An operation, even performed at the highest level, will not be effective without high-quality postoperative treatment. Comprehensive rehabilitation after hip replacement - exercise therapy, physiotherapy, prevention of complications - allows you to get the full potential from this type of treatment. Without rehabilitation, you risk maintaining pain, lameness, and limited range of motion.

Introductory briefing

After hip replacement, rehabilitation lasts an average of 3 months. It consists of stages, for each of them its own system of treatment and rehabilitation measures has been developed, based on physical exercises and auxiliary procedures. A step-by-step therapeutic effect on the prosthetic segment allows you to prevent complications, quickly eliminate swelling and painful signs, thoroughly develop the limb, restoring the functionality of the leg.

A good and calm stitch approximately on the 3rd day after the operation.

We hope that you have thought about such a device in advance.

Physical activity is planned and optimized in accordance with the timing and individual criteria by a rehabilitation physician. At home, you will need to take contraindicated types of activity seriously, train strictly according to the instructions, without forcing loads, always come to the clinic for scheduled examinations, and in case of any pathological manifestations (pain, swelling, hematoma, etc.) immediately contact your doctor.

General principles of rehabilitation

The goals of rehabilitation are the following:

• complete elimination of the inflammatory process and pain that results from surgical procedures;
• normalization of the state of the muscular-ligamentous complex, which brings the articular bones (pelvic and femoral) into coordinated movement;
• strong fusion of the prosthesis components with the bones, which occurs gradually during the natural reparative processes of bone tissue renewal;
• preventing the development of negative consequences.

Drug treatment

After surgery, you must strictly take all prescribed medications; this is vital. And if someone thinks that it is harmful to the body, then problems are not far off.

Includes taking or injecting specific medicinal compounds, namely:

• antibacterial medications from the spectrum of antibiotics (against the development of infection);
• anticoagulant protective drugs (against venous thrombus formation);
• non-steroidal anti-inflammatory drugs (against pain and inflammation);
• gastroprotectors and drugs that improve the functioning of the urinary tract;
• protein and calcium supplements to accelerate the regeneration of bone and muscle structures.

Comprehensive physiotherapy

Physiotherapy is an excellent addition to motor recovery.

These are procedures of electromyostimulation, electrophoresis, UHF, laser treatment, massage, balneotherapy and mud therapy, aimed at:

• reduction of pain and swelling;
• elimination of spasmodic phenomena in muscles;
• stimulation of blood circulation and lymph circulation in the structures of the problem leg;
• increased muscle tone and strengthened ligaments;
• activation of metabolic and regenerative processes in the lower limb.

Rehabilitation after hip replacement at home and in the hospital is a rather long and labor-intensive process that requires strength and patience. But if it is organized correctly, working capacity returns by the end of the 10th week. If the postoperative stages are complicated, recovery after hip replacement will most likely take 2 times longer.

There is a direct relationship; patients who are not overweight and lead an active lifestyle as much as possible before surgery recover faster than others.

Description of rehabilitation stages

Basic recovery after hip replacement takes 10 weeks. Of these, 3 weeks are the early phase, from the third to 10 weeks are the late stage. And all this time it is necessary to fruitfully carry out tasks and exercises for rehabilitation after hip replacement, dictated by the surgeon and rehabilitologist. Together, specialists create an effective physical therapy regimen.

The essence of training exercises is repeated, regularly repeated and consistently increasing physical activity, which gradually improves motor activity, dynamically improves and restores performance. After the entire specified period of time after surgery on the hip joint, rehabilitation does not completely end. All the achievements that the patient has been pursuing for so long and finally achieved the cherished painless freedom of movement must be consolidated.

Wonderful sanatoriums that provide proper rehabilitation after partial replacement and total hip replacement are located in the Leningrad region, Krasnodar region, and Karelia. If we talk about foreign European resorts, the clear leaders here are Teplice and Jáchymov, located in the Czech Republic.

Early stage

The person undergoing surgery is immediately transferred from the operating room to intensive care for 24 hours. This is done to control the main functionally significant indicators of the body’s condition: heart rate, breathing, blood pressure, etc., which is mandatory after any surgical procedure. They immediately begin antibiotic therapy and the administration of anticoagulants, take tests, and, if necessary, perform a blood transfusion. Breathing exercises are prescribed to prevent congestion in the lungs.

Compression cuffs are used to prevent thrombosis.

From the second day until the end of the 3rd week of the rehabilitation period after hip replacement, clinical care and recovery are carried out in the inpatient unit. The patient will be bothered by pain, which is a normal reaction of the body, therefore, in addition to taking NSAIDs, he will be shown physical therapy and cold dry compresses locally. They will relieve swelling located on the outer soft tissues above the replaced joint. Soreness and swelling, as soon as the suture heals, will stop causing suffering.

The arthrot is used from the second day after surgery for passive development of the joint.

Debilitating pain does not need to be endured; it will have a detrimental effect on both your psychological state and the activity of the main internal organs and systems, for example, the heart, stomach, intestines, circulatory and respiratory systems. Their dysfunction will prevent the normal launch of self-regulation and regeneration mechanisms. Therefore, do not torment yourself and your body, which is already weakened: if it hurts unbearably, tell the nurse or doctor about it, and they will provide you with the necessary help. If the painful manifestations are not severe, then, of course, it is better not to overuse pain relief.

Well, now let’s move on to consider the question: how is human activation carried out:

1. Walking on crutches is possible from 2-3 days in a light mode, leaning on crutches or a walker. The technique of using means of support and the method of movement when moving in space is usually taught to the patient in the preoperative preparatory period. Walking in the first days is allowed only under the guidance of a methodologist-instructor.

   

   At this time, drainage tubes will be placed in the wound, so even if there is no pain, walking will not be enjoyable.

