Why does my knee hurt after hip arthroplasty? Walking period after replacement of TBS

is an operation that is in demand all over the world, allowing a person to return the lost quality of life, the ability to move independently.

Despite the constant improvement of technology, the likelihood of complications remains high: 1% in young patients, 2.5% in older citizens. Problems can affect anyone, at risk are those who did not follow the rehabilitation program.

Symptoms

Characteristic symptoms after surgery are weakness, drowsiness, due to the action of anesthesia. When its influence recedes, soreness remains: normal reaction organism to the introduction of a foreign object.

Severe symptoms after the surgeon's manipulations, the development of complications are often associated with the following risk factors:

• advanced age of a person;
• revision pelvic replacement hip joint;
• previous surgical interventions on the thigh area;
• the presence of systemic diseases;
• local inflammation, etc.

To fight unpleasant symptoms after endoprosthetics, a rehabilitation program is being developed. It starts on the second day breathing exercises, continues with physical exercises, the complexity of which gradually increases.

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Hip surgery to do or not

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Possible Complications

During the first 2-3 weeks after surgery, the patient is in the hospital under constant surveillance doctors. Task medical personnel– to see the complications after hip arthroplasty and take measures to eliminate them.

Warning symptoms are:

• soreness that does not decrease after surgery;
• swelling of the thigh area;
• increased or decreased body temperature;
• general weakness, lethargy, fatigue;
• purulent discharge from a wound;
• later developing lameness, etc.

Despite the development modern technologies, doctors cannot 100% exclude the possibility of developing postoperative complications. The patient is informed in advance about the possible consequences, asked to listen to the signals given by his body.

General violations

In addition to the specific disorders associated with surgical procedures, patients often experience general adverse effects of the endoprosthesis. These include:

• allergic reactions to the elements of anesthesia, drugs recovery period;
• deterioration of the cardiovascular system;
• violation motor activity due to the fact that the prosthesis does not take root, it is perceived by the body as a foreign object.

To prevent general disorders, careful preoperative diagnosis and a competent choice of rehabilitation methods are necessary.

Pain and swelling

Pain after hip arthroplasty normal phenomenon how the body responds to surgery. Unpleasant sensations for 2-3 weeks after the operation are recognized as the norm.

The patient experiences some discomfort until the bones and endoprosthesis become a single kinematic system. The doctor must choose the right analgesics that will help get rid of soreness and concentrate on rehabilitation activities.

Sometimes soreness appears in areas that have not undergone surgery. The patient has aching knee cap the first months after surgery. This is due to the fact that the musculoskeletal system has been forced to adapt to the consequences of the pathology for a long time, and a successful endoprosthesis replacement starts the reverse process of returning to the physiological norm.

To eliminate puffiness, the patient is prescribed physiotherapy, including magnetic and UHF therapy. To help the citizen return to normal life, in the first days after prosthetics, the following exercises are shown:

The patient should avoid unnecessary loads on the operated limb, monitor its correct position, which does not bring discomfort.

infectious

According to official medical statistics, the probability of developing an infectious process after arthroplasty reaches 1% of cases. Reoperation increases the risk by up to 40%. The causes of pathology are:

• movement of bacteria from any other affected organ;
• use of insufficiently sterile medical instruments;
• not thorough enough debridement wounds;
• poor healing due to metabolic disorders.

The purulent-inflammatory process is manifested by the following characteristic symptoms:

• the appearance of swelling;
• pain, often acute;
• discharge of pus, blood clots from the wound;
• fever after hip arthroplasty, which can only be brought down for a while;
• rapid breathing;
• increased heart rate;
• skin hyperemia, etc.

Practice shows that most often clinical picture mild, which makes it difficult to make a timely diagnosis. At prolonged absence treatment in the hip joint, fistulas are formed.

To detect purulent inflammation are used:

• blood analysis;
• bacteriological research;
• MRI, radiography - are used as additional methods.

The appearance of a purulent focus in the hip joint interferes with implant implantation, causes instability, loosening. Effective conservative techniques there is no fight against the problem, partial or complete removal prosthesis, due to which re-installation is possible later long time. When an infection is detected, the patient is prescribed a course of antibiotics according to the diagnostic data, and treatment of the wound with an antiseptic solution.

Nerve or vascular injury

This problem is possible complication during operations on people with extra pounds: The surgeon may not notice the nerves under the layer of fatty deposits. Most often, the peroneal (sciatic) nerve is damaged, which leads to the appearance of the following symptoms:

The patient cannot move normally, which makes the rehabilitation of the operated limb difficult.

To diagnose the problem, a special procedure is used - electroneuromyography. It demonstrates the degree of nerve damage, allows you to choose the right treatment methods. For therapy, a course of medications is prescribed (tramadol, mydocalm, milgamma), foot massage sessions, saturation of tissues in the hip joint with oxygen.

vascular damage during surgical procedures leads to internal bleeding, which increases the likelihood of developing thrombosis, an inflammatory process.

Unequal limb length

Leg asymmetry as a result of hip arthroplasty is one of the most common postoperative complications. According to statistics, the problem is diagnosed in 16% of patients with complications. Often the pathology becomes the result of a history of fracture. Other reasons include:

• effects of arthritis, osteoarthritis;
• mistakes made during the operation;
• improper size of the prosthesis;
• improper rehabilitation.

Practice shows that the diseased limb is most often made longer than the healthy one. A complex of characteristic symptoms appears:

• lameness;
• pain in the legs, back;
• violation of kinematics;
• neurological manifestations.

These complications of hip replacement contribute to a decrease in the patient's quality of life and become the reason for assigning a disability group.

Sometimes the first months after surgical procedures, it seems to a person that the leg has become longer. If the feeling does not correspond to the real picture, it goes away after 8-12 weeks thanks to the right rehabilitation.

If the asymmetry does occur, the patient is shown to correct by wearing orthopedic shoes.

Bleeding

Bleeding may occur after a hip replacement with an implant or during surgery. Their causes are unsuccessful movement of the lower limb, doctor's mistakes, excessive passion for blood thinning drugs (anticoagulants).

The complication has dangerous consequences. In the best case, the patient will require a blood transfusion to restore losses; in the worst case, death occurs due to hemolytic shock. To avoid a fatal outcome, the doctor carefully monitors the condition of the person who has undergone the installation of the prosthesis.

Thromboembolism

The first days after the replacement of the femoral joint with an implant, the patient is actually immobilized, which leads to disruption of venous and arterial blood flow. The result is blockage of blood vessels by blood clots. The characteristic symptoms of the pathology are:

• dyspnea;
• fatigue, lethargy;
• loss of consciousness.

Often, cases of thromboembolism are asymptomatic, so it is important to constantly diagnose the condition of the operated patient. The statistics are disappointing: deep vein thrombosis occurs in 40% of cases of complications, pulmonary artery- in 20%.

This consequence of hip arthroplasty can occur during the operation, the citizen's stay in the hospital, after discharge. For diagnosis, contrast venography, ultrasound scanning is used.

