We will find out how rehabilitation goes after endoprosthetics of the knee joint at home and in the clinic. The operation is an important, but far from the only step in the fight against a serious illness. The most critical period of therapy begins immediately after the person is discharged from the hospital. It is at this moment that a full-fledged rehabilitation should begin, since the health of the operated patient directly depends on his efforts. How to carry out the restoration?
Basic concepts
This procedure involves the replacement with the help of implants of certain elements of the motor apparatus. This term has gained its popularity after the total use of artificial joints. In this case, polymer elastic materials (lavsan and others) are used.
General recommendations
Rehabilitation after knee replacement at home and in the clinic implies several areas, among which the main role is played by physiotherapeutic treatment along with gymnastics and medical support on demand. The purpose of rehabilitation is to soon achieve mobility in the area of the knee joint and lower limb. In this regard, we must try to get out of bed, and, in addition, walk almost immediately after the intervention.
Most patients already the next day after total knee arthroplasty perform a set of physical exercises. The physiotherapist should explain to the patient the methodology for implementing a special course for weeks. To prevent the occurrence of thrombosis (the formation of blood clots in blood vessels) and reduce swelling of the limbs, special measures are used (put on compression stockings, apply elastic bandages, anticoagulants are prescribed).
Within a month after knee replacement, doctors recommend restoring movement in the ankle and foot. This is required to improve the blood supply to the muscles and prevents the formation of blood clots and edema. After the operation, the prevention of congestive manifestations in the lungs consists in deep breathing, and doctors also recommend coughing more often. Due to this, the output of bronchopulmonary secretion is normalized, as a result of which it does not accumulate in the lungs. Here are the basic rules that patients must follow after surgery:
- Performing simple physical exercises regularly to maintain adequate strength with the mobility of the new joint.
- Avoid personal injury and falls. If the patient receives a fracture after the endoprosthetics procedure, then this may provoke additional surgery.
- It is always necessary to inform the dentist about the fact of knee replacement. Antibiotics should be taken prophylactically before appropriate treatment and other operations.
- Every year, an orthopedic surgeon is required to be examined and examined.
In more than ninety percent of cases, with strict observance of the recommendations of the attending doctor, recovery after knee replacement is quick, without any complications. This is achievable only if the patient is personally interested in a speedy recovery, and in this regard, faithfully complies with all medical prescriptions. Rehabilitation after surgery knee replacement How long does it take? Its duration should be at least three months. More on this below.
There are no fundamental differences between the recovery process after joint replacement and similar manipulations in other areas of the musculoskeletal system. Only the specifics of a workable set of exercises may differ.
OMS rehabilitation after knee replacement
As a rule, the postoperative recovery of patients in the hospital begins with isometric exercises some time after the operation, they suggest tension of the thigh muscles, provided there is no movement of the leg. Such gymnastics should be done several times a day in the first month after arthroplasty. The knee joint must be developed. For example, specialists require patients to move their foot in different directions in order to strengthen a vulnerable area.
What else does physical rehabilitation suggest after knee replacement? Walking with dosed loads on the operated limb using additional support (crutches, arena) begins already from the third day. Sutures are removed on the tenth day. An extract is made ten to twelve days after arthroplasty. Restrictions on physical exertion on the operated limb are observed for six to eight weeks, during this period, the mandatory use of additional support is required. Next, let's talk about the rehabilitation of patients outside the hospital ward.
We will talk more about rehabilitation after knee replacement at home.
Free home restoration
For various reasons, most hospitals involved in such operations do not have the ability to carry out full recovery measures. And here patients come to the aid of rehabilitation after knee replacement at home, which is quite feasible and does not require financial expenses.
Thus, with great success, you can return to its previous shape after the operation, without leaving home. This option is suitable for absolutely all patients, but, as practice shows, more often it is used by people aged twenty to fifty years. Effective restoration within the walls of their own homes can be done by older people, but this is only advisable if relatives or a well-trained instructor can deal with them. There are three important conditions in order to undergo free rehabilitation after knee replacement:
- First of all, this is regularity, since it is very important not the number of exercises, but how well they are planned and systematic.
- Do not forget about moderation. The fact is that all gymnastics must be done in a medium rhythm, without trying to bring yourself to exhaustion.
- It will also require patience, since a noticeable positive result will not immediately appear.
For a full rehabilitation course after endoprosthetics of the knee joint at home, the patient needs good reasons, because often in these conditions it is impossible to fully complete the exercises, in addition to all sorts of dangers for the operated person, there are much more in the native walls than in an equipped hospital.