2. Sitting is allowed for the 3rd day, but it is important not to allow an excessive bending angle at the hip; the permissible maximum is an angle of 90 degrees and no more. You cannot stay in one “sitting” position for a long time (maximum 15-20 minutes); moreover, you must sit on a surface of normal height, not with low seats.

   

   At first, the following rule applies: the patient either walks or lies horizontally, and cannot sit for a long time.

3. When a person is lying down, a special anatomical cushion must be placed between the limbs, which will protect against unwanted adduction of the limb and its crossing with the healthy leg. For now, you can only turn on your healthy side. You need to sleep and lie exclusively on your back.

   

   Crossing your legs increases the risk of dislocation.

4. It is recommended to perform flexion-extension of the ankle and rotation of the feet during rehabilitation after surgery on the hip joints, as soon as the anesthesia wears off.

   

   The exercise is safe and can be performed without special restrictions.

5. It is proposed to work with knee flexion/extension: sliding the heel along the bed sheet, bend the leg at the knee joint to a right angle and return it in the same way to a straight horizontal position.

   

   If it is difficult to slide your foot along the surface, remove the sock.

6. You will also need to perform the following exercise while in bed: smoothly move the problematic limb to the side, while the toe of the foot strictly “looks” at the ceiling. Return to the starting position, relax, rest for 1 minute. Do 5 sets in a row. All exercises after hip replacement should not be done intensively with jerks!

   

   In this exercise, the big toe should point straight up.

7. In the immediate postoperative period of rehabilitation after hip replacement, isometric exercises are prescribed to contract the quadriceps, gluteal, and calf muscles. Thanks to simple exercises on the tension of the corresponding segments, their tone increases, elasticity and firmness improve. Perform the workout in bed (lying on your back) according to the principle:

After leaving the hospital after hip replacement, rehabilitation in this scenario is easy to practice at home. However, the proposed range of activities must be supplemented, because then comes the late recovery phase, for which there are specific standards.

Late period

Successfully completed early stage rehabilitation measures culminate in the patient being discharged from the hospital. Now we either have to undergo rehabilitation after hip surgery at home or in a specialized treatment and rehabilitation center. There you will be organized high-quality, professional rehabilitation after surgery; it is unlikely that it will be possible to develop a hip joint at home so comprehensively and competently. Unless, of course, you yourself are an orthopedic traumatologist or exercise therapy instructor.

Balance exercises allow you to use stabilizer muscles that are not involved in normal life activities.

What are the specifics of late rehabilitation after hip replacement, and what new exercises are added?

1. Walking, starting from the 22nd day, is carried out up to 3-4 times a day for about half an hour, and closer to the third month, the total duration of walking daily should be approximately 4 hours. It is important to practice the correct posture of the body and gait when moving, to get rid of the usual adaptive postures and movements that a person is accustomed to long before the operation.
2. Walking with full load on the prosthetic limb is possible after 1-1.5 months if a cemented prosthesis model was used. If a cementless method was used, it is not advisable to create a full support until at least 2 months have passed.
3. The abolition of crutches and walkers, as a rule, occurs at the turn of 1.5-2 months, then the patient switches to a cane. It is not recommended to stop using a cane until the lameness disappears and you have absolute confidence in walking.
4. Late rehabilitation exercises after hip replacement include more varied and active types of training, but your doctor should recommend them to you. We suggest that you familiarize yourself with what common exercise therapy techniques are usually used in specialized centers.

• Work with the help of a rubber band, with exercises for abduction and flexion of the limb with resistance (do not cross your legs!).
  
  
  You can use a tourniquet or simply press on your knees with your hands if you don’t have one.
• Starting position lying on your back. Alternately bend your legs at the knee joints, lifting your limbs, the direction of movement of the knee is toward you.

  

  Your hands can be placed on your stomach or extended along your body.

• Lie on your stomach. Bend your legs simultaneously or alternately, bringing your feet closer to your buttocks. In the same position, lifting the straightened legs up (alternately) is useful. You can also imitate swimming, with only your arms actively working, your chest raised, your limbs straight (if it is not difficult for the patient, he can slightly lift his legs off the floor).

  

  Try to touch your heel to your buttock. It is unlikely that you will succeed, but this should be the goal.

• Alternate abduction of straightened limbs in the lateral direction from a lying position on the back and on the stomach. To do this, you need to slightly raise your working leg and move it to the side, then carefully return to the starting point. By analogy, we do gymnastics after hip replacement and in a vertical position.

  

  The toe is directed strictly upward as the exercise progresses.

• Lifting straight limbs one by one, while pulling the toe towards you. The task can be performed in both a lying and standing position. If the patient is exercising while standing, then you need to hold on to any support suitable for insurance, for example, the back of a chair.

  

  Hold for a few seconds at the end point.

• Raising the bent leg, extending it in weight, followed by bending, and at the end, place a flat limb on the floor. This technique, as you might understand, is done in a horizontal position of the body.

  

  You can give additional load by placing your healthy leg on top of the sore leg.

• If you had surgery on the hip joint 1-1.5 months ago, rehabilitation is proceeding well, then you can include the “bicycle” exercise in your daily routine.

  

  A bicycle is the best equipment for physical activity.

• In addition to the listed methods of training, partial squats, quiet exercises on an exercise bike, on balancing equipment to develop support strength and balance, as well as various techniques of movement with a ball and weights are included. Additionally, a visit to the pool is prescribed, where therapeutic exercises in water and recreational swimming will be carried out.

Distant phase

It is reasonable if rehabilitation after hip replacement takes place in a sanatorium at a later date. In addition to rehabilitation and physical education methods, which are implemented using various rehabilitation equipment and exercise equipment in the gym or in the aquatic environment, health clinics specialize in the use of natural healing sources, unique in their chemical and biological composition.

Start visiting the pool, it is very useful.

