgical procedure, complications can develop after hip replacement. Their occurrence is influenced by the patient’s age, the nature of the pathology in the joint, concomitant diseases, and excess weight. Therefore, before the operation begins, all possible reasons are taken into account to minimize the risk of complications in the postoperative period.

Dislocation of the endoprosthesis: causes

According to statistics, endoprosthesis dislocation is more often diagnosed in females than in males. The risk group also includes people with:

Aged people. This is due to their weak bone structure, which becomes more loose;
Suffering from overweight and obesity. This is due to the fact that a large body weight will place too much stress on the prosthesis on a daily basis;
Those who are tall.

The diagnosis of hip replacement indicates that the implant previously implanted in the hip area has moved beyond the acetabulum.

There are several reasons for this:

Other surgeries that have been performed in the hip area;
Violation of the regimen prescribed by the doctor;
Hip injury;
Existing pathological defects in the hip area;
Exercising too intensely or doing too much physical activity;
Muscle weakness;
Pushing out the cup itself;
Diagnosis of dysplasia.

Since the endoprosthesis is an artificially created implant, it is worth considering that the cause of its dislocation can also be:

Loosening the structure itself;
Breakage of polymer parts;
The size is too small.

A simple mistake when installing a prosthesis can cause its subsequent dislocation. Surprisingly, the vast majority of cases (almost 75%) of prosthetic dislocations occur within one year after installation.

Different leg lengths after endoprosthetics

Changes in limb length after endoprosthetics are more often observed when a hip joint endoprosthesis is installed. As a rule, the leg in which the joint was replaced becomes longer, less often - shorter, than the second limb.

Reasons for changes in leg length:

lack of radiological control during surgery;
selection of an implant without preliminary collection of parameter measurements (offset, SDU). This error is typical for cases of installation of a knee joint endoprosthesis or hip replacement with cementless monoblock legs.

In some cases, a change in the length of the limbs can also occur with the correct installation of a knee endoprosthesis . A common reason is the lack of quality rehabilitation or its negligent implementation.

Measuring the lateral inclination of the acetabulum. The right minor trochanter is located lower than the left, indicating a leg length discrepancy. Normal horizontal center of rotation (red line).

Endoprosthesis dislocation: symptoms and signs

Symptoms of hip prosthesis dislocation in most cases appear immediately after its occurrence. The patient begins to notice symptoms such as:

Severe pain that gets worse when you move your leg or try to stand on it;
Muscle tension in the thighs;
Weakness in the leg. Even if the patient can walk, he will feel insecure. The gait will be very shaky and unstable;
Limitation of limb mobility.

With a dislocated endoprosthesis, the patient can only walk with great difficulty.

Visual symptoms are shortening of the limb in which the prosthesis is placed. If the sprain was preceded by an injury, there will also be swelling, redness, and sometimes bruising.

It is rare that a person does not know about a dislocation for some time, since pain symptoms are completely absent. Unfortunately, this only aggravates the situation, because the earlier treatment is started, the lower the risk of developing serious complications.

Specific symptoms include increased body temperature. This phenomenon occurs when an inflammatory process develops in the body against the background of a dislocation.

Problems of endoprosthetics

joint replacement surgeries are performed . In Russia, the result is several times lower – up to 40–50 thousand manipulations. Although the need for such treatment significantly exceeds this number.

The high demand for surgery to install an implant and the activity of endoprosthetics is explained by the effectiveness of this treatment method. Remaining radical (surgical intervention), in many cases it becomes life-saving when non-surgical treatment is impossible.

But the surgeon’s responsibility is not limited to the invasion itself (the procedure for replacing part or the entire joint). In addition to the operation, monitoring the patient’s condition during the rehabilitation stage and after its completion is extremely important. The need for such control is explained by the aseptic instability of the endoprosthesis or its parts in the short or long term.

Failure of the endoprosthesis after endoprosthetics , as one of the complications of surgical treatment, is the main, but not the only problem:

with all its achievements, orthopedics and traumatology have not yet found an ideal material for an implant that is guaranteed not to cause any damage to the human body after many years of use;
even the most reliable materials begin to deteriorate over time - their smallest parts get into the tissue around the implant, causing inflammation, disruption of local blood supply and even cell death;
against the background of inflammation, the prosthesis itself becomes loose, which accelerates its destruction and leads to infection with all the ensuing consequences, fractures of the hip bone, including one of the largest bones of the skeleton - the femur.