Reasons why restoration should be done at home
Here are the arguments for the implementation of such a recovery course after knee replacement:
- If the family has an appropriate specialist.
- Provided that he is feeling well and is recovering, who needs almost no additional help.
- Conversely, the patient’s overly complex condition is characterized by prolonged ill health and a constant need for help, which he can only receive at home.
In order to realize the idea of recovery under such conditions, it will be necessary to bring the patient’s housing to a state in which the risk of injury will be minimal. The main condition is the ability to freely move around the house. It is necessary to prevent impacts from the operated joint against a hard surface and any sharp corners. In the event that such furniture and other objects cannot be completely removed, then they should be made soft and the shock absorbing pads should be fixed.
Housing optimization
Doctors recommend that the following measures be taken so that the native walls meet the needs of the operated person:
- It is always necessary to maintain order, each item should lie within the reach of the patient, he should not make dangerous movements in order to take or get something.
- In a private house, the patient should be allowed to stay on the ground floor so that he can use the courtyard space.
- All places accessible to a recovering person should be properly lit, the floor cannot be slippery, and the rugs must be removed or securely fixed.
- It is required to equip the patient's seat, it is best to provide him with a chair with armrests.
- The bathroom should be furnished with benches. It is advisable to put the seat in the bathing tank itself. It is also useful to make reliable handrails so that the patient has support during rising. It is important to build similar devices in the toilet.
CPM treatment
It should be borne in mind that during the period of the development of the disease, in addition to the destruction of articular elements, a change in the functions of the surrounding muscles occurs. In parallel with the development of contractures, their strength characteristics also decrease due to the convergence of attachment points. In this case, CPM treatment will serve as a good helper, the essence of which is the development of the joint with the help of a special device, which does not require active reduction of periarticular tissues.
Such rehabilitation gives the patient the opportunity to quickly get on their feet without pain and discomfort. Such therapy is carried out at home with the help of an apparatus called "Arthromot", it can be rented.
Physical therapy in combination with mechanotherapy (CPM treatment), electromyostimulation and massage are the main methods of the recovery period. A comprehensive program, selected by a good specialist, will certainly allow you to return to your usual way of life and lost range of movements. Now let's talk about the gymnastic effect on the diseased limb during physical rehabilitation after knee replacement.
What exercises are shown?
Simple gymnastic movements can be performed independently:
- It is necessary to bend and unbend the joint, starting with five repetitions. After a while, the amount is adjusted to twenty times.
- Alternately tensing the femoral muscles, trying to keep muscle tissue in good shape for up to five seconds.
- They maximize the muscles of the buttocks and try to keep them in this position for up to five seconds.
- Raise straight legs, but no more than forty-five degrees. With discomfort during the exercise, limbs help with the hands. But in the future they try to raise their legs on their own, without arms, and then hold them in this state for about five seconds. Exercises during rehabilitation after knee replacement surgery must be performed very carefully.
- It is necessary to unbend and bend the knee joint. A good help in performing this exercise is the articulated apparatus, as well as a special simulator.
- They take the straight leg to the side, and then a little up, try to hold it at the top point.
- The direct lower limb is retracted with a delay without bending the joint.
The above gymnastic complex is considered the simplest, so it can be done effortlessly at home immediately after discharge. After some time, it is worth adding elements to them to walk back along with squats and an exercise bike.
Water exercises and ladder use
Gymnastic exercises in water have proven excellent, allowing to increase the amplitude of movements, they train muscles without overloads. But such exercises during rehabilitation after knee arthroplasty are allowed to proceed only after complete healing of the wound and in the absence of the threat of infection.
An important step is learning to walk the stairs. Such exercises begin only fourteen days after surgery, when a person manages to stand confidently on his feet. The first attempts are required to be carried out only if there is an assistant who is able to support on occasion. First, the convalescent is taught to climb up, and then, conversely, down the stairs:
- A healthy leg is transferred to the upstream step.
- Leave the support in the form of a crutch or a cane on the same level with the operated limb.
- As soon as a person can lean on a healthy leg, the second (sick) is transferred to the step.
The descent tactics are somewhat different. It is necessary to rearrange crutches after a healthy limb, and after that the second. In most examples, the descent for patients is much more difficult, in connection with this, they transfer to such training much later. If you experience any symptoms of complications in the form of prosthesis rejection, dislocation, infection or inflammation, you should definitely stop any training and consult a doctor.
Regardless of the time that elapsed after the endoprosthetics and the general condition of the knee joint, patients are forbidden to jump, do aerobics, run or ski. Also categorically not allowed lifting any weights. In addition, you can not give a strong load on a sore leg.