In sanatoriums, recovery after hip replacement is based on the use of courses of peloid therapy (therapeutic mud applications) and balneotherapy in the form of brine (mineral), radon, carbon dioxide, pearl baths, etc. Swimming in the pool. Organic and inorganic substances contained in healing mud and waters penetrate into the body at the time of the treatment session and fruitfully contribute to:

• strengthening bones, increasing muscle endurance;
• resorption of skin, tendon, muscle scar formations, mobility increases not only at the site of the artificial joint, but also in other osteochondral organs;
• improving blood supply and nutrition in problem segments;
• eliminating swelling of soft tissue structures;
• getting rid of the pain factor, which often continues to disturb to one degree or another, even after a long time has passed from the moment of prosthetics;
• coherence of the central nervous system, mental harmony, positive attitude, normalization of sleep and daytime vigor.

Article publication date: 08/03/2016

Article updated date: 12/05/2018

Rehabilitation after hip replacement is an integral stage of postoperative treatment aimed at restoring muscle tone and functionality of the leg. Rehabilitation consists of limiting (specifically) physical activity in the period after surgery and performing physical therapy.

Principles of the recovery period after hip replacement:

• early start,
• individual approach when carrying out rehabilitation measures,
• subsequence,
• continuity,
• complexity.

Rehabilitation after endoprosthetics has three periods: early, late and long-term. A specific gymnastics complex has been developed for each of them. The total duration of rehabilitation is up to a year.

Restoration of the leg's functionality begins in the hospital, where the patient underwent surgery. The approximate length of stay there is 2–3 weeks. You can continue rehabilitation at home or in a rehabilitation center, and finish it at a dispensary or specialized rehabilitation clinic. If you are working out at home, it is important not to interrupt exercise therapy and therapeutic walks so that recovery takes place in full - only then the muscular-ligamentous system will reliably fasten the artificial joint, and all functions of the leg will be restored.

Lack of rehabilitation after endoprosthesis replacement threatens with dislocation of the head of the endoprosthesis due to weak ligaments, periprosthetic fracture, development of neuritis and other complications.

Rehabilitation after any type of joint surgery, including replacement of a hip with an endoprosthesis, is carried out by a rehabilitation physician and (or) a physical therapist. He will create an individual program taking into account the patient’s physical condition, degree of adaptation to physical activity, his age, and the presence of concomitant diseases.

After installation of an endoprosthesis, it is possible to restore working capacity. Persistence, the desire to recover, and strict adherence to doctors’ recommendations are the main criteria for a positive outcome of rehabilitation after endoprosthetics surgery.

Three periods of rehabilitation

Early rehabilitation period after endoprosthetics

This period begins immediately after recovery from anesthesia and lasts no longer than 4 weeks.

Six Rules of the Early Period

Sleep only on your back for the first few nights after hip replacement surgery;

You can turn on your healthy side with the help of a nurse at the end of the first day after surgery, on your stomach - after 5-8 days;

do not make sharp turns or rotations in the hip joint - this is contraindicated;

do not bend the affected leg so that the flexion angle is more than 90 degrees;

do not bring your legs together or cross them - place a wedge-shaped pillow between your legs;

Do simple exercises regularly to prevent blood stagnation.

Early goals

• Improve blood circulation in the operated hip area;
• learn how to sit up in bed correctly and then get out of it;
• prevent the development of complications (bedsores, thrombosis, congestive pneumonia, pleurisy);
• accelerate the healing of the postoperative suture;
• reduce swelling.

Basic exercises

The table contains exercises for the calf, gluteal, and thigh muscles of both legs:

(if the table is not completely visible, scroll to the right)

Exercise name	Description
Wiggle your toes	Bend and extend the toes of both the healthy leg and the operated one.
Foot pump	Do it immediately after coming out of anesthesia: bend your foot at the ankle back and forth. Per hour, do up to 6 approaches for several minutes until the muscles become slightly fatigued.
Rotation of feet	Rotate your foot first 5 times clockwise, then 5 times counterclockwise.
Isometric gymnastics with quadriceps tension	Start with the healthy limb. Try to press the popliteal fossa to the bed as much as possible and hold the muscle tension for 5–10 seconds. From 3-5 days, perform the same action with the sore leg, keeping the muscles toned for 2-5 seconds. Do 10 times of each.
Isometric contractions of the gluteal muscles	Alternately tense your right and left gluteal muscles, maintaining the tension until you feel slightly tired.
Knee flexion	Slide your foot along the surface of the bed and pull your leg towards you, bending it at the knee. Lower it. Do it slowly 10 times.
Straight leg abduction to the side	First move one leg away from the other, then bring it back and do the same with the other leg. Multiplicity – up to 10 times with each leg.
Leg extension at the knee	Place a small cushion or pillow under your knee. Straighten your leg, holding it in this position for 5–7 seconds. Do the same with the other leg.
Straight leg raise	Alternately lift your straight leg a few centimeters 10 times.

Rules for doing the exercises:

• make several passes per day, spending 15–20 minutes out of every hour during the day;
• keep a slow and smooth pace;
• combine exercises with breathing exercises according to the following scheme: when muscles are tense, take a deep breath; when relaxing, take a long exhale;
• perform breathing exercises to avoid congestion in the lungs.
• At first, do the exercises in the early period only while lying on your back (although you need to get on your feet already on the 2-3rd day), and then do the same gymnast while sitting on the bed.

A set of exercises for rehabilitation after endoprosthetics

I presented the exercises described in the table above in the order in which they were performed; they are relevant throughout the entire rehabilitation course. This exercise therapy complex is suitable for the rehabilitation of patients after almost any operation on the leg joints.

Additional exercises

In the first 2–10 days after endoprosthetics, doctors teach the patient to sit up in bed correctly, roll over, stand up, and walk on crutches.

