Hello. I had hip replacement surgery, 4 months have passed. The temperature remains at 37.6, they did a series of blood tests (everything is fine), there was a 2ml accumulation of blood - they pumped it out, constant pain in the joint area, X-rays were normal. Tell me how long the fever and pain will last. Thank you

Hello. If such a temperature is without pain and without an X-ray/ultrasound picture of inflammation, instability, etc., then this sometimes occurs and does not necessarily indicate something bad (although it is better that there is no temperature). But if there is pain, then you need to be examined very carefully, incl. and in dynamics to exclude instability of components and/or suppuration. This cannot be done over the Internet. I recommend going to specialized departments that deal primarily with endoprosthetics or bone-purulent infections, or better yet, both at once and undergo a full examination - X-rays, ultrasound, tests, sometimes CT, sometimes punctures with bacterial culture, etc.

Medicine develops with the times, and its discoveries have allowed a person to restore the activity of the lower extremities by replacing a damaged joint with a prosthesis. This operation can relieve pain and discomfort, restore normal leg mobility and help prevent disability. But it happens that various complications arise that require hip replacement. Anomalies can occur due to the fact that the prosthesis did not take root, the doctor made a mistake, an infection occurred, or restoration procedures were carried out incorrectly.

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Pain syndromes

When replacing a joint, pain will inevitably occur, because this is a standard post-operative syndrome. But only if the patient has unbearable pain and it lasts more than two weeks after surgery, then this is no longer normal! In such a situation, you should go to the hospital and see your doctor.

Pain may also be accompanied by concomitant symptoms. This is an increase in temperature, the occurrence of bleeding, suppuration and swelling. These signs also indicate the development of pathological processes in the body.

There are a certain number of complications that can develop after endoprosthetics and cause similar symptoms. These include:

• implant rejection;
• penetration of infection into the wound during surgery;
• the endoprosthesis has moved;
• periprosthetic fracture;
• dislocations or subluxations of the prosthesis;
• thrombosis of deep veins;
• change in leg length;
• neuropathy;
• blood loss

Groin pain

This is a rare complication. Pain in the groin occurs from the side of the surgical intervention. This symptom is caused by a negative reaction of the body to the endoprosthesis, an allergy to the material. Pain often occurs if the artificial joint is located near the anterior acetabulum.

Specific physical exercises relieve pain and help you get used to the implant. When this method turns out to be ineffective, revision endoprosthetics is performed.

In the lower back

Pain syndrome occurs in the lumbar region if the patient has osteochondrosis. More specifically, the lower back begins to hurt when this disease worsens. Exacerbation is provoked by the alignment of the limbs, which was carried out after surgery.

Those who give to the knee

There may be pain in the limbs that radiates to the knee. It is especially felt when turning your legs or placing heavy loads on them. When your leg hurts after endoprosthetics, the cause is easy to determine. Soreness is a clear sign of instability of the femoral component of the prosthesis.

Instability develops due to micromovements between the prosthesis and the bone. This causes the prosthesis to become loose. Various elements of the hip may become loose, such as the stem (femoral component) or the calyx (acetabular component).

Lameness and swelling

Lameness often occurs after an arthroplasty procedure. The following cases provoke its development:

• Patients who have had a fracture of the femoral neck or leg are quite susceptible to such a complication as shortening of one leg. This anomaly is a prerequisite for lameness.
• Prolonged stay without movement causes atrophy of the muscles of the limb and is the cause of lameness.

In the postoperative period, the lower limbs remain at rest for a long time, and a complication such as swelling of the legs is observed. Namely, in the extremities, blood circulation and metabolism are disrupted, which causes swelling and pain. They get rid of this symptom by taking diuretics and keeping the legs slightly elevated. Also using compresses to relieve swelling and performing simple exercises.

Uneven leg lengths

Loss of symmetry or leg length after hip replacement is a fairly rare occurrence. The cause of this anomaly may be injury to the femoral neck. If the technique of bone restoration is violated, there is a possibility of a change in the length of the affected leg.

This complication can be overcome with the help of an operation during which bone tissue is built up in order to equalize the length of the legs. Patients and doctors extremely rarely resort to this option. Most often, the problem is solved by using specific insoles, linings in shoes, or wearing unusual shoes with different heights of soles and heels. But such shoes are made to order.

Neuropathy

Neuropathic syndrome is a lesion of the peroneal nerve, which is part of the structure of the greater sciatic nerve. This pathology occurs and is provoked by the lengthening of the leg after the prosthetic procedure and the pressure of the resulting hematoma on the nerve root. Rarely is the cause of intraoperative damage due to careless actions of the surgeon. The nerve is restored by performing etiological therapy, optimal surgical techniques or physical rehabilitation.

Endoprosthetic infection

A purulent formation at the site where the joint was replaced is considered a very dangerous complication. It is usually difficult to treat. Therapy requires large material costs. And this pathology is usually cured by repeated surgery.

Symptoms of this pathology can manifest themselves like this:

• the place where the surgical scar is located turns red and swells;
• the suture slowly heals, and its edges diverge and form a fistula;
• serous or purulent fluid is released from the wound;
• the postoperative wound smells unpleasant;
• the patient complains of pain in the leg, which can be very powerful, so much so that it can provoke painful shock and immobilization;
• the prosthesis itself becomes unstable.

This infection progresses very quickly. Untimely or inadequate therapy provokes reclassification of the pathology into chronic osteomyelitis. Treatment takes a long time. The implant can be replaced only when the patient has completely overcome the infection.

As a preventive measure for this complication, immediately after the implant has been replaced, the patient is prescribed a course of antibiotic therapy. They are drunk for two or three days.

Temperature rise

The endoprosthetics operation often provokes the occurrence of hyperthermia, or an increase in the overall thermal state of the body. Patients also often complain of increased local temperature in the area where the implant was implanted. There are situations when the temperature rises due to stress from the operation, and there are situations when it is caused by inflammation or infection.

Usually, antipyretics are taken to reduce it. When it is provoked by some pathology, eliminating the temperature is not enough, you need to overcome the cause.

Implant dislocation and subluxation

This excess may occur in the first year after prosthetics were performed. This condition is the leader in its prevalence. The pathology is characterized by displacement of the femoral element in relation to the acetabular element. Because of this, there is a separation between the prosthesis cup and the head.

Provocative factors are abnormal loads, injuries, errors in the selected model and installation of the endoprosthesis, and the use of a posterior surgical approach. The dislocation is usually reduced without surgery or by open reduction. If you contact a specialist in a timely manner, the head of the implant is adjusted in a closed way, the patient is under anesthesia at this moment. In advanced situations, the doctor prescribes a repeat operation to reinstall the prosthesis.