Prevention of complications includes early rehabilitation after manipulations on the hip joint, competent selection of a course of postoperative medications, taking into account the characteristics of the patient's body.

Dislocation of the head of the prosthesis and lameness

Complications arise if the patient makes sudden movements in the hip joint, ignores the prohibitions of doctors, refuses to use crutches earlier than expected. Failure to follow the doctor's recommendations leads to displacement of the implant relative to the cup.

Pathology is manifested by the following symptoms:

Statistics show that the manifestations of the problem occur in the first month after arthroplasty and increase throughout the quarter. When such symptoms appear, you should tell the doctor about the discomfort: the sooner treatment begins, the higher the chances that it will be successful.

Structural loosening

Instability of an implanted hip joint prosthesis is a common complication, often leading to the need for repeated intervention by the surgeon. The reasons for loosening are:

• poor choice of endoprosthesis;
• certain loads performed despite the prohibition of doctors;
• wrong rehabilitation.

Characteristic signs of a complication are pain after hip arthroplasty. The thigh area aches constantly, the discomfort intensifies at night. Other symptoms are weakness of the lower extremities, loss of a sense of support, increased fatigue when walking.

Lack of treatment for loosening threatens the development of local osteoporosis. In order not to start the problem, if symptoms appear, you should consult a doctor.

Treatment of complications after arthroplasty

Complications that have arisen on the background of hip arthroplasty require careful diagnosis, based on the results of which doctors select a treatment. It includes:

In severe cases (for example, acute purulent-inflammatory process), the only method is the removal of the implant with implantation after a long period of time. Dislocations with subsequent lameness require a reduction operation under general anesthesia.

Prevention of unwanted consequences

Bone transplantation, successfully applied all over the world, leaves a high risk of complications that require complex, long, expensive treatment. To avoid their development after hip arthroplasty, it is important to take care of timely prevention including:

• thorough preoperative diagnostics for the presence of foci of infection, chronic diseases, allergic reactions;
• correct choice of antithrombotic therapy before and after implantation;
• use of antibiotics before surgical intervention for hip replacement;
• correct selection of the prosthesis, taking into account all the individual parameters of the patient;
• proper conduct operations (minimal trauma, sterility, prevention of hematoma formation);
• early start rehabilitation to prevent congestion.

The main reason for the appointment of knee arthroplasty is persistent pain and the inability to move independently. The decision to operate is made by the doctor and the patient, if conservative treatment did not help. Any intervention, even if it is performed by an experienced orthopedic surgeon, is stressful for the body. A wound, even properly treated and sutured, reacts to an aggressive invasion with pain, swelling, and infectious diseases.

If your knee looks like this, it's time to sound the alarm.

After operation pain over time, they will go away, “take root” and cease to be felt like a foreign body, inflammation will subside. For this, at first, stationary observation and enhanced drug treatment. Further "home" rehabilitation depends on the efforts of a person, his desire to start a full life, confidence in own forces, positive attitude on speedy recovery. If painful symptoms appear longer than a month after discharge from the hospital, a visit to the orthopedist is mandatory.

Often, the seam can be used to judge how the joint takes root. There is no well-established implant and at the same time a poorly healing suture. And vice versa: there is no good seam without inflammation in the bone.

Sometimes the suture is crooked, but this does not mean that the surgeon was inexperienced. Often this is due to the vessels that have to be “bypassed” during the operation.

Counting on an instant miracle is wrong. Pain for the first time after surgery is normal, no need to panic. The body simply adapts to new conditions. To stop painful sensations, to return the natural kinematics, rehabilitation measures both in hospital and after discharge.

Thanks to modern developments in surgery, the use of minimally invasive techniques, damage to healthy tissues is minimized, which reduces risks. swelling, sharp rise temperature, stiffness and severe pain after arthroplasty knee joint appear only in 1.3-1.6% of patients .

Types and signs of postoperative complications

Problem	Symptom
infectious inflammation	Fever, redness in the knee area
	Restriction of flexion / extension, up to complete immobility
	In this case, the main thing is not to confuse sanovit with infectious inflammation because the treatment strategies are completely different. Recovery for each proceeds individually; depends on age, gender, general indications health. The development of synovitis is not a medical mistake: in 95% of cases, the disease progresses due to violation of medical prescriptions. If you have been diagnosed with synovitis, it is possible to prescribe a course of further rehabilitation. Inflammation After the operation, the muscles or tissues around the endoprosthesis may become inflamed. In 4-11% of cases, infectious processes lead to implant revision. Most often, this phenomenon is observed in patients with or who have undergone. IN rare cases causes of infection - violation of sanitary standards in the operating room, the use of a low-quality implant and suture material. Before you read the reviews of people who did the replacement in this hospital. X-ray of an infected knee joint. Try to guess: what is superfluous in this picture? The development of the infectious process is provoked by malnutrition, excess weight, Availability immune diseases, alcohol use, diabetes and cancer. Immunosuppressants and corticoids are contraindicated as treatment - they increase the risk of infection. Signs of inflammation: steadily elevated, but not too high body temperature (rises more strongly in the evening); the leg does not work well, it hurts and swells; local redness; sometimes discharge of pus from a wound or joint. If something is wrong with the knee, the first sign is pain and fever in the area of ​​the implant. Inflammation is an unpredictable pathology, since it can occur both in the first months after arthroplasty and 1-2 years after knee replacement. If in a distant postoperative period you have a question: why is the knee hot and sore, most likely, this is a late hematogenous infection in the implant area. To stop the pain, and even more so to prescribe antibiotics for yourself, is categorically contraindicated. Only an orthopedic surgeon can prescribe antibiotics, prescribe anesthesia and suggest which ointment to use after the examination. Failure to comply with medical recommendations is fraught with revision knee arthroplasty. Re-dislocation or fracture The implant is installed in the place of the damaged joint with an accuracy of up to a millimeter. With the help of computer visualization, the kinematics in the flexed/extended position is checked. 1-1.2% of cases end in re-dislocation or fracture of the endoprosthesis. In rare situations, the problem is caused by improper installation or poor-quality prosthesis, 98% of patients create a problem for themselves by ignoring rehabilitation recommendations. This happens when an injury is received, a person, for example, falls. This is where revision surgery is needed. The main symptom of a fracture is a crunch inside the knee joint. If at an early stage such a symptom can be explained by a medical error or a postoperative complication, then in the future, a crunch indicates an increase in scar tissue. Improper recovery is due to non-compliance with the regimen and diet. When a crunch appears, do not expect further complications. Contact a specialist to correct defects. Often you can get by with a therapeutic effect, avoid revision. Knee arthroplasty: complications and recommendations A month after knee arthroplasty: "home" rehabilitation The home environment is relaxing - this is its danger. In order for the recovery to proceed correctly, there is no need to go to extremes: inactivity and vigorous activity are equally harmful. By adhering to medical recommendations, you will ensure yourself successful rehabilitation, save the endoprosthesis. The warranty period for the operation of an artificial joint is 10 years, but under improper loads, the elements wear out faster. Gymnastics for the first month: Print the picture and keep it as a guide. Under current legislation, a disability certificate is issued for 15 working days. If you work with physical exertion or being on your feet, it is better to go to the hospital at your place of residence to extend the sick leave. To make a decision, a special commission will be assembled, which, after reviewing the medical history, will issue a verdict - whether to extend the sick leave, for how long. The maximum period of validity of the commission's decision is 10 months. If the disability certificate needs to be extended for a year, another council is going to. The timing depends on the characteristics of the organism, it may be necessary to travel to a sanatorium or hospitalization to identify signs of implant instability. Failure to comply with the recommended exercise therapy is the reason for the refusal to extend the sick leave. 5 months after discharge, you can start training on special simulators, return to active image life. If during this period you are still worried about pain, consult an orthopedist. Most likely, the matter is in the pathological process. Disability after knee arthroplasty Most people assume that joint replacement provides disability. This is wrong. Implantation, on the contrary, guarantees the restoration of normal mobility. A person returns to active life in six months, forgetting about the pain. The group after the operation is awarded with the ineffectiveness of arthroscopy and the progression of the disease: at least stage 2; arthrosis with deformity of the leg (curvature, shortening); prosthesis of articular segments on both limbs with unforeseen consequences or deviations. No disability is allowed: the operation is done just so that the patient does not become disabled. A person agrees to endoprosthesis in order to maintain independence, therefore, with a normally performed operation and without pronounced violations of the musculoskeletal motor functions disability is not assigned! To prevent the development of pathologies, the patient constantly wears compression stockings for the first 3 weeks after implantation. The level of compression is determined by the attending physician based on the results of the examination. The effectiveness of the early stage of rehabilitation also depends on the choice of crutches. Good handy tools with support under the elbow reduce the load on the sore leg, providing peace and proper blood flow. Underarm crutches are very compact and mobile compared to conventional axillary crutches. Which crutches are best suited, the doctor decides. The patient's height, weight, anatomical features. With absence pain the axial load gradually increases, in the future a cane is used. Try classes on the step machine - it is soft and effective. Classes on simulators, swimming, walking in the fresh air, a balanced diet are the key to the success of treatment. Listen to yourself, control the state of the body. Feel free to disturb the doctor, then you can do without revision.