Having already learned to maintain balance and lean on the operated leg, the patient must supplement the complex with other exercises - they must be done every day from a standing position, holding onto the headboard of a bed or chair. Here they are:

(if the table is not completely visible, scroll to the right)

Starting position	Performing the exercise
Stand facing the headboard of the bed, grab it with your hands	Begin to alternately lift your right and left leg, bending it at the knee. This is reminiscent of walking in place with support in front of you.
	Leaning on one leg, move the other to the side, slightly lifting it. Then change your legs.
	Everything is the same, only slowly move your leg back, straightening the hip joint.

The sooner the patient begins to get up and walk after endoprosthetics, the less likely it is to develop muscle problems (limited mobility) in the hip area.

Late postoperative rehabilitation

Late rehabilitation after hip replacement begins 3–4 weeks after surgery and lasts up to 3 months. The duration of rehabilitation for each patient varies depending on his age and other factors.

Two late period goals:

training muscles to strengthen them, increase tone,

restoration of range of motion in joints.

After the patient confidently gets out of bed, sits on a high chair, walks on crutches for 15 or more minutes 3-4 times a day, the motor mode is expanded by training on an exercise bike (no longer than 10 minutes 1-2 times a day). The patient is also taught to walk up stairs.

Start climbing the step with your healthy leg, placing the operated leg next to it. When descending, lower one step lower: first the crutches, then the sore leg and then the healthy one.

Long-term rehabilitation period

This period begins 3 months after hip replacement surgery; and lasts up to six months or longer.

• complete restoration of the functioning of the artificial joint;
• acceleration of bone regeneration;
• improving the functional state of ligaments, muscles, tendons.

Adaptive motor mode involves preparing the patient for more intense physical activity and adaptation in everyday life. Exercise therapy is complemented by physical therapy (mud or paraffin applications, balneotherapy, laser therapy and other physical procedures).

Exercises to do at home

Later, the above gymnastics of the early period after endoprosthetics is supplemented with more complex exercises.

Examples of exercises that patients perform at home after discharge. Click on photo to enlarge

(if the table is not completely visible, scroll to the right)

Starting position	Execution order
Lie on your back.	Alternately bend and pull your legs towards your stomach, imitating riding a bicycle.
Lying on your back.	Alternately pull your legs towards your stomach, bending your knees and helping yourself with your hands.
Lying on your unoperated side with a flat cushion between your legs.	Raise your straight leg and hold it in this position for as long as possible.
Lying on your stomach.	Bend and straighten your knees.
On the stomach.	Raise your straight leg, moving it back, then lower it. Repeat the same steps on the other one.
Standing with your back straight.	Do half squats while holding onto some support.
Stand up straight. In front of you, place a flat, stable block - a step - 10 cm high.	Step onto the step platform. Slowly get down from it, taking a step forward with your healthy leg, then lower the operated one. Return in the same order. And so 10 times.
	Stand in front of the step, step onto it with your healthy leg, shifting your body weight onto the leg with the endoprosthesis, which you then lift onto the step.
Stand up and rest your hand on the back of a chair. Place a loop of elastic bandage around the ankle of the operated leg, and secure the other end of the bandage (for example, tie it to the leg of a sofa).	Stretch the affected leg straight forward (with a tourniquet). Then turn around so that you extend your straight leg back (also with a tourniquet).
Stand with your healthy side towards the object to which the tourniquet or elastic band is attached, and hold onto it with one hand.	Move the straight operated limb to the side and slowly return it back. And so 10 times in one approach.

The last two exercises and the rest, where movements must be done with a straightened leg, are necessary after surgery specifically on the hip joint, since they are aimed at developing a hip endoprosthesis. For the recovery period when replacing another large joint of the leg, they are only additional.

Step platform

Gymnastics on simulators

The adaptive motor regime in the long-term period is expanded through physical therapy on simulators. By this time, the ligaments and muscles have already become sufficiently strong after the operation, so the intensity of the load can be increased. The table below shows the most common exercises to fully restore range of motion in the hip joint.

(if the table is not completely visible, scroll to the right)

Exercise name	Execution Sequence
Bike	First, pedal backwards on the exercise bike. If this happens without effort, proceed to scrolling forward (15 minutes, 2 times a day). Gradually increase the time to 25–30 minutes. Conduct classes 3-4 times a week. Don't forget about the right angle rule: don't lift your knees higher than your hip joints.
Hip extension	Place the operated leg on a special roller of the simulator (you need a roller that you can press on - that is, not rigidly fixed), so that it is located under the thigh closer to the knee, hold the handle with your hands. Focus on the healthy leg. Press the roller as if pumping a pump - you perform flexion-extension movements of the endoprosthesis with force, since a weight is attached to the roller on the other side of the simulator (gradually increase its weight).
Exercise on an exercise bike with low pedals	Simulate riding a bike. Adjust the pedals so that each leg is fully straightened when the pedals are lowered.
Walking backwards on a treadmill	Stand with your back to the control panel and grab the handrails. Start walking backwards at a slow pace (set the speed to 1–2 km/h). When the foot completely touches the track, the leg should be straightened.

Conclusion

At each stage of rehabilitation, the supervision of a physical therapy doctor is important. He will tell you when you can complicate the exercises and increase the load.

Doing exercises for the hip joint on your own after endoprosthetics, especially using exercise machines, can lead to serious consequences. You cannot do gymnastics through pain or, conversely, stop it prematurely, even if you feel well and the endoprosthesis, as you think, moves well. Only strict implementation of all the tasks set by the doctor will make your new joint work fully.

Owner and responsible for the site and content: Afinogenov Alexey.