Diagnosis of pathology

Diagnosing a hip dislocation is quite simple. In most cases, the patient suspects prosthesis dislocation immediately after the first symptoms appear. Doctors with such a problem should consult a traumatologist or surgeon. During the visit, the doctor visually assesses the patient's condition and examines symptoms. But to confirm the diagnosis, it will still be necessary to seek the help of instrumental methods, namely:

X-rays. The photo clearly shows the location of the joint and the fact that it is located outside the acetabulum;
Computed tomography and magnetic resonance imaging. These are more advanced methods that are used when x-rays do not provide complete information about the cause of the sprain. Using these techniques may be especially important before surgery.

If necessary, additional testing procedures are performed.

Endoprosthesis dislocation: treatment

The prescribed treatment directly depends on the nature of the dislocation of the prosthesis. The primary case is usually treated conservatively. However, if a patient is repeatedly diagnosed with this problem, it is unlikely that surgery will be avoided.

Conservative treatment

Conservative treatment consists of traditional repositioning of the dislocated hip joint prosthesis. Since this procedure is quite painful, the doctor must use anesthesia or spinal anesthesia.

After the denture has been reduced, the patient should be advised to rest in bed. On average, this takes 8-10 days. The patient then begins to walk independently on crutches. The next stage is walking with a cane and, finally, walking without assistive devices.

Immobilization of the hip joint

To fix the prosthesis, a plaster cast can be placed on the patient immobilized in the correct direction:

Gypsum bandage. It may cover the entire limb or only part of it;
Orthosis. One of its varieties is derotational shoes;
Longett. In this case, it is attached under the knee joint on the back of the leg.

The listed procedures are the basis of conservative treatment. But everything will not work without drugs. They are necessary to speed up the body’s regeneration process, as well as to prevent complications. Therefore, drugs are prescribed in a comprehensive manner: anti-inflammatory drugs, anticoagulants, microcirculation stimulants, vitamin complexes. Antibiotics are added if necessary.

Surgical treatment

Since hip dislocation can occur for various reasons, related to both internal processes occurring in the patient’s body and external factors, the course of the operation is individual in each case. Therefore, the surgeon conducts a thorough diagnosis, on the basis of which the operation will be performed.

In addition to returning the prosthesis to its original position, surgical intervention should be aimed at eliminating the causes of possible relapse. Thus, the surgeon can perform the following procedures:

Restoring the strength of muscle tone surrounding the prosthesis;
Enlargement of the prosthesis head;
Increase in neck length;
Replacement of prosthetic components;
Replacement of prosthesis.

The nature of the operation is quite serious, and given that most patients are elderly with an already weakened bone structure, the surgeon must be aware of the responsibility of his work.

Life with a new hip joint

Memo for the patient

Before and after total hip replacement (endoprosthetics)

Instead of a prologue or what is endoprosthetics

Constant pain in your hip joint, which arose after an injury or disease of the joint, has recently become unbearable... It is difficult to remember at least one day when you did not feel it. All tested remedies that relieved pain before now provide only a short-term effect. Movements in the joint have become limited and painful. You began to notice that your leg cannot be fully straightened, it has become shorter. The attending physician at the clinic is less optimistic in his forecasts; he responds to persistent demands to reliably relieve you of pain either with silence or with poorly concealed irritation... What to do?

Our goal is not to scare you or throw you into panic. On the contrary, we will try to help you choose the right path for recovery.

So, all attempts to reliably get rid of pain using conservative treatment methods were unsuccessful. But even the thought of the possibility of surgical treatment seems terrible to you. Moreover, you hear a wide variety of, sometimes contradictory and frightening opinions about the results of operations...

To better understand possible operations, let's try to imagine the anatomy of the hip joint. So, the hip joint is a ball-and-socket joint where the thigh meets the pelvic bones. It is surrounded by cartilage, muscles, and ligaments that allow it to move freely and painlessly. In a healthy joint, smooth cartilage covers the head of the femur and the acetabulum of the pelvic joint. With the help of surrounding muscles, you can not only support your weight while supporting your leg, but also move. In this case, the head slides easily inside the acetabulum.