Restoring the health of a patient who has undergone surgery on the joints is necessary after the very first hours after waking up from anesthesia. Rehabilitation after hip arthroplasty (HJ) is a set of exercises that are different for each period. It may also depend on the type of fixation of the prosthesis, the condition and age of the patient, the presence of concomitant diseases. Rehabilitation should be carried out not only in the hospital, but also after discharge, in a medical specialized center or at home.

TBS rehabilitation - first of all it is physical exercises

Rehabilitation after hip arthroplasty

Rehabilitation after hip replacement is divided into early and late postoperative periods, which have different tasks and degrees of load on the diseased limb. The recovery of each patient is individual and is determined by many factors.

Recovery in the early postoperative period

Early Goals:

• Prevent postoperative complications
• Master exercises performed mainly lying down
• Learn to sit and stand
• Learn to walk on crutches

Dealing with possible complications

The main concerns for the early period after joint replacement:

• Care about correct position sore leg
• Reducing pain and swelling
• Wound dressing
• Maintaining a sparing diet

Requirements for leg position and movement

Reducing pain and swelling

No one can avoid pain after surgery. Anesthesia passes - and the inevitable pain attacks also accompanied by edema. It is difficult for an already exhausted patient to endure this, and they come to the rescue:

• Pain therapy
• Drainage of accumulated fluid in the joint:
  • a drainage tube is inserted into the joint cavity, coming to the surface
  • the tube is removed as soon as the exudate stops accumulating in the cavity
• Ice pack on affected area
• If the pain is accompanied infectious process then antibiotics should be used.

Wound dressings

• The first dressing is usually performed on the second day after surgery.
• The frequency of subsequent dressings is determined by the surgeon, with a frequency of at least one in two to three days
• The stitches are removed after 10-14 days:
  • removal of the threads can occur earlier if the wound is in a satisfactory condition
  • absorbable threads do not need to be removed

Intake of food and water

After the patient comes to, he may have thirst and appetite. This is a reaction to anesthesia. But you can drink a little and eat a little crackers only 6 hours after the operation. Usual reception food is allowed the next day.

The first days you need to keep a diet that includes:

• Meat broth, lightly salted, with pureed meat
• Oatmeal, mashed potatoes
• lactic acid products
• Fruit jelly, unsweetened tea

Then the usual diet or the usual diet is prescribed, corresponding to chronic diseases sick.

Prevention of thrombus formation

After the operation, blood clotting always increases - this is a natural reaction of the body, aimed at accelerating wound healing. Therefore, during this period there is always a threat of thrombosis, and if the patient also has a history of venous insufficiency, then the risk is doubled.

To prevent thrombosis, the following measures are used:

• Bandaging of the lower extremities with an elastic bandage
• Taking heparin, warfarin, and other anticoagulants
• Special exercises for limbs

Modes of loading on the operated side

• If a cement fixation method is used during joint replacement:
  • the initial load on the operated leg should already be in the early rehabilitation period, in the first postoperative days
  • full loads - later
• With cementless method of fixation:
  • 10 - 15% of full load - after 7 - 10 days
  • Half load - after 21 days
  • Full load - at the end of the two-month period
• Special clinical cases:
  • stroke, disease internal organs, oncological diseases, deep old age etc. - in all these cases, exercise therapy should be started as soon as possible after the operation, and in full load mode.
• For acute pain:
  • the mode of limited load is applied at any stage of rehabilitation

The artificial joint has perfect mobility, but by itself it will not move: you need to “tie” it to the muscles. And this is possible only with the help of active rehabilitation, which strengthens the muscles.

Passive exercises on mechanical simulators after hip replacement are usually carried out to prevent muscle contractures, but not to strengthen the muscles. They cannot replace physical therapy, which must be performed with the application of one's own efforts and without which full recovery is impossible.

Early postoperative exercises

The goals of exercise therapy in the early postoperative period

After hip replacement at the very beginning of rehabilitation, the following goals are set:

• Prevent blood stasis, accelerate wound healing and reduce swelling
• Restore the supporting function of the sore leg and the full range of motion

Exercise therapy during the first two to three weeks is performed while lying in bed. But you need to get up on your feet literally on the second day.

The complex of initial gymnastics is very simple, but there are certain requirements here:

• Exercises are performed frequently throughout the day:
  • intensity - up to five to six times an hour for several minutes (it turns out on average per hour for therapeutic exercises takes 15 - 20 minutes)
• The nature and pace of the exercises - smooth and slow
• All exercises are combined with breathing, approximately according to the following scheme:
  • at muscle tension inhale
  • exhale while relaxing

The complex includes exercises for the calf, femoral and gluteal muscles of both limbs.