Your comments and questions for the doctor:

Victor | 07/06/2019 at 19:43

Hello. I am 67 years old. On March 15 and September 19, 2018, he underwent endoprosthetics of the left and right hip joints (1 year 4 months, 10 months have expired, respectively). Pairs of metal + polyethylene + ceramics. Uncemented. Rehabilitation is going well, I can walk without crutches or a cane, I drive a car, and I passed the driver’s examination without any problems. I don't feel any pain or discomfort. Please tell me what LIFETIME restrictions exist for such operations? Is it allowed: 1. In a sitting position, placing the foot of the right/left leg on the knee of the opposite leg in order to put on socks without outside help? 2. Full (deep) crouch? 3. In a standing position, bend forward with your hands on the floor? (mopping the floor) 4. Swimming lessons in the pool with fins for scrolling, diving? (the difference in the design of the fins and, accordingly, the load on the muscles and hip joint). 5. When lying on your back, cross your leg behind your leg (left-right)? 6. Stop using a wedge-shaped pillow between your legs? After what period? 7. After what period of rehabilitation is it possible (or forever prohibited?!) to raise the knees to an angle of more than 90°? Turning the raised knee left and right? Thank you in advance for your detailed answer. Sincerely...

mikhail | 04/25/2019 at 03:25

hello, please tell me the operation was performed 17 days ago, the hip joint was replaced, I am 28 years old. The situation is such that the muscles ache and in the morning the leg is as heavy as a stone, tell me, is this normal?

Valentina Viktorovna | 03/04/2019 at 14:05

Operation PTB on December 6, 2017, the hip and buttock still hurt, the doctor who operated said that the pain was from the back because... this is possible osteochondrosis. The thigh along the suture is swollen, when touched it feels as if numb, but the pain is felt. I walk with a cane on the street, but at home without a cane. I do exercises every day while lying on the couch, thanks in advance.

Vladimir | 09.11.2018 at 01:20

Hello, during the hip replacement, the femur burst during the subsequent operation, they were secured with 5 ties along the length of the bone, the sutures were discharged, they were removed, recommendations were not to step on the leg for 3 months, what of the set of exercises you recommended can I do after the operation, 3 weeks have passed, thanks in advance for the answer

Olga | 09.17.2018 at 14:13

There is no temperature, pain, or redness. I will take your recommendations into account, thank you.

Olga | 09.16.2018 at 12:59

Hello! ; September I had endoprosthesis replacement of the right hip joint. My leg is still very swollen and it’s difficult to bend my knee. Upon discharge, they said that everything would pass, but almost two weeks passed. This was not the case during surgery on the left joint in February of this year. I live in a village and haven’t gotten to my clinic yet. Tell me if there is any danger and what to do, thank you.

Svetlana | 09/06/2018 at 20:25

Hello, my mother (70 years old) is preparing for total hip replacement. She has polyarthritis and severe pain in her elbows and shoulders, and I'm afraid she won't be able to use crutches properly. Is it possible to use a walker that has a support on wheels at the front, and legs like a chair on the side of the person leaning on?

Mina Minskaya | 09/05/2018 at 14:51

In January I had hip replacement surgery.
Since then, the sensitivity of the toes has been impaired. What do you recommend to restore normal sensitivity? Thanks in advance, Mina.

Yana | 08/30/2018 at 11:14

Hello! How long after endoprosthetics can I do a full body massage? I saw a physiotherapist, she prescribed different procedures, prescribed ALIMP, and said about massage that it was too early, in 3 months (one and a half months had passed). In the ward, we all took off our stockings after a week, and those whose heels were baked, the nurses cut the stockings at the heels to give freedom to the blood vessels. I walk for an hour and a half, sometimes 2 hours in the air with crutches, is this probably a lot? I want to go to the sea, why don’t I go to the sea? When a month passes after endoprosthetics - is it really impossible? Thank you!

Svetlana | 08/29/2018 at 16:52

Hello! I’m preparing to replace the TB of the right joint, I live on the 5th floor of a building without an elevator, will I be able to go home after the operation? If you write that there is no more than one flight of stairs. Thank you in advance.

Olga | 08/09/2018 at 15:56

I am 42 years old. We had surgery to replace the right hip joint on 06/05/2018, i.e. two months have passed. I do gymnastics. Added an exercise bike. I walk with a cane, but my gait is not straight. I can’t even lie down on my operated side (a nagging pain occurs along the entire leg). I have several questions:
1) When can you break the “90 degree” rule and sit low?
2) When can I take off compression stockings?
3) Will straight gait be restored and what should be done for this?

Valery | 07/29/2018 at 17:13

I am 61 years old. On July 6, 2018, an operation to replace the left hip joint was performed. A BC metal-ceramic joint (manufacturer "Zimmer") was installed. Three weeks have passed. I feel good. There are no acute pain sensations. Used axillary crutches. For the last week I have been using only an elbow crutch. Isn't it early? And another question: is it possible to go to the sea at the end of September-beginning of October?

Alexander | 07/06/2018 at 12:37

Hello! I confess, I love to lie in the bathtub, how long will it take for me to take a full bath after replacing the hip joint, at the moment almost 2 months have passed?

Natalia | 06/24/2018 at 19:35

Good afternoon. Done 40 days ago to replace the right hip joint. I walk with a stick. Question: Which side should you hold the stick on? On the side of the sore or healthy leg? It is written differently on different sites. I'm holding the stick on the side of my good leg!??? Question: How long after surgery (approximately) can you go to the pool or swim in the sea? Thank you.

Alexander | 06/17/2018 at 06:09

Hello! A month ago there was an operation to replace the hip joint. I am 70 years old, can I use an elliptical trainer instead of an exercise bike for rehabilitation? I feel good, there is no pain in the joint and never was. When can I start exercising on the machine? Thank you!

Ekaterina | 06/13/2018 at 06:12

Good afternoon I am 70 years old, 4.5 months have passed since the operation to replace the hip joint (01/25/2018), in general, nothing bothers me while I walk at home without a cane (I walked on crutches for about 3 months). But when I go outside I use a cane, I have to walk 200 meters. The operated leg immediately gets tired and I look for a place to sit down. Tell me what is the reason? I consulted a doctor with pictures in May and they said everything was fine. Thank you for your answer

Olga | 05/14/2018 at 04:25

Hello! I read all the comments, thank you very much to everyone, I learned a lot of useful things. Question: they write that you need to exercise on an exercise bike, but I have a cardio exercise machine - walking, is it possible to walk and how long - I had a replacement of my left hip joint on 02/2/18. Right - severe pain, September 3, 2018. there will be an operation.

