TREATMENT OBJECTIVES: Short-term goal: Active hip flexion up to 90° and patient is able to sit up. The patient is able to walk with a 3-point or 4-point gait with the help of two crutches. Long-term goal: to achieve the best function of the affected hip joint according to the needs of daily life. Preoperative rehabilitation assessment: gait; muscle strength of lower and upper limbs. Range of motion of both hips. Preoperative training: Teach the patient to walk with a 3-point or 4-point gait with the help of crutches. Teach the patient to transfer body position. Enhance the muscle strength training of the lower and upper limbs. I. Precautions in order to prevent the occurrence of postoperative joint dislocation. (1) Prevent the hip from flexing more than 90° within 3 months after surgery, avoid squatting to fetch objects and sitting on a low bed with a short chair that makes the hip flex more than 90°. (2) Prohibit doing hip internal retraction, internal rotation, or don’t put the affected leg on the other leg within 6 months after surgery. (3) In daily life, pay attention to preserving physical strength to prevent secondary injury and strain. After going home, the patient should insist on training according to the rehabilitation program and requirements. Therefore, in the training process, it should be repeatedly emphasized to the patients that they should pay attention to the following positions: 1) when sleeping on the side, a pillow should be put between the legs; 2) when sitting on the bed, the body should not be bent forward to pull the quilt; 3) when sitting, the feet should not be crossed; 4) low chairs and toilet bowls should not be sat on; 5) when standing up from chairs, they should not be bending forward to stand up; 6) the toes of the feet should not be inward. 7) the body should not be bent forward to the end. 8) the body should not be bending forward to the end. 9) the body should not be bending forward to the end; 10) the body should not be bending forward to the end. The training content of the training is based on the following Second, the training content of the training is in chronological order, in stages, step by step. Including: plyometric training, ROM, ADL training. (A), lying and sitting position training after the first day of surgery: the therapist began to participate in training, training content should be flexible according to the patient’s specific situation. 1, lying position when the patient supine position, between the knees pad pillow, so that its knees and toes up, in order to prevent the affected limb internal rotation, if necessary, with a box-type foot clip fixed. When the healthy side lying position, the affected limb in the upper, should also be in the double knee pillow, to prevent the affected limb internal rotation. (Day 1: Ankle Mercury Exercise. Perform isometric contraction exercises of quadriceps, N cord muscle and gluteal muscle. Cooperate with breathing exercises.) 2.Explain to the patient’s family about the postoperative precautions, the purpose and content of the training, in order to obtain the patient’s cooperation. Postoperative day three: 1. Complete each set of movements below the flat lying position ten times. During the training, the therapist can put his hand on the muscles contracted by the movement of the affected limb in order to observe and guide the patient’s movement effect, and explain the daily exercise procedures to the patient. (1) Gastrocnemius muscle training: first let the patient straighten the toes forward and pull the heel backward, then pull the toes backward and push the heel forward, paying attention to keep the knee straight. (2) Quadriceps training: let the patient tighten the thigh muscles, press the knee down, keep the knee straight for 5 seconds, and then relax for 5 seconds. (3) Biceps femoris training: the patient’s lower limb is in a neutral position, the heel of the foot downward pressure, the knee joint can not be bent, hold for 5 seconds, relax for 5 seconds. (4) Gluteus maximus training: tighten the hip for 5 seconds, relax for 5 seconds. (5) Hip joint training (within the pain-free range): move the foot of the affected limb upward along the bed, make the affected limb hip and knee flexion, but should ensure that the hip flexion can not exceed 90°. (Start abduction exercises and upper limb muscle strength training.) 2. Semi-recumbent position: first gradually raise the head of the patient’s bed to make the patient take the semi-recumbent position, measure the patient’s blood pressure and pulse rate in the recumbent position and semi-recumbent position respectively, and observe whether the patient has any symptoms such as dizziness, nausea, vomiting, sweating and so on. If the above symptoms occur, or if there is a big difference in pulse pressure before and after the measurement, or if the pulse rate increases obviously, let the patient take deep breaths, and at the same time move the ankles with force rapidly, and then observe the patient after half a minute. If the above symptoms are reduced, let the patient continue to sit in the semirecumbent position for 5 minutes, and if the symptoms are aggravated, let the patient lie