On the first postoperative day:

On the second day after the operation:

These exercises must be alternated with each other:

At one hour we do one thing, at the second we do something else, and so on.

How to sit properly

It is necessary to sit down carefully on the second day. How it's done?

You need to sit down, holding on to the handrail, in the direction of a healthy leg

• You need to lean on your elbows or hold on to the frame above the bed
• You need to sit down in the direction of a healthy leg, first lowering it to the floor, and then pulling up to it (you can also use an elastic bandage) the operated limb
• The roller between the legs must be mandatory
• Legs must first be bandaged with elastic bandages.
• When landing, you need to maintain a straight position of the body and do not turn the foot outward.

From the second day, mechanotherapy of the hip joint also begins.

Walking period after replacement of TBS

It can also be called "going through the throes": too little time has passed after the operation, the wound still hurts, and the doctor, despite the pain, already orders to stand on crutches the very next day. And this is not a whim of a surgeon:

The sooner you start walking, the less likely you are to develop contractures and the more likely you are to regain full range of motion.

All the difficulties of walking on crutches are described in detail in our article Rehabilitation after knee arthroplasty, so we will focus only on the loads and walking on crutches on the stairs

• During the first postoperative week, you only need to touch the floor with your foot
• Then we move on to a 20% load on the sore leg: this is equivalent to transferring our own weight to it without the weight of the whole body, that is, we stand on the leg without relying on it

An increase in the load with bringing it to half should be carried out for each patient individually:
If the pain and swelling in the leg have not gone away, then the increase in the load is premature.

What are they talking about prolonged pain and puffiness

Pain that does not go away for a long time and swelling that does not subside may be signs of a postoperative complication, dislocation of the prosthesis, abuse of walking, or improperly performed therapeutic exercises.

In any case, the surgeon must understand the reasons.

Walking on crutches up stairs

The method of walking on crutches on the stairs is determined by the direction of movement - up or down

The walking technique is determined by the direction of movement - up or down:

• When climbing up the stairs, they begin to move from the non-operated limb:
  • We lean on crutches and transfer a healthy leg to the step
  • We push off with crutches and transfer the weight of the body to it
  • We pull up the operated leg, at the same time rearranging the crutches to the upper step, or we transfer the crutches after the sore leg
• When descending the stairs, all movements occur in the reverse order:
  • First, crutches are transferred to the lower step
  • Leaning on crutches, we put the sore leg down without emphasis
  • We transfer the healthy leg to the same step and lean on it

Walking on crutches up the stairs can be started after the exercises for a sore leg in a standing position have been mastered.

Exercise therapy on the tenth day after surgery

Standing exercises

Exercises in a horizontal position

All this exercise therapy complex should continue to be done at home.

Late rehabilitation of the hip joint

And now, two months have passed since the operation, but the hip joint is still quite constrained, and you step on the operated leg uncertainly. This means that a full recovery has not occurred and you need to continue rehabilitation:

• At home, perform the previous exercises plus gymnastics based on a sore leg
• Engage in simulators

Hip Exercise Bike

Exercise bike - effective method strengthening absolutely all the muscles connected to the work of the joint.

On the exercise bike, you need to set the light mode and the seat height corresponding to a small angle of flexion of the joints

However, you should not overdo it with it:

• Use the treadmill at low speed
• Adjust the seat height so that the hip joint does not flex more than 90°, and when the knee is extended, the foot just touches the bike pedals

Video: Rehabilitation of hip joint after joint replacement

Recovery after hip arthroplasty

Relatively recently, many patients suffering from arthrosis of the hip joint (coxarthrosis), or who received a fracture of the femoral neck, were doomed to complete disability due to the loss of the ability to move independently. Fortunately, the introduction the latest technologies in medicine allowed patients to avoid this fate, and to live their former full life. One of these technologies is total hip arthroplasty (TETS), when the entire hip joint (head, femoral neck, cartilaginous surface of the acetabulum) is replaced with a synthetic prosthesis. But in order for the synthetic joint to work as well as the “native” one, it is important not only to perform the operation at the classroom level. Competent postoperative recovery or rehabilitation after arthroplasty is needed. And it depends not only on the doctor, but also on the patient.

Problems

Check out the article:


Suprapatellar bursitis of the knee

By itself, TETS is a rather technically complex and traumatic operation. The skin and muscles are dissected, the bone and cartilage tissues of the worn joint are removed. Then the leg of the prosthesis is fixed in the femoral canal. Severe surgical trauma is accompanied by pain, release of biologically active substances from tissues to blood. In turn, this leads to a change in the work of the heart, lungs, blood coagulation system. Preoperative preparation and anesthesia eliminate all these negative consequences, but only to some extent.

It goes without saying that people go for arthroplasty, to put it mildly, not from a good life. Such an operation requires strict indications. Such indications include the destruction of articular structures due to coxarthrosis or a fracture of the femoral neck. With coxarthrosis due to long-term movement disorders develop atrophic changes muscles of the lower limb, back, the work of the pelvic organs is disrupted. The load on the spine increases, which leads to the development of lumbosacral osteochondrosis and sciatica.

It should not be forgotten that the vast majority of patients operated on for TETS are elderly and old age. This means that they have varying degrees dysfunction of the heart, breathing, endocrine system. In some patients, the disorders are decompensated and worsen after surgery. In addition, the operation itself and postoperative bed rest lead to disruption of intestinal motility (contractions) up to the development of atonic intestinal obstruction. It should not be forgotten that in old age the ability to regenerate, heal tissues damaged during surgery is significantly reduced. The immune system is weakened, resulting in favorable conditions to introduce infection.

Thus, postoperative problems after hip arthroplasty are as follows:

• The patient is concerned about postoperative pain
• Existing muscle atrophy worsens
• Worsening cardiopulmonary insufficiency
• Disrupted bowel function
• The danger of cerebral strokes due to jumps in blood pressure is great
• Blood clotting disorders can lead to thrombosis of the veins of the lower extremities and to an extremely serious condition - pulmonary embolism
• Postoperative wound can serve entrance gate for infection.

Main directions of rehabilitation

Measures to restore motor functions and prevent postoperative complications are complex. Needless to say, the main emphasis is on exercise therapy (exercise therapy), which is designed to ensure optimal functioning of the newly found joint and the entire lower limb. In addition to exercise therapy, other therapeutic measures are carried out using drugs. various groups and physiotherapy procedures.

And the first such event is postoperative pain relief, during which they combine non-narcotic (Renalgan, Dexalgin) and narcotic (Morphine, Promedol) drugs. For the prevention of severe pulmonary heart failure, patients are prescribed cardiac agents (Mildronate, Riboxin, ATP). Such patients are shown inhalation (inhalation) of oxygen. Hydrated oxygen is supplied through a special breathing apparatus.