Periprosthetic fracture

People with a femoral neck fracture, excess weight, dysplasia, neuromuscular abnormalities, increased joint mobility and Ehlers syndrome can be considered at risk. And also in older people who are over sixty years of age, there is a high probability of developing a periprosthetic fracture. This anomaly, in which the integrity of the femur near the area of ​​fixation of the leg with a stable or unstable prosthesis is disrupted, occurs intraoperatively. It can occur at absolutely any time after the surgical session (after a couple of days, months or years).

A fracture is often caused by decreased bone density. But it can also be triggered by incompetently performed development of the bone canal before installing an artificial joint. Or the cause may be an incorrectly chosen fixation method. Treatment depends on the type and severity of the injury. Usually one of the methods of osteosynthesis is used. The leg, if necessary, is replaced with one that is more suitable in configuration.

Deep vein thrombosis

Reduced physical activity in the period after surgery provokes blood stagnation, which results in thrombosis. And then it all depends on how big the clot is and where the blood flow takes it. Because of this, the following consequences can occur: pulmonary embolism, gangrene of the legs, heart attack and others.

This pathology should be prevented as early as possible. Already on the second day after joint implantation, anticoagulants are prescribed.

Blood loss

During surgery to replace the pelvic joint or some time after the procedure, there is a possibility of bleeding. The cause could be a doctor’s mistake, or any careless movement or abuse of blood thinning medications. Postoperatively, anticoagulants are prescribed to prevent thrombosis.

Sometimes this very precaution can backfire. It can turn preventive measures from one complication into another complication. To restore blood reserves, the patient requires a blood transfusion.

Displacement of the endoprosthesis

The pelvic joint implant may become displaced due to impaired mobility and postoperative recommendations. It is strictly forbidden to cross your limbs or raise them high. The displacement causes severe pain and discomfort.

Implant failure

The body rejects the installed prosthesis very rarely, because before the operation the sensitivity of the body's cells to the material of which the prosthesis is made is always tested. In situations in which the material is not suitable, it is replaced and retested. The procedure is carried out until a suitable material is selected that will match the tissues.

Video “Complications after endoprosthetics”

In this video you will learn about complications after hip replacement surgery.

• Risk factors
• Possible complications
• Pain after endoprosthetics

Hip replacement is an operation to replace the affected joint with an endoprosthesis. As with any other surgical procedure, complications may occur. This is explained by the individual characteristics of the body, health status and complexity of the operation.

Pain after endoprosthetics is inevitable. This is explained by the peculiarities of the operation.

Risk factors

• Advanced age of the patient.
• Concomitant systemic diseases.
• History of previous surgery or infectious diseases of the hip joint.
• Presence of acute injury to the proximal femur.

Many patients are afraid to have surgery because of possible complications.

Possible complications

Rejection of a foreign body (implant) by the body

This consequence occurs extremely rarely, because usually before surgery, after selecting a prosthesis, tests are carried out to determine 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 is a serious condition that can be treated over a long period of time with antibiotics. Infection can occur on the wound surface or deep in 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, you will need to replace the prosthesis with a new one.

Bleeding

It can begin both during the operation and after it. The 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 will occur.

Prosthesis displacement

Changing leg length

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

The risk of complications is reduced with proper rehabilitation after endoprosthetics surgery

Deep vein thrombosis

After a decrease in physical activity in the postoperative period, blood stagnation may occur, and as a result, blood clots may occur. And then everything depends on the size of the blood clot and where the blood flow carries it. Depending on this, the following consequences may occur: pulmonary thromboembolism, gangrene of the lower extremities, heart attack, etc. To prevent this complication, you need to begin vigorous activity at the appointed time, and anticoagulants are prescribed on the second day after the operation.

The following complications may also arise over time:

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

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

Pain after endoprosthetics

The only complication that will accompany endoprosthetics 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 in about 3-4 weeks. When performing movements, pain will occur. And since movements are mandatory so that the muscles grow faster and correctly, pain will be felt almost throughout the entire rehabilitation period.

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.

MoyaSpina.ru

Pain after hip replacement: causes and treatment

Hip arthroplasty is the replacement of a damaged articulation element with an artificial implant.

This operation is prescribed for various reasons, these can be complex diseases of the hip joint or injuries.

After endoprosthetics, the patient must follow certain recommendations.

Indications for prosthetics

Most often, endoprosthesis replacement surgery is prescribed in the following situations:

1. Femoral neck injuries (usually fractures).
2. Severe, advanced stages of rheumatoid arthritis.
3. The presence of aseptic necrosis of the head (avascular necrosis).
4. Development of hip dysplasia.
5. Severe stages of coxarthrosis.

The need for an implant may arise as a result of post-traumatic complications, for example, arthrosis. The patient’s life after endoprosthetics changes, as a number of recommendations appear that must be strictly followed.

There are some restrictions; the patient must perform a set of special physical therapy. At first, the patient is forced to use crutches.

The duration of the postoperative period and complete recovery depend entirely on the general condition of the patient, his age and other numerous factors. In order to avoid possible complications from hip replacement, the patient must be disciplined about the recommendations of the attending physician.

The complex of therapeutic exercises, which is necessary to restore the hip joint, must be performed under the supervision of a medically qualified instructor. Living in a new mode will significantly bring the moment of complete recovery closer, thanks to which the patient will be able to start walking much faster without the help of crutches. It can also be noted that rehabilitation after hip replacement can continue at home.

After endoprosthetics, pain is usually pronounced. It is strictly forbidden to take any measures on your own, otherwise you may experience serious complications.

The main indications for endoprosthetics surgery are the symptoms that accompany the disease and the results of clinical and radiological studies. The symptoms indicated by the patient are the most significant factor that is an indication for surgery.

In some situations, despite the fact that coxarthrosis is in the last stage of its development (this is clearly demonstrated by x-ray examination), a person is not bothered by pain and other symptoms of the disease. This pathology does not require surgical intervention.

Modern hip endoprosthesis - its features

Modern orthopedics has made significant progress in its development. A feature of today's endoprosthesis is its complex technical structure. The prosthesis, which is fixed in the bone without cement, consists of the following elements:

• leg;
• cup;
• head;
• insert.

The endoprosthesis, which is fixed with cement, differs from the previous one in the integrity of the acetabular element.

Each component of the implant has its own parameters, so the doctor must determine the size that is ideal for a particular patient.

Endoprostheses also differ from each other in the method of fixation. Exists:

1. Fixation is cement.
2. Fixation is cementless.
3. Combined fixation (hybrid of the first two).

Since reviews about different types of endoprosthesis are mixed, before hip replacement surgery it is necessary to collect as much information as possible about the implant.

The endoprosthesis can be unipolar or total. The use of one or another artificial joint depends on the number of elements requiring replacement. The interaction in the endoprosthesis is called a “friction pair”.

How long an artificial hip implant can last depends entirely on the quality of the material from which the endoprosthesis is made.

How is endoprosthetics surgery performed?