In a diseased joint, the affected cartilage is thinned, has defects and no longer serves as a kind of “lining”. The articular surfaces, altered by the disease, rub against each other during movements, stop sliding and acquire a surface like sandpaper. The deformed head of the femur turns with great difficulty in the acetabulum, causing pain with every movement. Soon, in an effort to get rid of the pain, the patient begins to limit movements in the joint. This in turn leads to weakening of the surrounding muscles, “shrinking” of the ligaments, and even greater limitation of mobility. After some time, due to the “crushing” of the weakened bone of the femoral head, its shape changes, and the leg shortens. Bone growths (so-called “spikes” or “spurs”) form around the joint.

What kind of operations are used for severe joint destruction? The simplest, most reliable, but not the best is to remove the joint (resection) followed by the creation of immobility at the site of the former mobile joint (arthrodesis). Of course, by depriving a person of mobility in the hip joint, we create many problems for him in everyday life. The pelvis and spine begin to adapt to the new conditions, which sometimes leads to pain in the back, lower back, and knee joints.

Sometimes operations are used on muscles and tendons, which, when crossed, reduce pressure on the articular surfaces and, thereby, somewhat reduce pain. Some surgeons use corrective operations to expand the crushed head, thereby moving the load to undamaged areas. But all these interventions lead to a short-term effect, only for a while, reducing pain. Only an operation to completely replace the diseased joint can radically interrupt this entire chain of painful processes. To do this, the orthopedic surgeon uses a hip replacement (artificial joint). Like a real joint, the endoprosthesis has a spherical head and an imitation of the acetabulum (“cup”), which are connected to each other and form a smooth joint with ideal gliding. A ball-shaped head, often metal or ceramic, replaces the femoral head, and a cup, often plastic, replaces the damaged acetabulum of the pelvic bone. The stem of the artificial joint is inserted into the femur and securely fixed in it. All parts of the artificial joint have polished surfaces for perfect gliding during your walking and any movements of your leg.

Of course, an artificial joint is a foreign body for your body, so there is a certain risk of inflammation after surgery. To reduce it you need:

cure bad teeth;
cure pustular skin diseases, minor wounds, abrasions, purulent nail diseases;
cure foci of chronic infection and chronic inflammatory diseases, if you have them, monitor their prevention.

We remind you once again that an artificial joint is not a normal joint! But, often, having such a joint can be much better than having your own, but sick!

Currently, the quality of artificial joints and the technique of their installation have reached perfection and have reduced the risk of various postoperative complications to 0.8-1 percent. Despite this, certain complications are always possible, associated with the already described inflammation of the tissues around the joint or with early loosening of the elements of the endoprosthesis. Strict adherence to the doctor’s recommendations will reduce the likelihood of such complications to a minimum. At the same time, it is difficult to demand from the surgeon one hundred percent guarantees of the ideal functioning of the implanted joint, since its function depends on a number of reasons, for example: the advanced stage of the disease, the condition of the bone tissue at the site of the proposed operation, concomitant diseases, and previous treatment.

Typically, the service life of a high-quality imported endoprosthesis is 10-15 years. In 60 percent of patients it reaches 20 years. In recent years, a new generation of artificial joints (with the so-called metal-to-metal friction pair) has appeared, the estimated life of which should reach 25-30 years. namely, the “estimated lifespan”, since the period of observation of these joints for the most part does not yet exceed 5-6 years.

There are many different designs of hip joint endoprostheses, but the correct choice of the joint you need can only be made by an orthopedic traumatologist who deals with this problem. As a rule, the cost of a modern imported endoprosthesis ranges from 1000 to 2500 US dollars. Of course, this is a lot of money. But, in our opinion, life without pain and the ability to move are sometimes worth it.

So, we tried to openly talk about the problem of replacing a diseased joint with an artificial one. The final choice is yours. But let you be reassured by the fact that every year more than 200 thousand patients around the world choose endoprosthetics surgery.

By choosing to have a total hip replacement, you have taken the first step in returning to the pain-free and limited mobility you lived before your illness. The next step will be a period of postoperative rehabilitation. The purpose of the brochure that you are holding in your hands is to help you take this step correctly and as successfully as possible. To do this, you will have to change some old habits and behavioral patterns, and apply certain forces to restore walking and normal movement in the joint. We hope that your family, friends, and medical workers will help you through this thorny path to recovery. We will try to help you too.

