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Abstract: The patient presented with intermittent pain and walking effort in the hip joint 5 years ago, and gradually developed hip stiffness and lower limb weakness, which was temporarily relieved by self-medication, and came to the clinic because he did not adhere to the medication and did not rest. After X-ray examination, it was found that the hip joint was damaged by bone and the joint space was narrowed due to the wear of articular cartilage. After the surgery, the patient’s symptoms improved significantly and the pain was relieved.
Basic information】Female, 72 years old
Disease Type】Osteoarthritis of the hip joint
Hospital】Harbin First Hospital
Date of consultation】February 2022
Treatment plan】Surgery (total hip arthroplasty) + rehabilitation training
Treatment Period】7 days of inpatient treatment, 3 months of outpatient follow-up
Results】Hip pain relief and range of motion restored
I. Initial consultation
The patient, a 72-year-old female, developed intermittent pain and walking difficulty in the hip joint 5 years ago, but did not pay attention to it at the beginning. However, after the pain symptoms were relieved, the patient stopped taking the medicine and did not take comprehensive conservative treatment, and did not take rest. At present, the symptoms are more serious and the hip joint is severely restricted and the pain is persistent, so surgery is needed to replace the artificial joint to remove the lesion, relieve the pain and restore the function of the hip joint.
II. Treatment process
During the surgery, it was confirmed that the femoral head and acetabular cartilage were severely worn out, the joint surface was rough, the synovial membrane was severely congested and inflammatory, and the shape of the femoral head was severely damaged. The diseased tissue was completely removed and the artificial hip joint was replaced. After preoperative measurements, it was confirmed that the bone strength still met the requirements, so a biotype artificial joint was selected for replacement during the surgery. After the surgery, the surgical site was drained and the active and passive activities of the hip joint were started to restore the movement of the hip joint and prevent the formation of deep vein thrombosis in the lower limbs.
III. Treatment effect
After the artificial total hip replacement surgery, the clinical symptoms such as hip pain and limited hip movement were significantly improved, but it was still necessary to restrict hip rotation activities in the short term to avoid postoperative hip dislocation. The patient was able to complete hip flexion and extension activities in bed and straight leg elevation, so that the muscle strength of the lower limbs could be restored to a certain extent. As the function of the hip joint gradually improved, the symptoms of lumbar pain caused by the hip joint lesion were also gradually relieved, and the patient was discharged after 7 days of hospitalization and was instructed to come back to the hospital for a review in 3 months.
IV. Precautions
After the postoperative care and rehabilitation training, the patient had recovered the mobility of the hip joint. As a doctor, it is a great sense of accomplishment to see every patient regain health. Since patients with hip osteoarthritis cannot bear weight normally on the affected limb for a long time before surgery, they will have clinical manifestations such as muscle weakness and muscle atrophy in the lower limbs, and need to strengthen muscle exercises after hip replacement surgery. At the initial stage, self-weight training can be carried out, such as completing straight leg raise and side leg raise. With the relief of pain and swelling, it is necessary to strengthen resistance training, assist sandbags or elastic bands and other devices to complete the training, enhance muscle load, improve muscle strength and improve hip joint stability, which can further extend the service life of the artificial joint and protect the lower limb joints from hip trauma.
V. Personal insight
Osteoarthritis of the hip joint is a common degenerative disease that affects joint function to varying degrees due to the narrowing of the hip joint space and the destruction of articular cartilage. Once the disease occurs, patients need to go to orthopedic outpatient clinics for treatment in the early stages. Like the patient in this case, it is not advisable to take medication to control pain on your own. If the lesion develops at a faster rate, choosing conservative treatment can delay treatment and lose the best time for surgery.