The hip replacement process is performed by two teams - anesthesiology and operating room. The operating room team is led by a highly qualified practicing surgeon. In the photo you can see where the doctor makes an incision to remove and replace the joint.

The average duration of hip replacement surgery is 1.5-2 hours. The patient is under anesthesia or spinal anesthesia at this time, so he does not feel pain. To exclude infectious complications, intravenous antibiotics are required.

After endoprosthetics, the patient remains in the intensive care unit for some time, under constant medical supervision. Over the next seven days, the patient continues to be administered drugs that prevent blood clotting and antibiotics.

In order to maintain a certain distance between the legs, a pillow is placed between them. The patient's legs should be in an abducted position.

Body temperature after hip replacement is often unstable. The patient feels pain for some time, so he is given anesthetics.

It is impossible to predict in advance how long the recovery period after endoprosthetics will take. In order for the rehabilitation process to go much faster, the patient must be disciplined and must follow all the recommendations of the attending physician.

Recommendations that must be followed for the rest of your life The patient should start moving the very next day. And this is done without getting out of bed. The patient can move and perform therapeutic exercises right on the bed.

To fully restore mobility in the hip joint, it is necessary to constantly work on its development. In addition to a course of physical therapy, the patient is shown breathing exercises.

Most often, the patient can walk already on the third day of rehabilitation, but he must use crutches. After a few days, doctors will remove the stitches. After the operation to implant an artificial implant, the sutures are removed on the 10th, 15th day. It all depends on how quickly the patient recovers.

Many patients ask themselves: upon arrival home, how to live next? After all, in the hospital they were under the constant supervision of doctors and staff, and the entire recovery process was under control.

Indeed, life with an endoprosthesis is somewhat different from the life that preceded endoprosthesis. It has already been said above that you need to constantly work on an artificial hip joint.

The patient should move as much as possible, but avoid fatigue and hip pain. Therapeutic exercises play a huge role in the recovery process, but a set of exercises should be compiled by a doctor who keeps the patient’s medical history.

Returning home, the patient must work hard on the new joint, otherwise the recovery period may take a long time.

If the patient does not want serious complications to arise after the operation and pain to recur after returning home, he must follow a number of recommendations.

1. The artificial joint should not be allowed to bend completely.
2. In the “sitting” position, the knees cannot be in the same plane as the hips; they should be located lower. Therefore, it is recommended to place a pillow on the chair.
3. Whatever position the patient is in, he should not cross his legs.
4. When getting up from a chair, your back should remain straight and you should not lean forward.
5. You need to use crutches until the doctor stops them.
6. Walking in the first days after endoprosthetics can only be done with the help of medical staff.
7. Shoes should be as comfortable as possible, so heels are contraindicated.
8. When visiting another doctor, he must be informed that the hip joint is artificial.

Hip replacement requires work not only on the joint itself, the patient must always take care of his overall health. If pain occurs in the area of ​​the hip into which the artificial implant was implanted, accompanied by an increase in body temperature, you should immediately consult your doctor.

It is likely that many of these recommendations will eventually be abandoned. This will depend on how long it takes the patient to fully recover. Usually seven to eight months are enough for rehabilitation.

The patient should be informed that the artificial hip implant, like any mechanism, has its own service life. Therefore, over time, the endoprosthesis wears out. On average, its validity period lasts 10-15 years and depends on certain conditions and features.

If the endoprosthesis quickly fails, most likely it was not used correctly. Any active sports are contraindicated for a patient with an artificial hip prosthesis.

When doing physical therapy at home, the patient should be aware that ignoring the doctor’s recommendations can cause serious complications. Exercise therapy exercises should not be difficult or cause pain. Large loads should not be placed on the artificial joint.

sustav.info

Pain and complications after hip replacement

Hip replacement surgery allows a person to return to a full life and say goodbye to those arthritic symptoms that prevented them from experiencing the joys of life for many years in a row. Studies show that complications after hip replacement develop in 1% of young people and 2.5% of older patients. All this is true, but you shouldn’t relax! Despite the minuscule probability of developing negative consequences, an unpleasant situation can affect anyone, especially those who did not strictly follow the rehabilitation program.

Image of the position of the endoprosthesis in the human body.

As a rule, complications after hip replacement are caused by improper postoperative care and non-compliance with physical activity after discharge from the hospital. The second reason for an unfavorable prognosis, which happens much less frequently, is the surgeon’s mistakes. Thus, the overall success of the treatment is influenced by the status of the medical institution and the qualifications of the medical staff, where, in fact, the patient was operated on, observed and received high-tech medical care - surgical and rehabilitation treatment.

The pain comes in different forms, but there is the right kind - after moderate physical exertion. And there is an acute one, talking about problems that need to be diagnosed urgently.

Complication statistics as a percentage

The operation to install a hip joint prosthesis today is a tremendous success, since in modern orthopedics it is the only effective method that “puts” the patient on his feet, relieves him of debilitating pain and limited ability to work, and allows him to return to healthy physical activity. Unpleasant pathological situations associated with implantation occur infrequently. However, in isolated cases they were recorded, about which the patient should be informed. According to ongoing randomized controlled trials, the following data have been obtained about the most common problems:

• dislocation of the head of the prosthesis develops in approximately 1.9% of cases;
• septic pathogenesis – in 1.37%;
• thromboembolism – in 0.3%;
• periprosthetic fracture occurs in 0.2% of cases.

Often they develop not through the fault of the surgeon, but of the patient himself, who did not deign to continue rehabilitation at a specialized medical institution or did not adhere to a special physical regimen after the end of recovery. Deterioration of the condition often occurs at home, when there is no close monitoring from doctors that was in the clinic.

If you have had surgery, enough time has passed, but your leg cannot repeat the range of motion of the healthy limb, then this is the result of a lack of rehabilitation.

Forecasting possible complications, drug and non-drug control, mandatory early prevention of concomitant diseases, the use of adequate tactics of surgical intervention and a competent rehabilitation program can significantly minimize the likelihood of postoperative consequences.

Attention! In exceptional situations, even despite all precautions and safety measures taken, undesirable postoperative effects may occur. Not a single orthopedic specialist, even with rich and impeccable work experience, can 100% predict how a particular body will behave after such complex manipulations on the musculoskeletal system, and give the patient a complete guarantee that everything will go smoothly and without incidents.

Differentiation of pain: normal or not

Pain after hip replacement will be observed in the early period, because the body has undergone a serious orthopedic operation. The painful syndrome during the first 2-3 weeks is a natural response of the body to a recent surgical injury, which is not considered any deviation.

Until the surgical injury heals, the muscle structures return to normal, and oh, how they suffered from the previous illness, until the articular bones together with the endoprosthesis become a single kinematic link, the person will experience discomfort for some time. Therefore, at the initial stage of recovery, a good pain reliever is prescribed, which makes it easier to endure early painful symptoms and to better concentrate on treatment and rehabilitation activities.