You always need to remember that an endoprosthesis, unlike a natural joint, has a limited range of safe movements and therefore requires special attention, especially in the first 6-8 weeks. Since during the operation not only altered bone structures are removed, but also altered ligaments, cartilage, and the scar capsule of the joint, the stability of the operated joint in the first days is low. Only your correct behavior will allow you to avoid the danger of dislocation and form a new normal joint capsule, which, on the one hand, will provide reliable protection against dislocation, and on the other hand, will allow you to return to normal life with full range of motion in the joint.

First days after surgery

As we just said, the first days after surgery are the most important. Your body is weakened by the operation, you have not yet fully recovered from anesthesia, but in the first hours after waking up, try to remember more often about the operated leg and monitor its position. As a rule, immediately after surgery, the operated leg is placed in an abducted position. A special pillow is placed between the patient’s legs to ensure moderate separation. You need to remember that:

In the first days after surgery it is necessary to sleep only on your back;
You can only turn on the operated side, and then no earlier than 5-7 days after the operation;
when turning in bed, you must place a pillow between your legs;
You can sleep on the non-operated side no earlier than 6 weeks after the operation; if you still cannot do without turning onto the healthy side, then it must be done very
carefully, with the help of relatives or medical staff, constantly holding the operated leg in a state of abduction. To protect against dislocation, we recommend placing a large pillow between your legs.
During the first days, you should avoid a large range of motion in the operated joint, especially strong flexion in the knee and hip joints (more than 90 degrees), internal rotation of the leg, and rotation in the hip joint.
When sitting in bed or going to the toilet in the first days after surgery, you need to strictly ensure that there is no excessive flexion in the operated joint. When you sit on a chair, it should be high. A regular chair should be cushioned to increase its height. Low, soft seats should be avoided.
In the first days after surgery, it is strictly forbidden to squat, sit with crossed legs, or “cross” the operated leg over the other.
Try to devote all your free time to physical therapy exercises.

The first goal of physical therapy is to improve blood circulation in the operated leg. This is very important to prevent blood stagnation, reduce swelling, and speed up the healing of the postoperative wound. The next important task of physical therapy is restoring the strength of the muscles of the operated limb and restoring the normal range of motion in the joints and the support of the entire leg. Remember that in the operated joint the friction force is minimal. It is a hinge joint with ideal gliding, so all problems with limited range of motion in the joint are solved not through its passive development like rocking, but through active training of the muscles surrounding the joint.

In the first 2-3 weeks after surgery, physical therapy is performed while lying in bed. All exercises must be performed smoothly, slowly, avoiding sudden movements and excessive muscle tension. During physical therapy exercises, proper breathing is also important - inhalation usually coincides with muscle tension, exhalation with muscle relaxation.

The first exercise is for the calf muscles. Bend your feet toward and away from you with slight tension. The exercise should be performed with both legs for several minutes up to 5-6 times within an hour. You can start this exercise immediately after waking up from anesthesia. A day after surgery, the following exercises are added.

The second exercise is for the thigh muscles. Press the back of your knee joint into the bed and hold this tension for 5-6 seconds, then slowly relax.

The third exercise is to slide your foot along the surface of the bed, lift your thigh towards you, bending your leg at the hip and knee joints. Then slowly slide your leg back to the starting position. When performing this exercise, you can first help yourself with a towel or elastic band. Remember that the angle of flexion in the hip and knee joints should not exceed 90 degrees!

Fourth exercise - placing a small pillow (no higher than 10-12 centimeters) under your knee, try to slowly tense your thigh muscles and straighten your leg at the knee joint. Hold the straightened leg for 5-6 seconds, and then also slowly lower it to the starting position. All of the above exercises must be done throughout the day for a few minutes 5-6 times per hour.

Already on the first day after surgery, provided there are no complications, you can sit up in bed, leaning on your hands. On the second day, you need to start sitting up in bed, lowering your legs from the bed. This should be done towards the non-operated leg, gradually abducting the healthy leg and pulling the operated leg towards it. In this case, it is necessary to maintain a moderately apart position of the legs. To move the operated leg, you can use devices such as a towel, crutch, etc. When moving the operated leg to the side, keep your body straight and make sure that there is no external rotation of the foot. Sit on the edge of the bed, keeping your operated leg straight and in front. Slowly place both feet on the floor.