Features of therapeutic gymnastics
Daily during rehabilitation after total knee replacement, the exercises need to be complicated, and the load should increase. At the initial stage, painful sensations will not allow you to load the leg, in this regard, massage is not used at this time, and medications are prescribed for patients to anesthetize. Therefore, knee development should only be done after using the medicine.
Since rehabilitation after total knee arthroplasty in the home is carried out without the participation of a doctor, the patient must independently monitor all his sensations. To reduce soreness, an orthosis or bandage is used to limit the load. In the presence of severe pain that impedes the implementation of the required complex, a compress or massage is prescribed. The latter on the site of the thigh and lower leg should be carried out by a specialist or at home. At the initial stage of recovery, it is forbidden to carry out intensive exposure on the operated limb. In addition to the fact that the recovering people themselves must control the amount of load on the sore leg, they are also required to adjust the complexity of the exercises.
You can do any exercise only until a slight soreness appears. They need to be repeated until the movements are fully mastered and cease to provoke unpleasant sensations. Further, the load on the operated limb should be increased and complicate gymnastics, expanding the range of motion.
With the appearance of specific problems associated with performing gymnastics, for example, a limb began to bend badly, it is not possible to climb stairs, it must be borne in mind that it is impossible to perform the recommended gymnastic elements through force. In this case, you need to consult a doctor to find out the factors of the problem or to clarify the fidelity of the execution technique.
How long should rehabilitation take? In fact, careful care of the joint in the form of performing exercises is necessary to carry out all your life. Immediately upon completion of the recovery period, you cannot forget about the prosthesis forever. Useful Reminders:
- Six months after the operation, it is required to perform a control examination of the operated knee at the surgeon.
- Annual doctor visit.
- For several years, you need to engage in daily therapeutic exercises.
Possible complications
In most situations, rehabilitation after performing endoprosthetics in the area of the knee joint proceeds quite smoothly and without any complications.Of course, a big role is played by how well the operation was carried out. Insufficiently experienced surgeons, difficulties in the individual structure of the joint, as well as the presence of concomitant serious diseases serve as factors that can lead to complications. Here are some of them:
- The inflammatory process in the bones closest to the knee joint.
- Complication of an infectious nature.
- Embolism and thrombosis.
- Trauma to the vascular and nerve bundles.
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The recovery process after surgery may take several months. This directly depends on age, and, in addition, on the state of health and the degree of joint damage before surgery. Throughout the entire time, the load and duration of walking should be gradually increased. When moving a sick limb, it needs to be slightly bent at the knee.
It is best to walk several times a day, but not more than thirty minutes at a time. Particular care should be taken when climbing stairs. It is not recommended to go more than one flight of stairs at a time in the first couple of months.
Useful Tips
It is worth dwelling on some general instructions given by doctors:
- You can not sit for more than twenty minutes in one pose.
- During sitting, the pelvis should be above the knees.
- When shoeing and donning, outside help should be used.
- Do not lift weights.
- With great care, it is necessary to perform bending, rotation and crossing of the legs.
- Sleeping is required on the back so as not to bend the operated leg in a dream.
Usually walk with crutches no more than three months. Then you can move on to a cane, which is used for another three to five months.
Many people wonder how long the rehabilitation period lasts after knee replacement. We will deal with this issue in more detail.
The timing
Regardless of how severe the underlying disease was, due to which the surgery was performed, the operation, as a rule, is tolerated with a positive result by more than ninety percent of patients. What are the terms of rehabilitation after knee replacement?
As already noted, this period cannot take less than 3 months. After six months, an absolute restoration of articular performance is usually observed, so people can return to their previous way of life.
It is worth recalling that after the completion of rehabilitation measures, patients should regularly, once a year, carry out a preventive examination with a traumatologist to check whether there is wear of the prosthesis, and in this case, another operation may be necessary.
Reviews
According to reviews, after knee replacement, rehabilitation usually lasts from six to twelve months. During this time, subject to a successful operation and an adequate motor regime, according to patients, the previous functions are almost completely restored.
The reviews of rehabilitation after knee replacement surgery emphasize that it is very important to strictly follow all the recommendations of the operated surgeon. People also advise, in addition to home treatment, to engage in physical therapy, mechanical therapy, electromyostimulation, and observation in sanatorium conditions will not be out of place.
Thus, the process of replacing the affected elements with artificial ones today is a procedure that helps people to return to normal life again, and rehabilitation at home, as practice shows, is no worse than inpatient observation and also gives good results.