Another important point- prevention of thrombotic complications, which often develop in elderly patients after surgery. At the same time, parietal thrombi are formed in the veins of the lower extremities, which, breaking off, are brought into the pulmonary artery by the blood flow and clog it. Blockage of the main trunk of the pulmonary artery can cause instant death. To prevent this from happening, such patients are bandaged with an elastic bandage in the first few days after the operation and anti-clotting agents (Fraxiparine, Clexane) are injected subcutaneously. To eliminate postoperative atony of the intestine, injections of Prozerin, Ubretida are prescribed. Be sure to prescribe antibiotics (Ceftriaxone, Metrogyl).

Principles of exercise therapy

There is an erroneous opinion that exercise therapy after hip arthroplasty can be performed only in the late postoperative period, and strict rest is needed in the first days. This erroneous tactic can lead to contractures (persistent limitation of range of motion) and thrombotic complications. Therefore, some, the simplest loads, are carried out already on the first day after the operation, after coming out of anesthesia. In the implementation of exercise therapy, the principle of stages should be observed, when the exercises themselves are done in several phases.

Zero phase

Zero phase - on the first day after the operation, when the following types exercises:

• Adduction and abduction of the foot up and down several times every 10 minutes. - so-called. foot pump
• Rotations in the ankle joint in both directions 5 times
• Short-term, 10 min each, tension of the anterior quadriceps femoris muscle
• Flexion of the knee while pulling the heel
• Buttock contractions followed by tension for 5 seconds
• Abduction of the operated leg to the side and return to the starting position
• Raising the straightened leg for a few seconds.

First phase

The first phase, 1-4 days after the operation - the so-called. strict care. At this time, it is allowed to sit on a hospital bed or on a chair, and then move around with the help of crutches or special walkers. Important: when landing, do not bend the limb in the hip joint more than 900, do not cross your legs. On the contrary, lying on the bed, try to take your leg to the side. To do this, you can put a pillow between your legs. The main types of exercises in this phase are performed in a standing position:

• Flexion of the leg at the knee and hip joints
• Straightening the leg at the hip joint and pulling it back
• Taking the leg to the side.

Second phase

The second phase of rehabilitation or deceptive possibilities - 5 days - 3 weeks after surgery. Many patients at this time feel a surge of energy, they are tired of stiffness and inactivity. But the joint is not yet strong, and muscle atrophy persists. In this phase, motor loads are shown - movement along a horizontal surface, but not more than 100-150m. or going up and down stairs. Climbing the stairs, you should lean on a cane or on a crutch. At the same time, first a healthy leg is placed on the higher step, then the operated one, and then a cane. When descending the stairs, everything is carried out in the reverse order.

Third phase

The third phase of rehabilitation, "the start of work" - after 1-2 months. after operation. At this time, the implanted joint "has taken root", and the muscles and ligaments have become so strong that you can gradually increase the load, and do it at home. Exercises during this period are similar to the previous ones, but are performed with weights. An elastic band can be used as a weight. One end of the tape is tied to the operated leg at the level of the ankles, and the other end is tied to a fixed object, such as a doorknob, after which flexion, extension and abduction are performed.

During this period, you can increase the duration hiking- half an hour 3-4 times a day. Even exercises on a stationary bike are shown. At the same time, one rule should not be forgotten - the appearance of pain serves as a signal to stop exercising. At the same time, it is not worth it for a long time, more than an hour, to sit in a fixed position. The above rule right angle must also be followed. In general, during each hour you should walk a little, for several minutes.

In the course of rehabilitation after endoprosthetics, exercise therapy is necessarily combined with physiotherapeutic procedures, including darsonval, phonophoresis, magnet, amplipulse. Thanks to these procedures, edema is finally eliminated, and muscle work is stimulated. The final stage rehabilitation of hip arthroplasty is a stay at mud resorts.

How to behave after hip arthroplasty: general recommendations

Rules to follow after hip arthroplasty:

1. In the first days after the operation, you can only sleep on your back, it is allowed to turn on your side after 3 days under the supervision of the medical staff and on your unoperated side. You can sleep on your unoperated side two weeks after arthroplasty.
2. In the early days, you need to avoid a large range of motion: do not move sharply, turn your leg, etc.
3. When sitting on a chair or toilet, make sure that the operated joint does not bend more than 90 degrees, you can not bend down, squat, cross your legs and throw them one on top of the other. It is desirable to sleep on a high bed, chairs should also be high (like bar ones)
4. For the first six weeks after surgery, try to avoid taking a hot bath in favor of a warm shower. It is strictly forbidden during the first 1.5 - 3 months of the postoperative period to visit baths or saunas (to avoid thromboembolic complications).
5. You need to exercise regularly.
6. Sexual relations are allowed 1.5-2 months after the operation
7. It is better to exclude sports such as horse riding, running, jumping, weightlifting, preferring swimming and walking.

Nutrition after hip arthroplasty

After discharge and return home, the patient should eat a balanced diet. In this case, on the advice of a doctor, it is desirable:

• take certain vitamins;
• monitor weight;
• replenish the diet with iron-containing foods;
• limit your intake of coffee, alcohol and overconsumption vitamin K.

When do I need to see a doctor after joint replacement surgery?

Alarming symptoms indicating possible inflammation and complications of the rehabilitation period can be: high temperature (above 38 degrees), redness of the skin around the seam, discharge from the wound, chest pain, shortness of breath, increased pain in the joint, swelling. When these alarms you should contact your doctor immediately.

In some cases, a patient after hip arthroplasty is recommended to periodically take x-rays, take urine and blood tests so that doctors can follow the healing process.

The first follow-up examination is usually carried out 3 months after the operation. During it, it turns out how the joint "costs" and whether the leg can be fully loaded. The next follow-up examination is in 6 months. The purpose of this examination is to find out if you have osteoporosis or other pathologies. bone tissue. The third control visit is carried out one year after the joint replacement. In the future, it is recommended to visit your doctor at least once every 2 years. Typically, the prosthesis lasts 15 years, sometimes 20-25, after which it is recommended to replace it.

Factors that accelerate joint wear and lead to complications:

• hypothermia, colds leading to an inflammatory process;
• excess weight: increases the load on the joint;
• the development of osteoporosis (loss of bone strength), the appearance of which is promoted by a sedentary lifestyle, smoking, alcohol, use steroid hormones, malnutrition;
• carrying heavy weights, sudden movements and jumping on the operated leg.

Zero phase

The time period of this phase is the first day after arthroplasty. All movements are performed very carefully. During this time, you can do the following exercises:

1. "foot pump" - moving the foot up and down several times (this exercise should be done throughout the entire rehabilitation period);
2. short-term tension of the anterior thigh muscle;
3. contraction of the buttocks and holding them in this position for five seconds;
4. abduction to the side and return to the starting position of the operated leg;
5. bending the leg at the knee with heel support;
6. rotation of the foot of the operated leg clockwise and against it;
7. elevating the operated limb for a few seconds.