Well-healing suture after surgery. It is smooth, pale and has no discharge.

However, you need to understand that with all complications after hip replacement, the symptom of pain manifested at the site of the implanted prosthesis can signal an already existing serious danger. Therefore, pain sensations must be professionally differentiated: which of them is normal and which is a real threat. And this, as is easy to understand, is within the competence of only a qualified specialist. The patient’s task is to immediately notify the orthopedic doctor if any signs of discomfort occur.

Important! If pain increases after hip replacement or there is no positive dynamics in reducing the pain factor at any stage, this should be reported to a specialist immediately! Since there is a high probability that they indicate the emergence or already progression of dangerous complications. The doctor will identify what causes pain after hip replacement, determine the exact cause of postoperative pathogenesis and take emergency measures to eliminate it.

Main risk factors

Hip replacement, like any surgical intervention, does not exclude complications, and quite serious ones. Especially if mistakes were made during the intra- and/or postoperative period. Even small errors during surgery or during rehabilitation increase the likelihood of unsatisfactory hip arthroplasty. In addition, there are also so-called risk factors that increase the body’s susceptibility to postoperative consequences and often become their cause, these include:

• advanced age of a person;
• severe concomitant disease, for example, diabetes mellitus, arthritic disease of rheumatoid etiology, psoriasis, lupus erythematosus and other systemic ailments;
• any previous surgical intervention on the “native” joint aimed at treating dysplasia, femoral fractures, coxarthrosis deformities (osteosynthesis, osteotomy, etc.);
• re-endoprosthetics, that is, repeated replacement of the hip joint;
• local inflammation and purulent foci in the patient's history.

It should be noted that after hip joint replacement, older people, and especially those over 60, are more susceptible to complications. The explanation is simple: elderly patients, as a rule, in addition to the main disease, have a “bouquet” of concomitant pathologies that can complicate the course of rehabilitation , for example, reduce resistance to infection. In addition, in people of advanced years, due to physiological changes in the body caused by age, there is a reduced potential for reparative and restorative functions, weakness of the muscular-ligamentous system, osteoporotic signs, and a certain degree of lymphovenous insufficiency of the lower extremities.

It is more difficult for older people to recover, but this can be done successfully.

Replacement of a non-viable hip joint and complications from the above problems, as clinical experience shows, have a direct relationship. But this does not mean that hip replacement is contraindicated for the older generation. No, in most cases it is allowed, because it is precisely these people who most often need such intervention. It’s just that the specialist must take into account the patient’s health indicators down to the smallest detail and take all necessary measures to ensure that endoprosthetics and recovery go well for him. However, such a competent approach is practiced in all highly professional clinics, and for absolutely every patient, regardless of age.

Concept and methods of treating consequences

Complications after hip replacement, the symptoms for better understanding will be presented below in the table, must be detected in a timely manner. A quick visit to a doctor at the first suspicious signs will help to avoid the progression of adverse events, and in some situations, to preserve the implant without resorting to revision surgery. It is important to understand that the more advanced the clinical picture becomes, the more difficult it will be to respond to therapeutic correction.

You can’t talk about symptoms until it becomes clear what complications after hip replacement generally are. So, let’s explain the concepts of the main types of pathogenesis, the causative factor of their occurrence and ways to eliminate them.

Dislocations and subluxations of the endoprosthesis

As a rule, negative excess occurs in the first year after prosthetics. This is the most common pathological condition in which the femoral component is displaced in relation to the acetabular element, resulting in separation of the head and cup of the endoprosthesis. Provocative factors are excessive loads, errors in the selection of the model and installation of the implant (defects in the placement angle), the use of a posterior surgical approach, and trauma.

Dislocation of the femoral component on x-ray.

It should be noted that the risk group includes people with hip fractures, dysplasia, neuromuscular pathologies, obesity, joint hypermobility, Ehlers syndrome, and patients over 60 years of age. Individuals who have undergone surgery on a natural hip joint in the past are also particularly vulnerable to dislocation. The dislocation requires non-surgical reduction or open repair. If treated in a timely manner, the endoprosthetic head can be adjusted in the vast majority of cases using a closed method under anesthesia. If the problem continues, the doctor may prescribe a repeat operation to reinstall the endoprosthesis.

Paraprosthetic infection

The second most common unfavorable phenomenon, characterized by the activation of severe purulent-inflammatory processes of an infectious nature in the area of ​​the installed implant. Infectious antigens are introduced intraoperatively through insufficiently sterile surgical instruments (rarely) or after surgery they move through the bloodstream from any problematic organ that has a pathogenic microbial environment (often). Poor treatment of the wound area or poor healing (in diabetes) also contributes to the development and proliferation of bacteria.

Discharge from a surgical wound is a bad sign.

A purulent focus has a detrimental effect on the strength of fixation of the endoprosthesis, causing its loosening and instability. Pyogenic microflora is difficult to treat and, as a rule, requires removal of the implant and re-installation after a long time. The main principle of treatment is a test to determine the type of infection, long and expensive antibiotic therapy, and abundant lavage of the wound with antiseptic solutions.

The arrows indicate areas of infectious inflammation, this is exactly what they look like on an x-ray.

Thromboembolism (PE)

PE is a critical blockage of the branches or main trunk of the pulmonary artery by a detached thrombus, which formed after implantation in the deep veins of the lower limb due to low blood circulation resulting from limited mobility of the leg. The culprits of thrombosis are the lack of early rehabilitation and necessary drug treatment, prolonged stay in an immobilized state.

This complication is dealt with quite successfully at this stage of medical development.

Blocking the lumen of the lungs is dangerously fatal, so the patient is immediately hospitalized in the intensive care unit, where, given the severity of the thrombotic syndrome, they provide qualified assistance: administration of thrombolytics and drugs that reduce blood clotting, NMS and mechanical ventilation, embolectomy, etc.

Periprosthetic fracture

This is a violation of the integrity of the femur in the area of ​​fixation of the leg with an unstable and stable prosthesis, occurring intraoperatively or at any time after the surgical session (several days, months or years later). Fractures more often occur due to reduced bone density, but may be the result of incompetent development of the bone canal before installing an artificial joint, or an incorrectly chosen method of fixation. Therapy, depending on the type and severity of the damage, consists of using one of the methods of osteosynthesis. The leg, if necessary, is replaced with a corresponding part that is more suitable in configuration.

Implant failure occurs very rarely.

Neuropathy

Neuropathic syndrome is a lesion of the peroneal nerve, which is part of the structure of the greater sciatic nerve, which can be caused by lengthening of the leg after prosthetics, pressure of the resulting hematoma on the nerve formation, or, less commonly, intraoperative damage due to careless actions of the surgeon. Nerve restoration is performed through etiological treatment with the optimal surgical method or through physical rehabilitation.

