I. Issues to be noted before rehabilitation.
If the surgeon finds that the position of the prosthesis is not satisfactory enough and there is a tendency of dislocation in a certain direction, he/she should inform the rehabilitation technician and should explain it to the patient.
II. Rehabilitation during hospitalization
(i) Early postoperative rehabilitation procedures
1. When transporting the patient after surgery, bind the triangular pad between the knees so that the hip joint is abducted by 10-20 degrees to prevent dislocation during transport.
2. On the night of the postoperative period, add a pad under the affected limb and place the affected hip and knee in a slightly flexed and abducted position. Or continue to bind the triangular pad between the knees to make the hip joint abducted; the affected limb can also wear orthopedic anti-external rotation shoes, but to prevent pressure injuries.
3, the first day after surgery, remove the lower limb cushion, straighten the affected limb to prevent hip flexion deformity.
4. Remove the drainage tube 48 hours after surgery.
5.Prevent deep vein thrombosis: use elastic bandage for 3 days or plantar vein pump after surgery. Generally apply low molecular heparin sodium postoperatively. If the patient has a history of deep vein thrombosis in the past, the application time should be extended appropriately. Pay attention to the detection of prothrombin time.
6. Physical therapy program for the first three days after surgery: after recovery from anesthesia, encourage the patient to actively flex and extend the ankle joint to promote blood return; quadriceps and gluteus isometric contraction exercises; deep breathing exercises.
Postoperative active ankle flexion and extension to promote blood return; quadriceps and gluteus isometric contraction exercises
(II) Day 4-7 physical therapy program
1.Hip joint straightening exercises, do active straightening of the hip joint on the operated side, or put a pillow under the hip to fully stretch the flexor hip muscles and the anterior part of the joint capsule.
2. Isotonic exercises for the quadriceps.
3, upper limb muscle strength exercises, the purpose is to restore the upper limb strength, so that the patient can better use crutches after surgery.
Note: Avoid placing the hip joint on the operated side in the inward and outward rotation and extension position
(C) Rehabilitation from one week after surgery
1.Bed exercises
Do the active or active resistance hip flexion exercises in the semi-flexed position of the hip joint. After 7 days after surgery, if there is no special situation, the patient can be allowed to turn over.
Sling-assisted exercises: through the pulley device on the bed frame, rely on the upward traction force of the rope and thigh sling, while doing active assisted hip flexion exercises, hip abduction and adduction exercises. Patients can help themselves to hip and knee flexion and extension
2.Sitting exercises
Sitting time should not be long, 4-6 times a day, 20 minutes each time. The sitting position is the position where the hip joint is most likely to be dislocated. If the intraoperative joint stability is poor, sitting exercises should be abandoned. Before sitting, prepare a chair with backrest and armrests, add a cushion, back up, watch the position, hold it steady with both hands, and sit down slowly.
Hip flexion should not exceed 90 degrees, sit in a higher chair