Viktor Nikolaevich | 05/08/2018 at 23:39

Hello. I am 66 years old. The operation for total endoprosthetics of the right hip joint was performed on March 15, 2018. May 15 this year 2 months after surgery. The pair is cementless, polyethylene - ceramics. The seam has healed, the stitches have dissolved, the condition is normal. With the permission of the doctor, I now walk on one elbow crutch. After the discharge, there were no follow-up images and no examination yet; the doctor was on an internship abroad. There is his absentee permission to lie on the operated side, the sensations are normal. Please tell me when it will be possible during sleep, when getting out of bed, etc. stop using a wedge-shaped pillow between the thighs?! And secondly: when in terms of time and season (we have very hot weather and the summer is promised to be the same) is it better to have surgery on the second hip joint? Thanks for the answer.

Tatiana | 04/30/2018 at 09:24

Good afternoon In February there was an operation to replace the vehicle; now, that is, in May, you can get another vaccination against tick-borne incephalitis. Thanks for the answer.

Maryam | 04/07/2018 at 04:59

Hello! 02/27/2018 I had surgery to change the vehicle. While I'm doing gymnastics. When can I go to a rehabilitation center? And when will you be able to drive? Right leg. The car is left-hand drive. Thanks in advance for your answer!

Sergey | 03/01/2018 at 20:28

Thanks for the answer. In the pictures with exercises Exercises to perform at home Long-term rehabilitation period No. 3, 6, 12 movements that doctors usually prohibit doing. These pictures show movements and loads as if they were on a healthy joint. Does this mean that over time all movements will be restored? It’s scary that in life you won’t be able to tie your shoelaces and just squat down. I am 44 years old, but before the injury I led an active sports lifestyle. That's why the question. Traumatologists do not have a consensus on the current condition: either wait up to six months or get prosthetics. no nicrotic processes are observed, but there is no fusion. You are trying to assess what can await you after prosthetics.

Svetlana | 03/01/2018 at 08:52

Good afternoon! I have a question. I had hip replacement surgery in November 2016. I would like to know what I am strictly forbidden to do for life. I want to go to the gym and what machines I can use.

Sergey | 02/28/2018 at 21:01

Good afternoon. I have a displaced intra-articular fracture of the femoral neck. Within six months the fracture had not healed. There is a high probability of prosthetics. Tell. After completing a rehabilitation course - a year, two, three, will it be possible to bend the leg more than 90 degrees. To what extent is it possible to restore the degree of movement of the leg without fear of breaking the joint or dislocating it? Knee to chest, squats, etc. Or does it depend on the brand of the prosthesis?

karina | 02/26/2018 at 15:20

Good afternoon. I want to ask, a week has passed since the operation. I’ve read a lot, but it’s not clear how long I can walk, I’m hyperactive, it’s difficult for me to sit and lie down. Thank you.

Christina | 02/25/2018 at 06:23

Alex admin, thank you very much for your answer. A new one has arisen, how long should you sleep on your back after surgery? It’s just that my husband is already tired and wants to roll over onto his non-operated side. 2 weeks have passed since the operation.

Life after hip replacement involves, first of all, long-term rehabilitation and restoration of the sore leg and its functionality. During this period, it is necessary to limit heavy physical activity and prescribe special physical therapy. A set of exercises is prepared by the attending physician. At first, all of them are performed under his supervision, and over time they can be done at home. With due diligence and careful adherence to all the rules, it will be possible to live a normal life in the shortest possible time.

Early period

The early recovery period begins after anesthesia and lasts approximately 4 weeks. At this time, it is necessary to reduce the swelling caused by the operation. It is very important to heal the suture quickly, and also to ensure that no complications arise in the body.

Physical therapy begins on the first day after surgery. It is necessary to restore all functions of the joint and surrounding muscles. Exercises are performed 3 times a day with both legs in turn. The future life and functioning of the joint will depend on them. The following exercise options may be suggested:

1. The foot moves up and down.
2. Rotation of the ankle left and right. You cannot use your knees for work.
3. Tension the upper thigh with the leg straight for a few seconds, then relax. Repeat 10 times. At first, the leg will not straighten completely, so do not be alarmed.
4. Clenching and unclenching the buttocks for a few seconds. Repeat 10 times.
5. Lunge the straight leg to the side at a permissible distance and return to the starting position. You won't be able to do the exercise right away either.

Once the patient can sit, it is necessary to learn how to move correctly with the replaced joint. To use crutches or other support of your choice for the first time, sit on the edge of the bed and place your feet on the floor. With the crutches at your sides, slowly stand up, holding the crutches tightly and leaning on them. Make sure the floor is non-slip and there is nothing to prevent you from climbing.

Movement has its own system. Keeping your body straight and your foot position correct, lean on the crutches and move your operated leg to the side. In the first days, do not lower the sore limb to the floor. Gradually you are allowed to lower your leg, transferring your body weight to it. Monitor your physical condition, walk as much as your body allows.

The course of further therapeutic exercises is selected individually for each patient. She will completely restore the sore leg and move it to further stages of recovery. You need to do several approaches a day, keeping a slow and smooth pace. Breathing exercises, which are performed together with the rest of the exercises, will also be effective. When the muscles tense, you should inhale, when they relax, exhale.

Late period

Recovery time during this period begins one month after surgery and lasts 90 days. At this time, it is necessary to carefully strengthen the muscles through special training and restore full range of motion. After a person has recovered a little and can already get out of bed and sit down on his own, training on an exercise bike is added, and learning to walk up the stairs begins.

How to move up the stairs correctly? The ascent begins with placing the crutch on the upper surface, followed by the healthy leg, and only after that the operated leg. At this stage, the main thing is to restore balance and further attempts to move without support. Until you are sure that you can do without a cane, it is better not to give it up (this is also called Nordic walking).