down and rest. On the fourth postoperative day 1, complete the following movements in the horizontal position ten times in each group. (1)-(5) Same as above. (6) Knee training: put a small round pillow (or paper roll) under the knee joint, press down hard on the knee and raise the calf upward to straighten the knee joint for 5 seconds. (7) bridge exercise: knee flexion, foot flat on the bed, keep the knee (hip) joints, feet and shoulder blades in the same line, and then raise the hips upward to the same line with the shoulder blades, knee joints, hold for 5 seconds, then put the hips down, relax for 5 seconds. (8) femoral adductor training: the patient lies on his back, the therapist puts his hand on the inner side of the femur of the affected limb and gives it an outward force, and at the same time, the patient resists with force, and holds it for 5 seconds. (9) Adductor pollicis brevis training: the patient lies supine, the therapist puts his hand on the lateral side of the affected limb and gives inward force, at the same time, the patient resists with force, keep it for 5 seconds. 2, lying position – sitting position transfer the patient lying flat on the bed, the affected limb is out of the booth. Let the patient flex the healthy side of the lower limb, straighten the affected limb, use both hands to support the semi-sitting up. Use both hands and the healthy side to support the force, move the buttocks to the affected side, and then move the healthy side of the lower limbs and upper body. Repeat to bring the patient to the edge of the bed on the affected side. The therapist stands at the bedside of the affected side, holds the affected limb with one hand, holds the patient’s shoulder with one hand, and asks the patient to support the bed with both hands and the healthy side at the same time, and rotate the hip as the axis to sit up. Note that the affected hip flexion should not exceed 90°. Let the patient’s feet hang down and sit on the edge of the bed. Observe whether the patient has any uncomfortable symptoms, and pay attention to the patient’s blood pressure and pulse rate. Postoperative day 5 1. Flat lying position (1)-(9) as before. 2. Horizontal transfer from lying position to sitting position as before. 3. When moving to the affected side in sitting position, the affected limb should be moved first, naming it as an external stand, then support the bed with both hands and move the buttocks and key limb. When moving to the healthy side, support the bed with both hands, move the buttocks and healthy limb, and then move the affected limb. 4.Sitting position – standing position transfer The patient sits beside the bed, both feet on the ground, the healthy limb in front, the affected limb in the back, both hands holding the walker, using the healthy limb and hands of the support force of the hip to stand up. (B) Standing position training On the sixth day after surgery, complete the following actions ten times for each group in the standing position. (10) Adductor muscle training: let the patient’s foot straighten, and the affected limb extends outward from the neutral position, and then returns to the neutral position beside the patient. Note that the affected limb should always keep the foot straight, knee and toes outward. (11) Hip training I: Flex the knee to elevate the affected limb. Be careful not to be higher than the hip, and keep the knee forward, the calf perpendicular to the ground, and do not bend the body forward. (12) Hip Joint Exercise II: Straighten the lower limb and push it backward to the back of the body. Be careful not to bend the body forward. 2.Standing position balance training Let the patient hold the walker with both hands and stand with feet naturally apart. Slowly shift the center of gravity to the healthy limb and lift the affected limb; reset and then shift the center of gravity to the affected limb and lift the healthy limb. Repeat the exercise. (Bone cemented: no crutches; non-cemented: use crutches to start 20% weight-bearing) Walking training the eighth and ninth days after surgery 1, Standing position (10)-(12) Same as before. 2, walking training I – walker-assisted walking let the patient help walker practice walking, pay attention to correct the patient’s parallel posture. When turning around, if you turn to the affected side, let the affected limb take a step outward first, then move the walker, and then follow the healthy limb; if you turn to the healthy side, let the healthy limb take a step outward first, then move the walker, and then follow the affected limb. Postoperative days 9 and 10 1. In standing position (10)-(12) as before. 2. When walking training II – double four-legged crutch-assisted walking and walking, you should first move the affected crutch forward, and the healthy limb follows, and then move the healthy crutch accordingly, and finally the affected limb follows. Pay attention to the gait. On the eleventh and twelfth postoperative days 1, in standing position (10)-(12) as before. 2, Walking training III – single four-legged crutch-assisted walking This program is only a guideline for treatment, and should be chosen according to individual differences.