You must immediately remember that before sitting down or standing up, you must bandage your legs with elastic bandages or put on special elastic stockings to prevent thrombosis of the veins of the lower extremities!!!

First steps

The goal of this rehabilitation period is to learn how to get out of bed, stand, sit and walk so that you can do this safely yourself. We hope that our simple tips will help you with this.

As a rule, you are allowed to get up on the third day after surgery. At this time, you still feel weak, so in the first days someone must help you, supporting you. You may feel a little dizzy, but try to rely on your strength as much as possible. Remember, the faster you get up, the faster you will begin to walk. The medical staff can only help you, but nothing more. Progress is entirely up to you. So, you should get out of bed in the direction of the non-operated leg. Sit on the edge of the bed, keeping your operated leg straight and in front. Before standing up, check that the floor is not slippery and that there are no rugs on it! Place both feet on the floor. Using crutches and your non-operated leg, try to stand up. Caring relatives or medical staff should help you in the first days.

When walking in the first 7-10 days, you can only touch the floor with your operated leg. Then slightly increase the load on your leg, trying to step on it with a force equal to the weight of your leg or 20% of your body weight.

After you have learned to confidently stand and walk without assistance, physical therapy should be expanded with the following exercises performed in a standing position.

Knee lift. Slowly bend the operated leg at the hip and knee joints at an angle not exceeding 90 degrees, while raising your foot above the floor to a height of 20-30 cm. Try to hold the raised leg for a few seconds, then also slowly lower your foot to the floor.
Taking your leg to the side. Standing on your healthy leg and holding the headboard securely, slowly move your operated leg to the side. Make sure your hip, knee and foot are pointing forward. Maintaining the same position, slowly return your leg to the starting position.
Taking the leg back. Leaning on your healthy leg, slowly move your operated leg back, placing one hand on the back of your lower back and then making sure that your lower back does not sag. Slowly return to the starting position.

We recommend doing the exercises listed above up to 10 times a day for several minutes. They will help you significantly speed up the rehabilitation period and quickly start walking without assistance.

So, you walk quite confidently on crutches around the ward and the corridor. But this is clearly not enough in everyday life. Almost every patient needs to walk up stairs. Let's try to give some advice. If you have had one joint replaced, then when moving up, you should start lifting with the non-operated leg. Then the operated leg moves. The crutches move last or simultaneously with the operated leg. When going down stairs, you should move your crutches first, then your operated leg, and finally your non-operated leg. If you have both hip joints replaced, then when you lift, the more stable leg begins to move first, then, as described earlier, the less stable leg begins to move. When descending, you should also lower your crutches first, then your weak leg, and finally your strong leg.

We remind you once again that during this period: it is advisable to sleep on a high bed;

You can sleep on your healthy (non-operated) side no earlier than 6 weeks after surgery;

You should sit in high chairs (like bar stools) for 6 weeks after surgery. A regular chair should be cushioned to increase its height. Should

Avoid low, soft seats (chairs). It is important to follow all of the above when visiting the toilet.

It is strictly forbidden to squat, sit cross-legged, or “cross” the operated leg over the other;

get rid of the habit of picking up fallen objects from the floor - either those around you or you should do this, but always with the help of some kind of device such as a stick.

Current control

An endoprosthesis is a rather complex and “delicate” design. Therefore, we strongly recommend that you do not abandon the monitoring regimen recommended by your doctor for the behavior of the new artificial joint. Before each follow-up visit to the doctor, it is necessary to take an x-ray of the operated joint, it is advisable to take blood and urine tests (especially if after the operation you had some kind of inflammation or problems with wound healing).

The first follow-up examination usually occurs 3 months after the operation. During this visit, it is important to find out how the joint “stands”, whether there are any dislocations or subluxations in it, and whether it is possible to begin to put full weight on the leg. The next control is after 6 months. At this moment, as a rule, you already walk quite confidently, fully loading the operated leg. The purpose of this examination is to determine what and how has changed in the condition of the bones and muscles surrounding the joint after normal load, whether you have osteoporosis or some other bone tissue pathology. Finally, the 3rd control - one year after joint replacement. At this time, the doctor examines the joint to see if there is a reaction from the bone tissue, how the surrounding bones and soft tissues and muscles have changed in the process of your new, higher quality life. In the future, visits to your doctor should be made as necessary, but at least once every 2 years.