When an inexperienced surgeon works, there is a risk of injury to the femoral nerves, which leads to constant pain after surgery.

Symptoms in the table

Syndrome	Symptoms
Dislocation (impaired congruence) of the prosthesis	Paroxysmal pain, muscle spasms in the hip joint, aggravated by movements; in a static position, the severity of pain is not so intense; forced specific position of the entire lower limb; Over time, the legs shorten and lameness appears.
Local infectious process	Severe pain, swelling, redness and hyperthermia of the soft tissues over the joint, exudate from the wound; increased general body temperature, inability to step on the foot due to pain, impaired motor functions; purulent discharge from the wound, up to the formation of a fistula, is observed in advanced forms.
Thrombosis and pulmonary embolism (thromboembolism)	Venous congestion in a diseased limb can be asymptomatic, which can lead to unpredictable separation of a blood clot; with thrombosis, swelling of the limb, a feeling of fullness and heaviness, and nagging pain in the leg (increased with load or change of position) can be observed in varying severity; PE is accompanied by shortness of breath, general weakness, loss of consciousness, and in the critical phase – blue discoloration of the skin of the body, suffocation, and even death.
Periprosthetic bone fracture	Acute pain attack, rapidly growing local swelling, redness of the skin; crunching sound when walking or palpating a problem area; severe pain when moving with an axial load, tenderness of soft structures on palpation; deformation of the leg and smoothness of the anatomical landmarks of the hip joint; impossibility of active movements.
Lesser tibial nerve neuropathy	numbness of a limb in the hip or foot area; ankle weakness (foot drop syndrome); inhibition of motor activity of the foot and toes of the operated leg; the nature, intensity and location of pain can be variable.

Preventive measures

Complications after hip replacement are much easier to prevent than to then undergo labor-intensive and lengthy treatment to get rid of them. Unsatisfactory development of the situation can simply reduce all the efforts of the surgeon to zero. In addition, therapy for a pathological condition does not always give a positive effect and the expected result, therefore leading clinics provide a comprehensive perioperative program for the prevention of all existing consequences. It begins to operate from the first days of the patient’s admission to the medical center.

Infections are treated with antibiotics, which in itself is quite harmful to the body.

At the preoperative stage, a comprehensive diagnosis is carried out for the presence of infections in the body, diseases of internal organs, allergies, etc. If inflammatory and infectious processes, chronic diseases in the stage of decompensation are detected, surgical measures will not begin until the identified foci of infections are cured, venous -vascular problems will not be reduced to an acceptable level, and other ailments will not lead to a state of stable remission.

Currently, almost all implants are made from hypoallergenic materials.

If there is a predisposition to allergic reactions, this fact is qualitatively examined and taken into account, since the choice of medications, endoprosthesis materials and type of anesthesia depends on it. Moreover, the entire surgical process and further rehabilitation are based on assessing the health status of internal organs and systems, age criteria, weight and other individual characteristics. To minimize the risks of complications after hip joint replacement, prophylaxis is carried out before and during the procedure, after surgery, including the long-term period. An integrated preventive approach is based on the implementation of such measures as:

• drug elimination of the infectious source, full compensation of chronic ailments;
• prescribing certain doses of low molecular weight heparins 12 hours in advance to prevent thrombotic events; antithrombotic therapy continues for some time after surgery;
• the use of broad-spectrum antibiotics active against a wide group of pathogens a couple of hours before the upcoming hip replacement and for several days;
• technically impeccable surgical intervention, with minimal trauma, avoiding significant blood loss and the appearance of hematomas;
• selection of an ideal prosthetic structure that completely coincides with the anatomical parameters of the real bone connection, including its correct fixation at the correct orientation angle and in the most advantageous way, which in the future guarantees the stability of the implant, its integrity and excellent functionality;
• early activation of the patient in order to prevent stagnant processes in the leg, muscle atrophy and contractures, inclusion of exercise therapy and physiotherapy procedures (electromyostimulation, magnetic therapy, etc.), breathing exercises from the first day, as well as high-quality care for the surgical wound;
• informing the patient about all possible complications, permitted and unacceptable types of physical activity, precautions and the need to regularly perform physical therapy exercises.

Communication between the patient and the doctor or other medical personnel plays a huge role in successful treatment. This is what is called service, because when the patient is fully instructed, he better perceives the processes occurring in his body.

The patient must realize that the outcome of the operation and the success of the recovery depend not only on the degree of professionalism of the doctors, but also on himself. After hip replacement, it is possible to avoid unwanted complications, but only if you strictly follow the recommendations of specialists.

Advice! In order to protect yourself as much as possible from the development of negative processes, it is imperative to undergo a full-fledged rehabilitation course in a good medical institution that directly specializes in the recovery of people after joint replacement.

msk-artusmed.ru

How to get rid of pain after endoprosthetics

Joint pain will disappear in a few days. Write down grandma's recipe...

Hip replacement is a surgical procedure aimed at replacing the affected joint with a special prosthesis. The operation is considered quite complex, and various complications can often arise after endoprosthetics. They may be characterized by pain in the hip joint.

Pain almost always occurs after surgery. This is explained by the peculiarities of endoprosthetics.

Possible complications causing pain

Complications that may occur after endoprosthetics cause severe pain. These include:

1. Rejection of the implant by the body;
2. Penetration of infection into the wound during surgery;
3. Implant displacement;
4. Deep vein thrombosis;
5. Bleeding;
6. Changing leg length.

Rejection of an installed prosthesis rarely occurs, since individual tissue sensitivity to the prosthesis material is usually tested before surgery. In cases where the material is not suitable. It is being replaced and retested. The procedure is carried out until a material is selected that matches the cells of the body.

When an infection enters the wound, not only pain is observed, but also noticeable swelling and redness of the skin at the site of the suture. To eliminate this complication you will need to take antibiotics. The source of infection may be on the surface of the wound or inside it, for example, where a joint prosthesis is installed.

Hip implant displacement can occur due to irregularities in activity patterns and postoperative guidelines. For example, it is strictly forbidden to cross your legs or lift them high. Displacement can cause severe pain and discomfort.

Blood stagnation due to decreased physical activity can cause blood stagnation, which develops into deep vein thrombosis. The consequences are not only severe pain, but also the occurrence of such serious diseases as heart attack and gangrene of the lower extremities.

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Doctors' opinion...

Bleeding can occur not only during the operation, but also after it. In this case, pain occurs quite rarely.

If the prosthesis is installed incorrectly, the muscles that are located in close proximity to the joint weaken. This may cause a sensation of change in leg length and mild pain.

Pain after endoprosthetics, which is considered normal

Pain is the only complication after endoprosthetics that accompanies the postoperative period in any case. This is due to the numerous muscle cuts that are made to access the joint.

