Rehabilitation after endoprosthetics: gymnastics, especially walking on crutches, a review of sanatoriums

In the article, we will consider how rehabilitation takes place after endoprosthetics.

These concepts are very closely related. It is rightly believed that it is the recovery period after surgery that can provide half the success of a case.

Rehabilitation after hip replacement

Endoprosthetics is a very difficult operation to replace the entire joint or part of it with an anatomical implant, which is made of a hypoallergenic and wear-resistant material with good survival. The result of such an intervention should be the absolute restoration of articular functions. And although the procedure itself is not very complicated, the rehabilitation course is quite long and often painful. Especially when it comes to an elderly person.

Rehabilitation after endoprosthetics is designed to eliminate pain, preventing a possible complication, improving well-being and preparing the patient's limbs for the necessary loads. When developing a recovery program, doctors take into account factors in the form of muscle tone, general health, the complexity of the operation, the body's response to surgery, and at the same time age, and so on. The attending physician, prescribing the program, will tell you where to get rehabilitation after endoprosthetics.

Muscle tone affects the initial load. It is very important that its increase occurs gradually. Workouts that begin when the patient’s body is not yet ready can interfere with the healing of postoperative wounds. To assess the general condition, an analysis of urine and blood is performed, which may indicate an inflammatory and allergic reaction that occurs against the background of rejection of the implants by the body.

Possible consequences may also include:

1. The appearance of an infectious joint disease.
2. Loosening of the prosthesis along with its displacement or loss of functional properties.
3. Wound infection.

It is worth noting that the percentage of complications is usually small. Especially if the rehabilitation after hip replacement has been correctly performed.

According to available statistics, only one percent of patients develop negative consequences. Whatever rehabilitation program is prescribed for the patient, there are general recommendations for all people who have undergone endoprosthetics:

1. Excessive joint extension is strictly prohibited.
2. Avoid bumps, jerks and other dangerous movements.
3. It is necessary to bandage the limb for three months after surgery.
4. In the first few months you can not visit the bath.
5. It is not recommended to drive a car on your own.
6. It is forbidden to wear shoes with heels.

Do not neglect the doctor’s instructions, since rehabilitation after knee replacement, like any other, is very important. Restoring the working condition of the operated organ is directly related to the quality of human life.

After knee replacement

The postoperative period following the replacement of the knee joint is conditionally divided into three periods:

1. The early stage is up to ten days.
2. Late - the period of time is from ten days to three months.
3. Remote stage - more than three months.
   

The tasks of the early rehabilitation period after knee replacement include prophylaxis with the use of exercise therapy methods of all kinds of postoperative complications of the respiratory and cardiac systems. As part of this stage, activation of blood circulation in the lower extremities is important along with improved mobility of the artificial joint. In addition, a general recovery of the patient is carried out. It is about training in sitting, walking, standing up, performing certain gymnastic exercises.

The tasks of the late stage include strengthening the muscles of the extremities along with the development of descent and climb stairs, restoring proper walking and the like.

The further strengthening of the lower extremities in combination with adaptation to everyday working physical activity is considered to be the tasks of the distant interval. Now we will analyze how the recovery period occurs and where rehabilitation after endoprosthetics can take place.

Recovery period in the center

Usually, postoperative rehabilitation of patients begins some time after surgery. Classes are carried out by isometric exercises, consisting in tension of the thigh muscles in the absence of leg movement. Such exercises must be done several times a day.

The first goal of rehabilitation is the development of an injured organ after surgery. In addition, experts recommend moving the foot in different directions in order to strengthen the ankle joints.

Among other things, the rehabilitation center after endoprosthetics practices walking with measured loads on the operated limb with additional supports (crutches, arena). You can do this from the third day. Sutures are removed on the tenth to twelfth day.

An extract from the rehabilitation center after hip or knee replacement is performed twelve days after surgery. The limitation in physical activity on the restored limbs must be observed within eight weeks after the intervention. Throughout this time, the use of additional support is recommended.

Rehabilitation phase after surgery

Rehabilitation after endoprosthetics of the knee or hip joint is usually twelve months. During this period, with successfully performed surgical manipulation and adequate motor activity in a patient, almost all previously impaired functions are almost completely restored.

These or other rehabilitation measures should be continued with strict observance of all available recommendations from the operated surgeon. In most situations, recovery within the hospital is only required in the first period. Further therapy (exercise therapy along with electromyostimulation), as well as observation, are possible in sanatoriums as well as at home.

Rehabilitation after endoprosthetics surgery in simple cases can be carried out outside the hospital.

Home restoration

Due to organizational factors, most surgical hospitals involved in endoprosthetics do not have the ability to conduct a full-fledged postoperative rehabilitation event. And here the patient comes to the aid of rehabilitation after endoprosthetics at home, which today is quite feasible.

It should be borne in mind that during the period of the development of the disease, in addition to the destruction of articular elements, there are also changes in the functions of the surrounding muscles. Simultaneously with the development of contracture, the muscular strength characteristics are also reduced by the convergence of their attachment points.

In this situation, CPM therapy may turn out to be an indispensable assistant, the essence of which is to develop an organ using a special device that does not require active contraction of the periarticular muscle. Such rehabilitation allows the patient to quickly get up on his feet without any pain and discomfort. CPM treatment is carried out at home using the Arthromot device, which can be rented.