All exercises should be done slowly and very carefully. Each should be repeated about 10 times. Not all of these exercises can be obtained immediately. If in the process of performing any movement there are difficulties, then you can wait a little with it, and try again a little later.

Exercise therapy after endoprosthetics is one of the elements of rehabilitation

To prevent vascular disorders, it is recommended to bandage both legs with elastic bandages. Do not forget about a healthy leg: it is recommended to raise and lower the leg, as well as take it to the side. It is forbidden to cross your legs. It is best to lie on your back. If you need to lie on your side, then there should be a roller between the thighs.

First phase ("strict care")

The duration of this phase is from one to four days after the operation. The patient can now gently sit on the bed. In this case, you can not cross your legs and strongly bend them at the hip joint, as well as lie on the operated side.

In a sitting position, the hip joint should not be allowed to be lower than the knee. It is recommended to sit on hard chairs, putting a pillow under the buttocks. It is not recommended to sit in soft chairs, as when standing up, the load on the hip joint will be too great. Lying on the bed, it is recommended to take the leg to the side. It is contraindicated to cross your legs.

The next day after arthroplasty, you can already start walking slowly, leaning on crutches. Almost all patients are advised to immediately try to step on the operated leg, the so-called loading according to the principle of pain tolerance. By the fourth day, you can already walk 100-150 meters several times a day.

New exercises are added to the exercises of the zero phase, which are performed in a standing position, but with support:

• flexion of the legs in the hip and knee joints;
• abduction of the straightened leg back.

Second phase ("deceptive possibilities")

This phase begins on the 5th and ends on the 21st day after arthroplasty. During this period, an increase in motor loads is expected. You can slowly go down and up the stairs, more time is spent walking, observing the following rules:

1. Walking is recommended no more than 30 minutes at a time.
2. Climbing the stairs, first they put a healthy leg on the step, and only then the operated one.
3. Walking is allowed only with the help of crutches or special walkers.

This phase got the name “deceptive possibilities” because the pains almost disappear, and it seems to the patient that he can already do more than the doctor allows. Many of the patients neglect the rules, the observance of which prevents dislocation of the joint, stop putting the roller between the thighs. Violation of the rules can lead to increased pain and dislocation in the operated joint.

The main exercise therapy exercises that are added in this phase:

1. Lying on stomach:

• bending the leg at the knee so that the heel is directed towards the buttocks;
• raising the legs with the tension of the gluteal muscles.

1. Lying on your back:
2. alternately abducting the legs to the sides;
3. bending the legs at the knees, without lifting the feet from the floor.

Third phase ("getting started")

Exercises from the third phase of exercise therapy begin to be done when the muscles and ligaments are strong enough and the joint takes root. As a rule, this occurs 1-2 months after hip arthroplasty. All exercises can be done at home. The load is increased by weighting. Suitable for this elastic bandage. At this time, it is no longer necessary to put a roller or pillow between the thighs.

The duration of walks on foot is gradually increasing up to 3-4 hours a day. Despite the fact that quite significant loads on the joint are already possible during this period, it is recommended to stop exercising if pain occurs.

At first, a rehabilitation specialist will help you to do special exercises.

Basic exercises:

• flexion of the leg in the hip joint with resistance;
• abduction of the operated leg to the side with resistance.

In this phase, you can start exercising on an exercise bike. The seat must be adjusted so that with a straightened knee, the feet barely reach the pedals. It is recommended to start classes by pedaling backwards. The first lessons should be short-term.

Late postoperative period

If more than three months have passed since hip arthroplasty, and when walking in the operated leg, pain or discomfort occurs, you can unload it using a cane. Patients who have undergone hip replacement surgery can return to work in the workplace and drive a car after three months. However, if the job requires active movements, it is recommended to take a rest break every one to two hours. For those who cannot imagine their life without sports, skiing, swimming and cycling are recommended. It is important to remember that self-treatment after hip arthroplasty can not only not bring benefits, but also cause harm. Therefore, before you begin to perform certain exercises, you need to consult with your doctor.

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What is osteoarthritis

Osteoarthritis can affect any joint. Most often, DOA of the knee joints develops, then the spine. Osteoarthritis of the hip joints is the third most common. The process can be either one- or two-sided.

In this case, the cartilage lining the surfaces of the adjacent bones is destroyed in the joint, the joint fluid becomes prone to inflammatory processes, marginal bone growths appear. On late stages the joint space (the gap between the bones) disappears, and movement in the joint becomes impossible. The causes of the disease are:

• genetic predisposition;
• trauma;
• metabolic disorders (for example, deposits in the joints of uric acid, hydroxyapatites).

A characteristic symptom is pain in the projection area of ​​the joint, which intensifies during physical activity (walking). The pain syndrome can reach such intensity that the patient loses the ability to move independently. Osteoarthritis cannot be cured conservative methods. With proper traditional treatment, it is only possible to maintain a state of remission. So the replacement of the hip joint is the only way to restore health and maintain working capacity. The duration of the operation is 1-3 hours. It depends on whether the prosthesis is carried out - full or partial. The patient is under general or spinal anesthesia. For a quick recovery and optimal results of treatment, it is necessary to start performing special exercises within a few hours after the end of the operation.

Stages of rehabilitation

Initial phase (1st day after surgery)

First of all, a set of exercises is prescribed to improve blood circulation in the legs and prevent the formation of blood clots. Such gymnastics is performed while sitting or lying down 3 times a day with both legs, regardless of whether the joint was replaced on one or both sides.

1. Static tension of the quadriceps femoris muscle.
2. Flexion of the leg at the knee.
3. Foot movement up and down.
4. Raising a straight leg 10 cm from the surface of the bed.
5. Leading the straight leg to the side.

The first phase (2–4 days after surgery)

The patient continues to perform the set of exercises he already has. New ones are being added.

1. Raising the leg bent at the knee. Starting position - standing at the support.
2. Leading a straight leg to the side in a standing position.
3. Retraction of a straight leg back in a standing position.

The main goal of this rehabilitation period is to switch to complete self-care (get up, sit down, walk, go to the toilet on your own). At this time, there is a risk of dislocation of the prosthesis. In order to level it, it is necessary to sleep with a pillow between the knees, not to lie down on the operated side and not to keep the knees constantly bent, even if this reduces the pain.

Second phase (up to 21 days after arthroplasty)

The patient needs to continue to increase the load. Already at the end of the first week, you should learn to walk carefully up the stairs. When lifting, you first need to step with the operated leg, then with a healthy one, while descending - vice versa.

The risk of dislocation of the prosthesis remains, so it is necessary to follow all the recommendations of the previous stage.

Third phase (up to 2 months after surgery)

Phase of active training of the gluteal and femoral muscles. An elastic band acts as a kind of simulator, which allows you to perform all exercises with resistance (flexion in the hip joint while standing at the support, abduction of the leg in a standing position).

The patient should walk little and often, gradually increasing the walking time up to 2 hours a day in several stages.