When training endurance, you first need to walk 3 times a day for 5 minutes, gradually increasing the load. To maintain the results achieved, take long walks and do a number of exercises, for example with a band. To do this, secure the latter to furniture or a door, and wrap the other part around the ankle of the operated leg. Turn your back to the fabric and move your limb slightly to the side. Lift your leg forward with your knee straight and slowly return it back. Turn your healthy side towards the band, move the limb to the side, and then return it to the starting position.

Exercise on an exercise bike will help restore joint mobility. The seat is adjusted so that your feet lightly touch the pedals when your leg is extended. Start pedaling in the opposite direction. When you feel no special effort, start turning in standard mode. Exercises begin with 15 minutes twice a day, after which classes are carried out 3 times for 30 minutes. Exercise bikes with short pedals will simulate regular cycling. The time is set individually.

Walking backwards on a treadmill will also help. Stand on the machine with your back to the dashboard and grab the railing with your hands. Approximate speed - 2 km/h. Start the movement by rolling from your toes to your heels, and when your entire leg is on the treadmill, straighten your knee completely.

Another exercise:

1. Lying on your healthy side, bend your knees and hips.
2. Keep your heels together and slowly lift your knee up.
3. There should always be a pillow under your head and a bolster between your legs. They can be removed only with the permission of a doctor.

Remote period

This period is final; it can last from six months or longer, depending on the age, physical condition and willpower of the patient. Here, complete restoration and adaptation of the joint occurs: bones grow together faster, ligaments and muscles function better. More complex ones are added to the basic exercises from previous periods:

1. Lying on your back, do a “bicycle.”
2. In the same position, pull one leg at a time towards your stomach, bending them at the knees and lightly pressing on them with your hands.
3. Lying on your healthy side with a bolster in your perineum, lift your leg and hold it as far as possible.
4. While lying on your stomach, bend and straighten your knees.
5. In the same position, lift both legs in turn and move them back.
6. Standing with your back straight, squat slightly while holding onto the object.

Exercises with a low step platform (10 cm) will be effective. Stand on the step and, keeping your body weight on your affected leg, take a step forward from the platform with your healthy leg. It is necessary to have a mirror in order to control your own actions, perform the exercises correctly and not roll your foot to the side. Second exercise: standing on the floor, step up onto the step with your healthy leg, keeping your injured leg on the floor. Both steps increase over time to 15 and 20 cm.

During any recovery period, all physical therapy occurs under the strict supervision of the attending physician. Never ignore his prohibitions. Gymnastics is not performed through pain and does not stop prematurely. Additionally, during this and other periods, various types of medications are prescribed. All of them are adjusted individually for each patient. The complex of drugs will necessarily include the following:

• painkillers (over time, their use will decrease significantly and then stop);
• antibiotics to reduce infectious threats;
• vitamins;
• medicines aimed at treating concomitant diseases of the body.

Allowed during this period

You can and even need to do therapeutic exercises after discharge. Do necessary housework as long as it doesn't put a lot of stress on your leg. Go for walks in the company of relatives and friends so that someone is nearby if your condition suddenly worsens. Alternate gymnastics, rest and work.

When can you drive a car? Only 2 months after surgery. When boarding, the seat should be moved back as far as possible. It is allowed to carry heavy objects, but only for short distances or with long breaks. If possible, it is better to use a backpack that will distribute the weight of the item being carried evenly.

Is it possible to resume previous training? Continue your favorite sports activities, especially if it's walking or skiing, as they will keep your body in good shape. Swimming pool allowed. It is better to give up aggressive sports: running, wrestling, etc., as they significantly exceed the capabilities of the joint.

Sex after hip replacement is allowed 2 months after surgery. This time is most optimal for ligament restoration.

You can wash in the bathroom, but if possible, the first 6 weeks should be given preference to the shower. It is better to leave the bathroom doors open at this time so that loved ones can come to the rescue.

Do not turn your bathroom into a sauna - this will have a bad effect on still fragile muscles.

You can not relax and strictly follow the advice of your doctor during all recovery periods, not forgetting about physical therapy at all stages. The late period is often called “deceptive”, because by that time the leg no longer hurts, the ability to move around and independently perform more complex actions returns. At these stages, patients often relax and forget about all the doctor’s instructions. As a result, frequent dislocations and the return of previous pain.

Strictly prohibited

There will be restrictions during the recovery period, so it is necessary to follow a number of rules. At the early stage of rehabilitation, try to sleep only on your back for several days, it is better to turn over on your side with the help of a nurse, and after about a week you are allowed to lie on your side. Do not overload your leg during this period: do not make sharp turns, do not bend it more than 90 ° and do not cross your legs. For convenience, you can place a pillow between them.

For the entire rehabilitation period (especially in the first days), be as careful as possible, avoid falls, do not twist your feet and do not turn your torso if you are standing still. Do not sit in one position for more than 20 minutes, avoid soft and low chairs, chairs without armrests. Ideally, when sitting, your legs will be at right angles. Lift carefully, holding the armrests firmly.

Do not walk or stand for too long; running is prohibited. Various types of leg exercises are useful, but overloading them is not recommended. The load should increase gradually. The integrity and strength of the prosthesis directly depends on this. Try not to bend over to pick up a fallen object, but to lift it using special devices or with the help of loved ones.

Analgesics should not be taken during physical therapy. Every kilogram is an additional load on the leg, which significantly reduces the life of the prosthesis. There is no special diet: you need to monitor your weight and physical condition.

At home, follow the standard recommendations after endoprosthetics, which your doctor will advise you about. Shoes should only be low-heeled; for the time being, it is necessary to remove all objects that can be caught by feet: wires, rugs, children's toys. Keep a close eye on your pets, especially if you know they tend to get in the way.