When the tissues grow together, pain occurs in the hip joint, which can last about 3-4 weeks. If you follow the recommendations after endoprosthetics and regularly perform the necessary movements, you can achieve rapid pain relief.

What to do to reduce pain and eliminate it completely?

In order to try to reduce the duration of pain and completely get rid of them, first of all, it is necessary to establish their cause. To do this, you should contact a specialist who will prescribe the necessary examination of the replaced hip joint in order to diagnose the causes of the pain.

If pain is caused by complications of endoprosthetics, then their nature of occurrence is clarified and competent treatment is prescribed. In cases where pain is caused by the postoperative period, experts give recommendations for quickly eliminating it:

1. Follow all recommendations of a specialist on physical activity and rest after surgery;
2. Perform a complex of therapeutic exercises;
3. Do not make sudden movements, do not raise your legs high or cross them;
4. Do not allow blood to stagnate in the tissues in the hip joint area;
5. Use crutches at first;
6. If you experience any discomfort or increased pain in the hip joint, immediately contact a specialist.

Conclusion

In conclusion, we can say that pain after endoprosthetics can have a different nature of origin. It is very important to accurately establish their nature and causes. In cases of postoperative pain, which is a normal manifestation of the body, you should follow all the specialist’s recommendations in order to eliminate them as soon as possible.

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systavi.ru

Complications after hip replacement

New medical discoveries have made it possible to restore the activity of the lower extremities through hip replacement. This procedure helps to get rid of debilitating pain and discomfort, restores the functioning of the legs and helps to avoid disability. But sometimes various kinds of complications arise after hip replacement. Pathologies can develop due to medical error, infection, failure of the prosthesis to take root, or improper restoration procedures.

Common complications after hip replacement

The operation to replace patients with an artificial hip joint has been carried out very successfully for more than thirty years. Such intervention is especially in demand after hip (neck) fractures, damage to the musculoskeletal system, when the cup wears out due to age-related changes. Regardless of the cost of hip replacement surgery, complications are uncommon. But if the treatment of problems is not started in a timely manner, the patient faces disability, immobility of the lower extremities, and in the event of pulmonary embolism (thromboembolism), death.

Conventionally, all the causes of the consequences and difficulties of the postoperative period after such prosthetics are divided into several groups:

• caused by the body not accepting the implant;
• negative reaction to a foreign body;
• allergy to the prosthesis material or anesthesia;
• infection during surgery.

Complications after hip replacement negatively affect not only the hip area, but also affect the general physical and psychological state, physical activity and the ability to walk. To regain your previous health, you need to undergo a series of rehabilitation measures, which are prescribed based on the developed pathologies and problems. For a quick and effective recovery, it is necessary to establish the causes of complications and limitations after hip replacement.

General complications

The development of the medical industry does not stand still; hundreds of discoveries occur every year that can change lives and give a chance to many patients. But complications after surgery are common. During hip replacement, in addition to specific difficulties, general pathologies may arise:

• Allergy to medications used before or during surgery. For example, for anesthesia.
• Deterioration in the functioning of the heart muscle (surgery is always a burden on the heart), which can provoke attacks and diseases of the cardiovascular system.
• Impaired motor activity, which is not caused by the body’s perception of a foreign body or an allergy to the implant material (for example, ceramics).

Infection at the surgical site

Often during hip replacement surgery, a complication such as infection of the soft tissue at the incision site or the implant itself occurs. Why is infection dangerous?

• Severe pain occurs in the area of ​​surgery and placement of the endoprosthesis.
• At the site of the incision, suppuration, swelling and discoloration of the skin are observed.
• Septic instability of the new joint can become critical, resulting in impaired motor function of the lower extremities.
• The formation of a fistula with purulent discharge, which is especially often observed if timely treatment is not started.

To prevent complications after hip replacement from nullifying the efforts during surgery, treatment should be selected and started in a timely manner. Taking special antibiotics and using temporary spacers (implants) will help get rid of the infection. The treatment process will be long and very difficult, but the achieved result will please the patient.

Pulmonary embolism

The most dangerous complication that can develop after installation of an artificial joint (endoprosthesis) is pulmonary embolism. The formation of blood clots is often caused by immobility of the leg, which leads to poor circulation in the lower extremities. This disease often ends in death, so it is necessary to take preventive measures, for example, take anticoagulants, which are prescribed by the doctor for several postoperative weeks.

Blood loss

Bleeding may occur during hip replacement surgery or some time afterward. The causes are medical error, careless movement or abuse of medications that thin the blood. In the postoperative period, anticoagulants are prescribed to prevent thrombosis, but sometimes such caution can play a cruel joke, turning preventive measures into a source of trouble. The patient may need a blood transfusion to replenish supplies.

Dislocation of the prosthesis head

One of the complications after hip replacement is dislocation of the head of the prosthesis. This complexity is caused by the fact that the endoprosthesis is unable to completely replace a natural joint and its functionality is much lower. Falls, improper rehabilitation, performing difficult exercises or sudden movements can trigger a dislocation, which will lead to complications. As a result, the functioning of the musculoskeletal system and the activity of the lower limb will be disrupted.

To avoid complications after endoprosthetics, you should be extremely careful in your movements during the postoperative period: you should not turn your leg inward too much, and its bending at the hip joint should not be more than 90 degrees. Revision hip replacement will help eliminate the complication, and for complete healing it will be necessary to completely immobilize the leg for a while.

Loosening of the endoprosthesis structure

As a result of vigorous activity and leg movements, the artificial joints become loose. This negatively affects the condition of bone tissue. Loosening causes destruction of the bone where the endoprosthesis is inserted. Subsequently, such instability of the prosthetic area can lead to fracture. The only option to prevent loosening is to reduce motor activity, and to eliminate an existing problem, revision hip arthroplasty is used.

Lameness

Lameness is a common complication after hip replacement. This pathology can develop as a result of some cases:

• Patients who have had a leg or hip fracture after hip replacement surgery often experience shortening of one leg, which leads to a limp when walking.
• Long-term immobilization and a state of rest of the lower limb can provoke atrophy of the leg muscles, which will cause lameness.

Surgical intervention, during which bone tissue is built up to equalize the length of the legs, will help get rid of the complication. Patients and doctors resort to this option extremely rarely. As a rule, the problem is solved by using special insoles, linings in shoes or wearing special shoes with different sole heights and heels, which are sewn to order.

Groin pain

A rare complication after hip replacement is pain in the groin area from the surgical intervention. The pain caused may be a negative reaction of the body to the prosthesis, or an allergy to the material. Often pain occurs if the implant is located in the anterior part of the acetabulum. Performing special physical exercises will help you get rid of pain and get used to the new joint. If this does not bring the desired result, revision endoprosthetics will have to be performed.