In the department physiotherapy exercises(in a hospital and clinic) the patient is assigned exercises on an exercise bike, which perfectly develop muscles, as well as stepping onto the platform.

Fourth phase (up to 4 months after prosthetics)

This time is hiding hidden danger for patients. Having successfully passed the previous stages of rehabilitation, having learned to walk without a cane, without feeling pain and mobility restrictions, people stop doing exercises. This is a big mistake! Insufficiently strong muscles, especially in the elderly, quickly detrain, which increases the risk of injury (falling due to loss of balance, for example).

Exercises to strengthen the muscles of the legs should be performed regularly for a long time, preferably for life. You can't train through pain. However, do not confuse joint pain with muscle pain (due to the accumulation of lactic acid) and, under this pretext, refuse to exercise. You should perform semi-squats (strictly with a straight back), stepping, abducting a straight leg with resistance or a slight weight, walking along the track or exercising on an exercise bike.

You should also follow a balanced diet. The diet should contain a large number of proteins (an exception is made for patients with gout), carbohydrates (better than long ones, i.e. cereals, whole grain pastries), fats (required with enough omega 3 unsaturated fatty acids from seafood). Proper nutrition will help not to gain excess weight to avoid stress on the joint.

The list of medicines will be issued by the attending physician. It usually includes vitamin complexes and supplements containing glucosamine and chondroitin at therapeutic doses.

Hip arthroplasty, with proper rehabilitation, allows the patient to return to Everyday life as soon as possible.

Hip arthroplasty: recovery and rehabilitation

The hip joint is the most big joint V human body. By connecting the torso and legs, it receives a large load, so diseases and lesions of this joint cause unbearable pain, which requires immediate medical intervention.

Among the diseases of the hip joint: coxarthrosis, infectious arthritis, pathology of blood supply to bones and others. Endoprosthetics of the hip joint is the replacement of a destroyed joint element with an implant. The implant can be made of materials such as metal or ceramic and contain stainless steel, cobalt, chromium or titanium. The surgeon selects the appropriate material and the size of this material, based on individual indicators. The prosthesis lasts (in older people) for life, but younger patients may need reoperation on the hip joint.

Operation on the hip joint

These operations have been carried out for thirty years and every year it is carried out with the help of more and more advanced technologies, which significantly improve the results. As a result, patients undergo unbearable pain that accompany any lesion of the hip joint. To ensure that there are no complications during and after the operation, tell your doctor comprehensive information about your state of health. If you smoke, the doctor should definitely be aware of this, since nicotine affects both the speed of rehabilitation and the patient's well-being during surgery. To avoid unforeseen circumstances, you should also not place the dentist before the operation - blood from the mouth can enter the bloodstream, infecting the joint. Hip arthroplasty requires a thorough examination.

During surgery, sometimes suddenly become the right blood patient - it is better to hand over yours in advance, because it is not known how the body will react to someone else's blood, which is usually prepared by doctors for every firefighter.

Total hip arthroplasty (both the pelvic and femoral elements of the joint are replaced) is, first of all, a longer-term operation of the implant, which eliminates the need for revision hip arthroplasty. In addition, in this case, the implant performs its function better, although there are also disadvantages: this operation is more dangerous and blood loss in this case is greater.

Complications of hip arthroplasty occur and depend on the characteristics of the body and lifestyle of the patient, as well as on the quality of the operation and the knowledge of the surgeon who performs it. Statistics show that the most frequent complications occurred when using implants of poor quality - these are the first implants of the last century. With progress in modern medicine the number of complications has been significantly reduced. After hip arthroplasty, the patient can apply for a pension. The disability group after hip arthroplasty and the size of the pension, respectively, are set according to the patient's ability to move around, go to the store, and so on.

Recovery after hip surgery

The duration of recovery after surgery depends on the patient - each period of rehabilitation is individual. Recovery after hip arthroplasty does not include any specific technique, but some rules should still be followed.

1. When sitting on a chair, place a pillow on the seat so that your knees are lower than your hips.
2. Avoid too sudden movements, turns with legs, crossings, and so on - all these manipulations will negatively affect the patient's well-being and the speed of his rehabilitation.
3. Lying on your side (just not on the leg that was operated on), put a small pillow between your legs to avoid displacement.

If symptoms such as fever appear, pain increases, swelling or other similar phenomena are observed, then you should immediately consult a doctor.

It is worth remembering that it is important when exactly the operation was performed - immediately after the joint was damaged or after a long time. Of course, in the first case, muscle work can be fully restored, which cannot be said about the second case.

Rehabilitation after hip arthroplasty begins already in the hospital and continues at home for about a month. To increase the chances of fully rehabilitating, the patient must strictly follow the recommendations of doctors.

It is more difficult to rehabilitate older patients, therefore medical rehabilitation start before surgery. Of course, hip arthroplasty, the rehabilitation of which takes time, is a complicated procedure, but do not despair - you will succeed.

Exercises for rehabilitation after hip arthroplasty

Exercise is an important part of restoring the work of muscles that atrophy if they are not done. Exercises after hip arthroplasty are quite painful, as the pain does not subside immediately after the operation. However, you should not spare yourself too much, because then it will be much more difficult to recover.

It is important that the patient knows what he is facing. Hip arthroplasty, the video of which can be viewed on the Internet, will give you an idea about this.

Hip arthroplasty is an operation to replace the affected joint with an endoprosthesis. As with any other surgery, complications can occur. This is explained individual features organism, state of health and complexity of the operation.

Pain after arthroplasty is inevitable. This is due to the nature of the operation.

Risk factors

• The advanced age of the patient.
• Associated systemic diseases.
• Transferred operations or infectious diseases history of hip joint.
• The presence of acute trauma of the proximal femur.

Many patients are afraid to undergo surgery due to possible complications.

Possible Complications

Rejection of a foreign body (implant) by the body

This consequence occurs extremely rarely, because Usually, before the operation, after choosing the prosthesis, tests are carried out for individual sensitivity to the material. And if there is intolerance to the substance, then another prosthesis is selected.

The same applies to allergic reactions to anesthesia or the material from which the prosthesis is made.

Infection in the wound during surgery

This serious condition, which is treated for a long time with antibiotics. The infection may occur in wound surface or in the depth of the wound (in soft tissues, at the site of the prosthesis). The infection is accompanied by symptoms such as swelling, redness, and pain. If treatment is not started in time, then the prosthesis will need to be replaced with a new one.

Bleeding

It can begin both during the operation and after it. main reason is medical error. If help is not provided in time, then the patient, at best, may need a blood transfusion, at worst, hemolytic shock and death.

Prosthesis displacement

Change in leg length

If the prosthesis has not been fitted correctly, the muscles near the joint may weaken. They need to be strengthened, and exercise is the best way to do this.