REMEMBER! If pain, swelling, redness and increased skin temperature appear in the joint area, if the body temperature increases, you need to contact your doctor URGENTLY!

Tips for the future

Your artificial joint is a complex structure made of metal, plastic, ceramics, so if you are going to travel by plane, take care to obtain a certificate of the operation performed - this may be useful when going through control at the airport.

Avoid colds, chronic infections, hypothermia - your artificial joint may become the “weak spot” that will become inflamed.

Remember that your joint contains metal, so deep heating and UHF therapy on the area of the operated joint are undesirable. Watch your weight - every extra kilogram will accelerate the wear and tear of your joint. Remember that there are no special diets for hip replacement patients. Your food should be rich in vitamins, all necessary proteins, and mineral salts. No one food group has priority over the others, and only together can they provide the body with complete, healthy food.

The “failure-free” service life of your new joint largely depends on the strength of its fixation in the bone. And it, in turn, is determined by the quality of the bone tissue surrounding the joint. Unfortunately, in many patients who have undergone endoprosthetics, the quality of bone tissue leaves much to be desired due to existing osteoporosis. Osteoporosis refers to the loss of bone mechanical strength. In many ways, the development of osteoporosis depends on the age, gender of the patient, diet and lifestyle. Women over 50 years of age are especially susceptible to this disease. But regardless of gender and age, it is advisable to avoid the so-called risk factors for osteoporosis. These include a sedentary lifestyle, the use of steroid hormones, smoking, and alcohol abuse. To prevent the development of osteoporosis, we recommend that patients avoid highly carbonated drinks such as Pepsi-Cola, Fanta, etc., and be sure to include foods rich in calcium in their diet, for example: dairy products, fish, vegetables. If you have symptoms of osteoporosis, you should urgently discuss with your doctor the optimal ways to treat it.

Avoid lifting and carrying heavy weights, as well as sudden movements and jumping on the operated leg. Walking, swimming, gentle cycling and gentle skiing, bowling and tennis are recommended. Usually, with complete restoration of limb function, patients have a desire to continue playing their favorite sports. But, taking into account the peculiarities of the biomechanics of an artificial joint, it is advisable to avoid those types of sports activities that involve lifting or carrying heavy objects, or sharp blows to the operated limb. Therefore, we do not recommend sports such as horse riding, running, jumping, weightlifting, etc.

If this does not contradict your aesthetic views and does not affect the attitude of others towards you, use a cane when walking!

If you dance, do it calmly and slowly. Forget about squat dancing and rock and roll.

Normal sex is allowed 6 weeks after surgery. This period is required for the healing of the muscles and ligaments surrounding the operated joint. The following picture illustrates the recommended positions and, conversely, those that should be avoided by a patient after total hip arthroplasty.

We recommend making some simple adaptations to make your daily life easier. So, to avoid excessive hip flexion when bathing, use a sponge or washcloth with a long handle and a flexible shower. Try to buy shoes without laces. Put on your shoes using a horn with a long handle. Some patients with an advanced process continue to have certain difficulties when putting on socks. For them, we recommend using a simple device in the form of a stick with a clothespin at the end when putting on socks. You need to wash the floor with a mop with a long handle.

When traveling in a car, try to move the seat back as far as possible, taking a semi-reclining position. And finally, I would like to warn against one more dangerous misconception. Remember that your artificial joint will not last forever. As a rule, the service life of a normal endoprosthesis is 12-15 years, sometimes it reaches 20-25 years. Of course, you should not constantly think about the inevitability of repeated surgery (especially since most patients will be able to avoid it). But at the same time, repeated joint replacement or, as doctors call it, revision endoprosthetics is far from a tragedy. Many patients are terrified of repeat joint surgery and try to endure the pain they experience, but do not consult a doctor, hoping for some kind of miracle. This should not be done under any circumstances. Firstly, not all pain and discomfort in the joint require mandatory surgical intervention, and the sooner the doctor becomes aware of them, the greater the chances of getting rid of them easily. Secondly, even in case of fatal loosening of the joint, the previously performed operation is much easier for the patient and the surgeon and leads to a faster recovery.