Swelling of the legs

After surgery, as a result of keeping the leg at rest for a long time, a complication such as swelling of the lower extremities is often observed. Blood flow and metabolic processes are disrupted, which leads to swelling and pain. Taking diuretics, keeping your legs elevated, using compresses that relieve swelling, and regularly performing simple exercises will help get rid of this problem.

Therapeutic exercises for recovery after endoprosthetics

To get rid of complications after hip replacement and make the rehabilitation process as fast and painless as possible, you must regularly perform physical exercises prescribed by the doctor. Thanks to simple actions, the motor activity of the new artificial joint develops, and the patient regains the ability to move with his legs without the use of crutches.

A set of exercises for recovery after hip replacement is selected individually. It takes into account the following factors:

• patient's age;
• activity of the lower limb where the joint was replaced;
• the general health of the patient;
• psycho-emotional state of the patient.

When performing physical exercises and while walking, it is important to remember that patients after hip replacement surgery are strictly prohibited from:

• crossing legs;
• flexion of the lower limbs at the hip joint by more than ninety degrees;
• twisting the leg to the side.

To make rehabilitation more effective, perform a set of exercises after hip replacement surgery:

1. Take a lying position on your back (a harder surface is ideal - an elastic mattress or the floor), perform a number of simple exercises one by one:

• Bending the legs at the knee joint without lifting the foot from the surface.
• Abduction of the lower extremities to the side (alternately with a leg with an artificial and natural joint).
• Bike. Raise your legs slightly up and perform movements that simulate riding a two-wheeled pedal vehicle.
• Alternately straightening and returning to a bent position with legs bent at the knees.

1. Change position by turning onto your stomach. In this position, perform the following exercises:

• Flexion and extension of the knee joint.
• Raising your leg up.

1. Lying on your side, lift your straight lower limb up and then move it to the side. Repeat a similar exercise, turning on the other side.
2. In a standing position, swing your legs forward, backward and move your lower limb to the side.
3. When performing this complex, do not make sudden movements so that the cup of the joint does not jump out or become loose, causing all sorts of complications and pain.

Rehabilitation centers and costs

For rehabilitation and relief from complications after endoprosthetics, people often choose clinics abroad, giving preference to sanatoriums or hospitals, for example, in Germany and Israel. But in Russia there are also medical centers where it is possible to undergo recovery after surgery and cure pathologies that arose after it. There are such clinics in large cities of the country, for example, Moscow, Voronezh, St. Petersburg, where qualified doctors work who can provide assistance in rehabilitation.

The cost of rehabilitation measures after hip replacement in different sanatoriums may vary depending on many factors:

• Location of the hospital. In sanatoriums located in picturesque corners, the price per day will be much higher than in clinics located on the outskirts of the city.
• Services provided at the clinic. The larger the list of procedures, the higher the cost. Especially relevant are massage, exercise therapy, and classes on special exercise equipment (for example, an exercise bike).
• The comfort of wards or rooms directly affects the price of accommodation in rehabilitation centers.

Sanatoriums, clinics and the cost of rehabilitation after hip replacement in Moscow and St. Petersburg:

Video about rehabilitation methods

A rehabilitation course in a clinic or sanatorium will help you cope with complications after hip replacement. Medical institutions with experienced and polite staff, the latest equipment and the use of modern recovery techniques are available not only in newfangled foreign health resorts, but also in Russian hospitals. Rehabilitation measures are aimed at reducing pain, improving general health, restoring joint functionality, and generating strength so that the implant can withstand certain loads.

For recovery after hip replacement, methods are used whose effectiveness has been proven by many patients:

• Specialized therapeutic massage aimed at postoperative recovery and relief of pain arising after surgery.
• Electrotherapy – relieves pain and promotes rapid recovery.
• Laser therapy is a procedure that has a beneficial effect on the postoperative suture.
• Magnetic therapy – promotes tissue regeneration in the area of ​​surgical intervention.
• Drinking thermal waters, which promotes rapid restoration of joints, improves their mobility and reduces pain.
• Therapeutic exercises, exercises, which are carried out to improve the motor activity of the leg, depending on the physical, psychological and emotional state of the patient, and are prescribed after a thorough examination.

To obtain maximum results, it is necessary to use all methods in combination. Watch the video to learn more about the methods of dealing with the consequences after hip replacement:

Content

An operation to restore the functionality of the lower limb is necessary to improve the patient’s quality of life - this is hip replacement. It is one of the largest and most heavily loaded. If the hip joint is ineffective, a person cannot even stand on his feet. You have to completely forget about sports and dancing. How hip replacement surgery is performed, preparation for it, types and rehabilitation are discussed below.

What is hip replacement

A complex surgical operation that requires replacing worn or damaged parts of the largest bone joint in the body, the hip joint (HJ), with artificial parts is arthroplasty. The “old” hip joint is replaced with an endoprosthesis. It is called so because it is installed and located inside the body (“endo-”). The product is subject to requirements for strength, reliable fixation of components and biocompatibility with tissues and structures of the body.

The artificial “joint” bears more load due to the absence of friction-reducing cartilage and synovial fluid. For this reason, dentures are made from high-quality metal alloys. They are the most durable and last up to 20 years. Polymers and ceramics are also used. Several materials are often combined in one endoprosthesis, for example, plastic and metal. In general, the formation of an artificial hip joint is ensured by:

• prosthetic cups replacing the acetabulum of the joint;
• a polyethylene liner that reduces friction;
• a head that provides soft gliding during movements;
• legs, which absorb the main loads and replace the upper third of the bone and the femoral neck.

Who needs it

Indications for endoprosthetics are serious damage to the structure and functional disorders of the hip joint, which lead to pain while walking or any other motor activity. This may be due to injuries or previous bone diseases. Surgery is also necessary if there is stiffness of the hip joint or a significant decrease in its volume. Specific indications for endoprosthetics include:

• malignant tumors of the femoral neck or head;
• coxarthrosis grade 2-3;
• femoral neck fracture;
• hip dysplasia;
• post-traumatic arthrosis;
• aseptic necrosis;
• osteoporosis;
• osteoarthritis;
• Perthes disease;
• rheumatoid arthritis;
• formation of a false hip joint, more often in older people.

Contraindications

Not all people who need hip replacement surgery can undergo hip surgery. Contraindications to it are divided into absolute, when surgical intervention is prohibited, and relative, i.e. it is possible, but with caution and under certain conditions. The latter include:

• oncological diseases;
• hormonal osteopathy;
• 3 degree of obesity;
• liver failure;
• chronic somatic pathology.