The risk of complications decreases with proper rehabilitation after hip replacement surgery

Deep vein thrombosis

After a decrease in motor activity in the postoperative period, blood stasis may occur, and as a result, the occurrence of blood clots. And then it all depends on the size of the blood clot and where it will be carried by the blood stream. Depending on this, the following consequences may occur: pulmonary thromboembolism, gangrene of the lower extremities, heart attack, etc. To prevent this complication, it is necessary to start active activities at the appointed time, and anticoagulants are prescribed on the second day after the operation.

Also, over time, the following complications may occur:

• Weakening of the joints and disruption of their functioning.
• Destruction of the prosthesis (partial or complete).
• Dislocation of the endoprosthesis head.
• Lameness.

These complications after hip arthroplasty occur less frequently and over time. To eliminate them, you need surgical intervention(replacement of the endoprosthesis).

Pain after hip replacement

The only complication that will accompany arthroplasty under any conditions is pain.

To get to the joint, it is necessary to cut the fascia and muscles of the thigh. After stitching, they will grow together for about 3-4 weeks. When performing movements, pain will occur. And since the movements are mandatory so that the muscles grow together faster and correctly, the pain will be felt for almost the entire period of rehabilitation.

Endoprosthetics is a serious operation. After it, certain complications are possible, but with timely diagnosis and treatment, everything can be eliminated without unnecessary harm to health.

Negative consequences and complications after hip arthroplasty (HJ) occur infrequently, but still they are not excluded. In the postoperative period, the patient may experience inflammation with the addition of a bacterial infection. Dislocations and fractures of the prosthesis, thrombosis and other disorders occur due to non-compliance with the doctor's recommendations. If a person feels worse after an arthroplasty operation, you should not expect the situation to normalize on its own. Only timely provided health care help prevent serious complications.

Causes of complications after hip arthroplasty

The operation is complex and traumatic, so it can not always pass without negative consequences. To reduce the risk of complications, it is important to follow the doctor's recommendations during the rehabilitation period after arthroplasty. In the risk zone for postoperative disorders are:

• elderly people over 60 years old;
• suffering from systemic pathologies, for example, diabetes mellitus, arthritis, psoriasis or lupus erythematosus;
• patients with a history of fractures or dislocations of the hip joint;
• patients suffering from chronic inflammatory diseases;
• violating the advice and recommendations of the surgeon.

In the elderly, complications after knee or hip arthroplasty develop due to physiological features. Due to the fact that as the body ages, the articular structures become thinner and destroyed, in humans old age more risk of negative consequences. Young men and women during the rehabilitation period when moving should use special devices, because walking without crutches can cause dislocations or fractures of the prosthesis.

Types and symptoms

paraprosthetic infection

A rise in temperature in the postoperative period may be a symptom of an infection.

If a person has a fever after hip arthroplasty, swelling, a purulent fistula, and severe pain in the thigh, most likely, an infection was introduced into the wound during the operation. With such symptoms, the doctor prescribes antibiotics and aids which can help relieve inflammation. If the temperature persists for a long time, and the patient does not go to the doctor and does not take any measures, it is possible to repeat, revision arthroplasty of large joints.

Dislocations and subluxations

Often develops late rehabilitation periods when the patient ignores physical limitations and early refuses to move on crutches. Because of increased load the hip component is displaced in relation to the acetabulum, as a result of which the head does not coincide with the cup. The damaged area swells and hurts, a person cannot take some of the usual postures, the leg loses its functionality, lameness is observed.

If the discomfort has just begun to appear, it is better to visit a doctor immediately, the sooner you begin to eliminate the violations, the less consequences there will be.

neuropathy

With neuropathy, a person may experience a feeling of numbness in the foot.

If during the operation on the hip joint nerve fibers were affected, a neuropathic syndrome develops. This complication may be due to lengthening of the leg after implant placement or pressure on nerve endings formed hematoma. The main symptom of neuropathy is an acute pain syndrome that spreads to the entire lower limb. Sometimes it feels as if the foot is numb or worried about the burning sensation and the feeling that goosebumps run along the skin. With such symptoms, it is dangerous to endure pain and self-medicate. If you consult a doctor in a timely manner, you will be able to normalize your well-being with the help of exercise, otherwise the operation is indispensable.

Periprosthetic fracture

After replacement of the T-B joint, the integrity may be impaired bone structures thigh in the place where the leg of the endoprosthesis is fixed. Often this is a consequence of a decrease in the density of the pelvic bones or a poorly performed endoprosthetic operation. If a fracture occurs, the person is worried strong pain, edema and hematoma form at the site of damage, the functionality of the joint is impaired.

Thromboembolism

The first days after endoprosthetics, the patient will be partially immobilized, due to which the blood flow in the veins and arteries will be disturbed. This leads to critical blockage of blood vessels by a thrombus. Often the state does not have severe symptoms Therefore, it is important to control blood circulation and not violate the doctor's recommendations during the postoperative recovery stages. Sometimes, with thrombosis, the patient observes that the limb hurts and is swollen, shortness of breath, general weakness, and loss of consciousness may also be disturbed.

Other consequences

If the prosthesis has not taken root, then the person may be tormented by pain in the groin.

Complications during arthroplasty can be very diverse. One of the most common is the rejection of the implant by the body. After a prosthesis operation, the body may not respond adequately to foreign material, resulting in inflammatory and allergic reactions. At the site of implantation, edema, suppuration and fistulas form. In addition, a person may experience:

• blood loss;
• loosening of the prosthesis design;
• lameness;
• pain in the groin;
• edema, due to which the legs swell so that the work of the joint is completely disturbed.

Treatment of complications

If in the first days after the operation symptoms of infection began to appear, and a fistula formed at the resection site, the doctor prescribes antibiotics, NSAIDs and painkillers. If dislocations, subluxations or fractures are suspected, an MRI study is prescribed. When the diagnosis is confirmed, revision arthroplasty is performed with the replacement of the destroyed structure with a new one. If the knees, lower leg and feet hurt due to neuropathic disorders, a course of exercise therapy is prescribed. In advanced cases, the problem is fixed surgically. With thromboembolism, thrombolytic drugs and drugs that reduce blood clotting are prescribed.

Prevention of negative consequences

You can walk with crutches after 5 days.

To prevent complications after hip replacement, at the initial stages and in distant periods After the operation, it is important to follow the recommendations of the doctor, to monitor the state of health. On the 2-3rd day after endoprosthetics, it is allowed to sit on the bed, then on a chair, but you should not immediately load the diseased joint. For 4-5 days, you can go to the toilet with two or one crutch. An elastic bandage, which is wrapped around the legs along the entire length, will help prevent thrombus formation. This will be followed, during which you will need to regularly engage in exercise therapy and gymnastics.

An important factor influencing the patient's condition in the postoperative period is proper nutrition. The diet should include plant foods, red meat and fish, dairy and fermented milk products, nuts, seafood, cereals, aspic. Proper and balanced nutrition, in addition to recovery, will help control body weight, which is especially important in the first months of rehabilitation, when the patient's activity will be limited and the risk of gaining extra pounds will increase.