The procedures included in the rehabilitation program after hip replacement surgery (or knee including) include pain relief along with swelling and inflammatory process, tissue nutrition is also improved, bone structure recovery is stimulated, muscle weakness after surgery is eliminated.

It should be noted that physical therapy along with mechanotherapy, electromyostimulation and massage is the main method of rehabilitation therapy after the endoprosthetics process. A comprehensive program, which is selected by a competent specialist, will certainly allow you to restore mobility in the joints in order to be able to quickly return the patient to his usual lifestyle.

Rehabilitation at home after hip arthroplasty is not at all difficult to carry out. The main thing is to do it regularly.

Gymnastic exercises

Immediately after discharge, rehabilitation is continued at home, it is considered mandatory. It is extremely important to exercise physical therapy every day, doing a few twenty-minute approaches per day. Homework should be combined, performing in various poses. In the supine position (any actions are repeated six to fifteen times, without overworking), you can perform the following exercises:

1. Bend your legs, and then alternately push each knee to the side to a distance of no more than twenty centimeters.
2. Bend one leg and hold the other straight, raise the pelvis a couple of centimeters, while straining the gluteal muscles.
3. They roll over onto the stomach, lay a pillow under the stomach, raise one leg and stretch the heel to the buttocks until they feel tension. This position is maintained for fifteen to thirty seconds, and then the exercise is repeated with the other limb.
4. They lie on their stomach with a pillow, which should be under the navel, spread their legs, bend their knees and connect the heels. They remain in this position for six seconds (this exercise is strictly contraindicated if the surgical incision is located on the front of the thigh).
5. In the same position (that is, on the stomach, when the pillow is under the belly button), put a rolled towel under the ankle and lift the thigh until the knee is fully straightened, hold for six seconds.

Complicated Exercises

For rehabilitation after endoprosthetics in the third month of the recovery period when you are at home, you can already move on to more difficult exercises that must be performed while standing or sitting (but this should be done after consulting a therapist):

1. They become a shoulder against the wall on a healthy leg and use the back of the chair as a support for the other hand. Along the wall, bending at the knee, lift the operated limb, without exceeding the angle of ninety degrees. Repeat the same exercise, standing on a sore leg (while a healthy limb is near the wall).
2. They are placed with their backs to the wall and rest with their hands on the back of the chair, while raising the operated thigh (we must not forget that the angle should be less than ninety degrees). Then they gradually complicate the task and give up support, arms crossed on the chest.
3. They stand with their backs to the wall and rest on a chair, raise their sore leg to the side by fifteen to twenty centimeters. They slide their heels against the wall and hold their foot for six seconds.
4. They sit on a chair with outstretched legs and take their sore leg to the side, then repeat the movement with a healthy limb.

In addition to gymnastic exercises, it is important to walk every day. You can do this at home, choosing small distances, it is also useful to climb and descend the stairs. In the last exercise, a healthy leg is placed first, then the operated leg and crutches are raised at the end.

During the descent, crutches are put on the step first, then a weak leg and the process is closed with a healthy limb. It is necessary to engage in therapeutic gymnastics after endoprosthetics only after consulting a doctor. It should be noted that the rehabilitation course must be carried out exclusively under the supervision of a medical specialist.

Resorts Overview

Consider where you can get rehabilitation after knee or hip joint arthroplasty.

The provision of qualified assistance in sanatoriums is carried out in all periods of rehabilitation, from the earliest to the late. Those who are only at the stage of deciding on endoprosthetics are offered specially designed programs that allow them to prepare for the operation and then perform the most comfortable recovery.

Consider some popular sanatoriums:

1. Rehabilitation center "Zagorskie Dali". The cost of stay per day is 4000 rubles. The sanatorium is located in the Moscow region.
2. Center "Moscow Region UDP". The cost of stay per day is from 4300 rubles. Located on the Kashirskoye highway thirty kilometers from the Moscow Ring Road. This is the most popular center today, offering more than twenty specialized programs designed to restore health on basic profiles. The presence of our own artesian well with healing mineral water, a pool and a balneological complex, along with an extensive diagnostic base and the latest physiotherapeutic equipment, noticeably distinguish this place among most rehabilitation centers located in the Moscow region.
3. Patients speak no less well of the sanatorium "Pushkino", which is also located in the suburbs and has a large park and picturesque area. In their comments, people who have undergone rehabilitation here are very positive about the level of therapeutic measures of this center.

Features of walking on crutches

In order for crutches to serve a person as a reliable support when walking, it is very important not only to precisely select and adjust them to their size, but also to learn how to correctly walk on them, go down stairs and climb, sit down and get out of a chair. For each type of these devices, there are a number of general rules that must be followed in order to achieve the maximum effect from the use of this orthopedic instrument.

In the event that the crutches are axillary, then, while relying on them, it is necessary to transfer the body weight to your hands, and not to the axillary hollows, in order to avoid the negative consequences of their strong compression. Support racks should be kept as close to the chest as possible, and the tips should be placed at a distance of about ten centimeters from the foot.

Conclusion

It is very important during rehabilitation after endoprosthetics of the hip or knee joint while walking to look not under the legs, but forward, keeping your back straight and the knee of a healthy limb slightly bent.

When the crutches are located under the elbows, then during movement you should make sure that the handle (i.e. the support under the wrist) is facing straight ahead with its free end, and that the cuff grips the forearm securely (nothing is squeezed, but at the same time does not hang out).