Absolute contraindications include more diseases and pathologies. Their list includes:

• foci of chronic infection;
• absence of a bone marrow canal in the femur;
• thromboembolism and thrombophlebitis;
• paresis or paralysis of the leg;
• skeletal immaturity;
• chronic cardiovascular failure, arrhythmia, heart disease;
• cerebrovascular accident;
• inability to move independently;
• bronchopulmonary diseases with respiratory failure, such as emphysema, asthma, pneumosclerosis, bronchiectasis;
• recent sepsis;
• multiple allergies;
• inflammation of the hip joint associated with damage to muscles, bones or skin;
• severe osteoporosis and low bone strength.

Types of hip replacements

In addition to classification by materials, hip joint endoprostheses are divided according to several other criteria. One of them is based on the components of the prosthesis. It could be:

1. Single pole. In this case, the prosthesis consists only of a head and a stem. They replace the corresponding parts of the hip joint. Only the acetabulum remains “native”. Today such a prosthesis is rarely used. The reason is that there is a high risk of destruction of the acetabulum.
2. Bipolar, or total. This type of prosthesis replaces all parts of the hip joint - neck, head, acetabulum. It is better fixed and maximally adapted to the body. This increases the success of the operation. The total denture is suitable for older people and young people with high activity levels.

Endoprosthesis service life

The number of years that an endoprosthesis can last depends on the materials used in its manufacture. The strongest ones are metal ones. They last up to 20 years, but are characterized by less functional results in relation to the motor activity of the operated limb. Plastic and ceramic prostheses boast a shorter service life. They can only serve for 15 years.

Types of endoprosthetics operations

Depending on the prostheses used, endoprosthetics can be total or partial. In the first case, the head, neck and acetabulum of the articulation are replaced, in the second - only the first two parts. Another classification of the operation uses the method of fixation of the endoprosthesis as a criterion. Ceramics or metal must be firmly connected to the bones so that the hip joint can function fully. After selecting the endoprosthesis and its size, the doctor determines the type of fixation:

1. Cementless. Fixation of the implant in place of the hip joint is carried out thanks to its special design. The surface of the prosthesis has many small protrusions, holes and depressions. Over time, bone tissue grows through them, thus forming an integral system. This method increases the recovery time.
2. Cement. It involves attaching the endoprosthesis to the bone using a special biological glue called cement. It is prepared during the operation. Fixation occurs due to the hardening of cement. In this case, restoration of the hip joint is faster, but there is a high risk of implant rejection.
3. Mixed or hybrid. It consists of a combination of both methods - cement and cementless. The stem is secured with glue, and the cup is screwed into the acetabulum. It is considered the most optimal way to fix the prosthesis.

Preparing for surgery

The first step before surgery is to have your feet examined by a doctor. X-rays, ultrasound and MRI of the operated area are used as diagnostic procedures. The patient is hospitalized two days before the scheduled operation for a series of other procedures that will help eliminate the presence of contraindications. Conducted:

• blood clotting test;
• OAM and UAC;
• determination of blood group and Rh factor;
• biochemical blood test;
• tests for syphilis, hepatitis, HIV;
• consultations with more specialized specialists.

Next, the patient is provided with information about possible complications and asked to sign a consent for surgical intervention. At the same time, instructions are given about behavior during and after the operation. Only a light dinner is allowed the day before. In the morning you can no longer drink or eat. Before the operation, the skin in the thigh area is shaved, and the legs are wrapped with elastic bandages or compression stockings are put on them.

Progress of the operation

After transporting the patient to the operating room, I give him anesthesia - full anesthesia with controlled breathing or spinal anesthesia, which is less harmful and is therefore more often used. The hip replacement technique is as follows:

• after anesthesia, the doctor treats the surgical field with antiseptics;
• then he cuts through the skin and muscle, making an incision of about 20 cm;
• then the intra-articular capsule is opened and the femoral head is removed into the wound;
• Next comes its resection until the medullary canal is exposed;
• the bone is modeled taking into account the shape of the prosthesis, and it is fixed using the chosen method;
• Using a drill, he processes the acetabulum to remove cartilage from it;
• the cup of the prosthesis is installed into the resulting funnel;
• after installation, all that remains is to match the prosthetic surfaces and strengthen them by suturing the incised wound;
• A drain is inserted into the wound and a bandage is applied.

Temperature after hip replacement

An increase in temperature may be observed for 2-3 weeks after surgery. This is considered normal. In most cases, the body tolerates elevated temperatures well. Only if your condition is very bad, you can take an antipyretic tablet. You should only tell your doctor if your temperature rises after a period of several weeks when it was normal.

Rehabilitation

Hip replacement surgery requires the start of rehabilitation within the first hours after its completion. Rehabilitation measures include physical therapy, breathing exercises and early activation in general. The leg should be at functional rest, but movement is simply necessary. You can’t get up only on the first day. Changing the position of the body in bed and performing slight bends in the knee joint may be allowed by the doctor. In the following days, the patient can begin to walk, but with crutches.

How long does it last

Rehabilitation within the clinic lasts about 2-3 weeks. At this time, the doctor monitors the wound healing process. Postoperative sutures are removed approximately 9-12 days. The drainage is removed as the discharge decreases and completely stops. For approximately 3 months, the patient must use walking support. Full walking is possible after 4-6 months. Rehabilitation after hip replacement lasts approximately this long.

Life after hip replacement

If a person is somatically healthy and has no concomitant diseases, then he is able to restore the functionality of his leg almost completely. The patient can not only walk, but also play sports. You cannot perform only exercises related to strength tension of the limbs. Complications after endoprosthetics are more common in older people or when the postoperative regimen is not followed.

Disability after endoprosthetics

Not all cases of hip replacement result in disability. If the patient is suffering from pain and cannot perform his work normally, then he can apply for registration. Recognition of a person as disabled is carried out on the basis of a medical and social examination. To do this, you need to go to the clinic at your place of residence and go through all the necessary specialists.

The basis for disability is often not the endoprosthetics itself, but the diseases that required the operation. Experts consider the severity of impaired motor functions. If, after surgery, reduced functionality in the hip joint remains, the patient is given disability group 2-3 for 1 year with the possibility of subsequent re-registration.

Cost of the operation

Almost all patients are interested in the question of how much a hip replacement costs. There are several programs by which this operation can be performed:

• free under the compulsory medical insurance policy (in this case, you may face a queue for 6-12 months in advance);
• paid in a private or public clinic;
• free of charge under the quota of high-tech medical care (here circumstances are necessary to provide benefits).

In addition to the price of the operation itself, the cost of the hip joint prosthesis is also important. It depends on the reason that led to the need for endoprosthetics. In case of coxarthrosis, the cost of the prosthesis will be higher than in case of a femoral neck fracture. The approximate cost of surgery to replace the hip joint and prosthesis is shown in the table:

Video

You can find expert opinion on hip replacement, as well as patient reviews, on the website.

Attention! The information presented in the article is for informational purposes only. The materials in the article do not encourage self-treatment. Only a qualified doctor can make a diagnosis and give treatment recommendations based on the individual characteristics of a particular patient.

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