Under no circumstances should you visit a sauna or bathhouse in the first 3 months after surgery. Avoid taking hot baths. The heat itself will not be affected - the problem may arise in the leg itself due to blood clots formed there.

Take some time to take a steam bath, keeping this rule in mind. Use caution when immersing yourself in a bathtub or shower: hold the sides firmly with your hands, shift your weight to the bottom, then move your limbs there.

If you notice changes in the joint area, do not try to get rid of the pain yourself. If there is pain, redness, swelling, or fever, consult a doctor immediately. By following these rules, the patient will achieve significant improvements, and his life after hip replacement will be as comfortable as possible.

Memo for the patient

Before and after total hip replacement (endoprosthetics)

Instead of a prologue or what is endoprosthetics

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

First days after surgery

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

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

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

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

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

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

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

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

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

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

First steps

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

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

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

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

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

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

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

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

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

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

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

Current control

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

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

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

Tips for the future

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

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

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

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

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

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

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

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

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

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

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

So the hip replacement happened. The worst was behind us, as it seemed at that moment; ahead of the patient was a labor-intensive process called rehabilitation. Life after hip replacement will depend solely on your thorough approach to rehabilitation.

When it happens, rehabilitation will be more successful if you strictly follow some rules:

• To prevent this, you should not bend your leg at the hip joint more than 90 degrees. It is prohibited to cross your legs, throw them over each other, or squat down. This can be done when the painful sensation goes away and complete recovery occurs;
• Placing pillows between your legs will save you from similar actions in your sleep;
• If you want to sit on a chair, you must choose it so that your knees do not exceed the level of your navel, and the hip joint itself is at a right angle to the surface of the chair;
• When you take a sitting position or lie on your back, your legs should be slightly apart;
• Do not bend below the level of the navel when performing any activity, sitting or lying down, do not forget about the right angle.

So, after surgery, you need to relieve pain, you can use. Drugs containing narcotic substances are prescribed in exceptional cases. To prevent cardiopulmonary failure, take medications for the heart, and inhalations are recommended. Inhalation helps oxygen enter the body in sufficient doses.

Possible complications and measures to combat them

It is necessary to avoid complications, especially thrombosis, which often occurs in older people after such a procedure. A large number of blood clots form in the veins in the legs - this can be very dangerous if you do not pay attention and do not take any action. There is a great danger of them tearing off and getting into the pulmonary artery, which can cause blockage.

To avoid thrombosis, as a complication, during the rehabilitation period after surgery on the hip joint, it is necessary to wrap both legs with elastic bandages. A medicine is injected intramuscularly to improve blood clotting.

Intestinal atony can occur as a complication; injections are prescribed to relieve exacerbation. Next, you need to take a course of antibacterial drugs.

Then, to ensure your recovery from hip replacement is as good as possible, you will need someone to care for and support you during the early stages. This is due to possible dizziness and weakness in the first few days. In the first steps you take, it is advisable to have a safety net.

Stages of rehabilitation

Rehabilitation after hip replacement takes place in several stages.

First stage

The initial stage includes the first postoperative day; it is from this moment that recovery after hip replacement begins. The doctor will develop a set of exercises specifically for your case after hip replacement. It is necessary to restore all functions of the joint and adjacent muscles. Your daily life after hip replacement will depend on this.

Here are a few possible exercises:

If there are no complications, then the first day marks the beginning of recovery after hip replacement surgery. You will be allowed to sit down, leaning on your hands. Every other day you just need to sit up in bed, lowering your legs to the floor.

Correctly sitting down in bed should be as follows: take a sitting position in the bed, legs should be lowered to the floor on the side of the healthy leg. Carefully lowering the healthy leg first, without sudden movements, pulling the operated limb towards it. It is important to remember that the leg spread should be small.

Having mastered the correctness of standing up, we move on to the correctness of walking.

Second stage

The next step in rehabilitation after hip replacement begins with learning to move. This is also a kind of set of exercises after hip replacement; it cannot be neglected.

Sitting on the edge of the bed, make sure that the floor is non-slip and there are no rugs or rags under your feet. Place your feet on the floor. Place the crutches on your sides, leaning on them, and begin to stand up.

For your information, crutches are the most common aid after such operations, but there may be other devices.

You need to move correctly as follows: the operated leg is moved to the side, the body is kept straight, crutches are the support. Be sure to ensure that your foot does not turn outward. When leaning on crutches, the healthy leg should be the leading one; at first you cannot stand on the operated leg and touch the floor.

After a few days, gradually increasing the load on the leg with the endoprosthesis, you must step on it with the force of the weight of your leg. You need to walk as much as your health and the operated joint allow. During this period, when the physical activity is quite large, swelling of the leg may appear after hip replacement. With such ailment, you need to contact your doctor to find out the truth of the swelling. It is possible that edema may form due to any concomitant diseases.

When a hip replacement has occurred, the postoperative period will depend only on you. Every day you need to work, taking one step at a time.

Third stage

Having learned to walk with crutches, stand up and sit, the third stage of the rehabilitation period after hip replacement begins.

Your doctor will prescribe it for you. This set of exercises after hip replacement is designed individually for each patient. Therapeutic exercises are intended for complete rehabilitation after hip replacement surgery. The purpose of such exercises is to improve blood circulation in the operated joint, prevent blood stagnation, and relieve swelling. With the help of therapeutic exercises, muscle strength and motor function of the joint are restored.

After completing the entire rehabilitation course, you will see the results immediately. Daily life will be completely restored after hip replacement. This will take you about two months. In the future, you simply need to constantly perform therapeutic exercises, this will have a beneficial effect on the hip joint.

At the final stage, it is advisable to undergo rehabilitation after hip replacement surgery. In specialized rehabilitation sanatoriums they will help you consolidate the results you have already achieved.

In conclusion, let us remind you that do not neglect the advice of doctors, they have extensive experience in treating hip joints.