Dr. Cheng Biao how to recover after hip contracture arthroscopy?

  In addition to the routine postoperative treatment of infection prevention, hemostasis and drug exchange, early and active functional exercise is particularly important.  Within three days after surgery: 1. Observe the bleeding of the diseased area and the tightness of the elastic bandage. (prevent the bandage from being too tight to crush injury). 2. rest in bed in free position. 3. reduce the bed activity as much as possible, with permission to walk to the toilet with crutches without weight.  First postoperative day: immediately after surgery, bind both lower extremities together with a towel or restraint belt and put a soft pillow under the knee. The lower extremities were bent at 15°~20° and the hips were bent at 60° at the same time (maintain the nocturnal side-knee strapping until 3 weeks). Observe the amount and nature of drainage fluid after surgery if there is a drainage tube, and remove the tube on the 2nd postoperative day. Active muscle contraction exercise: After surgery, take both lower extremities in straight position with knees together, and after awakening from anesthesia, start quadriceps static contraction, foot exercise and hip muscle clenching exercise, each lasting 5 seconds. 3 groups/day, 20 times/group.  The second day after surgery: training methods: ① Passive double knee crossing exercise: the patient lies flat. The assistant helps to cross one leg on the other leg with the knee as the cross point, alternating left and right, repeatedly. This method can avoid gluteal muscle adhesions. It should be performed no less than 30~50 times a day. ② Passive double knee flexion exercise: the patient lies flat on his back, the assistant helps to bring his legs together and flex his knees, and then instructs the patient to hold his knees with both hands. Try to keep the thighs close to the chest for a few seconds and then release the legs and repeat. The purpose of this method is also to prevent adhesions of the hip muscles, no less than 30 times a day.  Second, 4-5 days after the operation Walk with weight indoors with double crutches. During the daytime, you can practice hip inversion, that is, the action of crossing the thigh to the opposite side. But the limit is to feel pain that need to stop, the range can not be too large, otherwise it is easy to cause hematoma and prolong the recovery time.  Passive squatting exercise: the patient gets out of bed, holds the end of the bed with both hands, squats with knees, the assistant stands behind and holds his back, instructs the patient not to bend as far as possible, the heel does not leave the ground, lasts 1 to 2 min and then stands up. Each exercise repeatedly, the number of times can be progressive according to the condition. It should be kept at 30~50 times a day.  Third, 5-8 days after surgery, walking and hip flexion (sitting position) with the help of single crutch or de-crutch.  Gait training: encourage the patient to get out of bed and practice walking, with the patient’s chest raised, both upper limbs stretched forward, and the assistant holding the patient’s hands with both hands, walking in a straight line with both feet crossed, 3 times/day, walking back and forth along 20 meters each time, and adjusting the patient’s posture at any time to make it coordinated.  ”One-step” exercise: the assistant faces the patient, holds his hands, and asks the patient to walk one step (i.e., walk “cat” step) to correct the patient’s abnormal gait, no less than 300 steps per day.  Knee squat training: 5-7 days after surgery, instruct the patient to hold the railing and take the initiative to squat with the knee, the height of the railing is appropriate to level the patient’s waist, practice with both feet and knees together, the heel does not leave the ground, waist and back straight, bend the knee to squat, the speed of squatting must be slow, prevent hip abduction and external rotation, 3 groups/day, 30 times/group, gradually increase the intensity and time of the exercise.  Fourth, two weeks after surgery to remove the stitches, to encourage the hip inward (crossed legs), without abduction.  Cross-leg exercise: assistants assist the patient to sit on a chair with a backrest, with the hips close to the back of the chair. Upper body and thighs at right angles, put one leg on the other leg, knee as the cross point, adhere to 3~5min and then change the other leg, repeatedly. Should be maintained at 30~50 times a day.  Knee squat: After the wound is removed, instruct the patient to squat with both hands holding the knee. 3 groups/day, 20 times/group. At the same time, stand with both feet separated front and back, front lower limb knee flexion, back lower limb knee straight, hands pressed on the front knee joint, body leaning forward, adhere to 10s, legs crossed.  V. Instruct patients to run and jump exercises one month after surgery, and follow up regularly to encourage and supervise patients to adhere to the above training for six months to one year in order to promote the recovery of hip joint function.