We hope that the artificial joint has relieved you of the pain and stiffness you previously experienced with your own painful joint. But the treatment does not end there. It is very important that you take proper care of your new joint and remain fit and on your feet at all times. Taking into account some of the precautions we discussed above, you can fully recover and return to your normal active life.

Features of the rehabilitation period

The rehabilitation period for a dislocated hip prosthesis is as important as the treatment itself. If the patient treats it irresponsibly, there is a high risk of developing various complications, as well as the risk of displacement of the prosthesis.

Rehabilitation after hip dislocation replacement includes physical therapy and massage.

If the patient's condition is satisfactory, he can be helped to stand the next day after surgery. Basic rehabilitation measures include:

Walking training. Spheres will be needed initially. They will help not to put too much pressure on the operated leg;
Basic motor training, namely: independent sitting position;
They undergo physiotherapeutic procedures. They are aimed at accelerating regenerative functions;
Attending physical therapy classes. During these therapeutic physical exercises, all joints are connected so that in the future the limbs can be moved painlessly;
Performing therapeutic massage. This is necessary in order to relax the thigh muscles.

Let us immediately note that the duration of the rehabilitation stay in each specific case is different. Each subsequent stage of rehabilitation is based on the patient’s well-being. Independent walking without crutches and a cane is possible on average 5-6 months after surgery.

Possible complications

As mentioned above, prosthetic dislocation usually occurs shortly after surgery. This fact is not difficult to discover. The patient begins to experience all the same symptoms as before treatment, namely:

Sharp pain in the thigh area;
Limitation of limb mobility;
Shortening of the diseased limb compared to the healthy limb.

In this case, the patient will undergo surgery to return the prosthesis to its original position. But in addition to this fairly standard phenomenon, various complications can also occur. They can be associated both with the body’s reaction and with mistakes made during the operation.

Possible post-operative consequences include:

Infectious processes. This may be indicated by symptoms such as swelling or redness of the skin; nerve inflammation. This can be expressed in various manifestations, for example, a feeling of numbness in this area;
Joint spasm. This means that the joint cannot perform some of its functions;
Venous and arterial thrombosis.
To reduce the risk of developing these and other complications, it is important to follow a number of preventive measures and follow all doctor's recommendations.

Since dislocation of the endoprosthesis, although rare, is quite unpleasant, it is important that people who have undergone surgery to put it on follow all the rules to prevent this situation. These measures are as follows:

Prevention

Regular visits to the doctor to monitor the installation of the endoprosthesis;

Carrying out all necessary procedures: massage, therapeutic exercises;
Strict control of the amount of physical activity. Heavy loads and excessive physical activity are not allowed;
Avoid excess weight. This means that the diet should be as healthy and balanced as possible;
Wearing comfortable shoes, preferably orthopedic;
Body position control. The more the patient's back is straightened, the less load on the prosthesis.
The most important thing that a patient should do after surgery is to follow all the recommendations of the attending physician. If the patient is required to wear special equipment or take medications, this is to help you recover as quickly as possible and reduce the risk of spraining the prosthesis. However, if there are symptoms that directly indicate recurrent denture dislocation, do not try to wait it out or self-medicate. The best solution is to seek professional medical help immediately.

How to avoid mistakes during endoprosthetics

Summarizing all of the above, we can identify 5 rules for preventing complications of endoprosthetics associated with improper installation of a knee endoprosthesis , as well as an artificial hip joint.

The key condition for the success of installing a hip joint (knee) endoprosthesis is the choice of a high-quality implanted structure. Cheap products lead to fractures, infections, dislocations and significantly increase rehabilitation time.
The doctor must decide how the prosthesis will be fixed strictly individually, taking into account all indications. A wrong decision can lead to cracks and fractures of the bone, severe post-operative pain, etc.
Even if the model is chosen correctly, the surgeon must also correctly install its components to avoid their rapid loosening.
When using systems with a cementless monobloc stem, it is important to select the correct size of the stem(s).
To avoid fractures and component loosening, it is important to select the correct knee replacement size.

Finally, a general rule for all cases: only high-quality preoperative planning and effective control after surgery will help reduce all errors of the surgeon and patient during treatment to a minimum and obtain a predictable result.