Artificial hip arthroplasty has a history of over 30 years. For patients with femoral head necrosis, advanced femoral neck fractures, comminuted acetabular fractures and femoral head tumors, it is the only treatment that can relieve pain and improve joint function. After years of clinical application and improvement, the current satisfaction rate of this procedure is over 90%.
I. Common causes of hip joint pain and dysfunction
The most common causes are osteoarthritis, rheumatoid arthritis and traumatic osteoarthritis.
1, osteoarthritis: often occurs in patients over 50 years of age and has a tendency to occur in families. In this disease, the cartilage cushion of the hip joint disappears, and direct wear and tear occurs between the femoral head and acetabular bone, resulting in pain or stiffness of the hip joint.
2, rheumatoid arthritis: a synovial disease, inflammation of the synovial membrane produces a large amount of synovial fluid and destroys joint cartilage leading to joint pain and stiffness.
3, traumatic osteoarthritis: secondary to severe trauma or fracture of the hip joint. Hip fracture can cause the familiar ischemic necrosis of the femoral head, which eventually leads to hip pain and stiffness.
Second, what is artificial joint replacement
Artificial joint replacement is an operation to replace a diseased joint with an artificial joint that can no longer be used normally, to solve the pain, deformity and dysfunction, and to restore and improve joint movement function.
Third, the purpose of artificial joint replacement is to
1.To relieve pain
2.To restore and improve the motion function of the joint
3.Correct deformity
The purpose of the surgery is to solve your pain and give you a normal life.
Fourth, what kind of patients need artificial hip replacement surgery
1.The function of the hip joint is obviously affected, such as the inability to sit on a low stool, difficulty in going to the toilet and going up and down stairs, inability to wear socks and cut toenails, etc.
2, accompanied by moderate to severe persistent joint pain, need to take long-term painkillers to relieve
3.Non-surgical treatment, i.e. physiotherapy, acupuncture or oral Chinese and Western medicine, etc. cannot relieve the pain.
4.There are signs of joint destruction by X-ray examination
V. Notes on rehabilitation training
The following actions should be avoided as much as possible, otherwise the chance of your artificial hip joint loosening will be greatly increased.
1, early postoperative period, it is forbidden to “stagger”, and do not apply pressure while stagger
2.Prohibit sitting on a low stool (about 20cm), including squatting
3.Prohibit jumping from high places with straight legs
4.Avoid doing strenuous exercise
5.Avoid falling
6.Don’t lie on the side of the surgery as much as possible when lying on the side
In order to make your training easy and enjoyable, we have developed the following training plan for you.
Within 72 hours after surgery
1.A drainage tube is placed at the wound to avoid postoperative hematoma, and it is removed after 24~72 hours.
2.In the early stage, you should lie as flat as possible, open the leg of the operated side 30o outward, keep the front of the knee joint and the toe upward, and place a triangular pillow inside both legs. Avoid turning over to the side of surgery. After you can lie on your side, it is better to place a pillow between your legs when you sleep.
3. Elevate the leg on the operated side and actively flex and extend the ankle joint. Use a lower extremity venous pump to promote blood circulation in the lower extremity.
4.The pain will be more intense within 72 hours. Early postoperative pain is mostly due to surgical trauma, so take appropriate sedative painkillers or use patient-controlled pain pumps to reduce pain stimulation to ensure better rest for the patient.
5, postoperative routine use of antibiotics, the specific need to be determined according to individual circumstances.
6.Patients with general intravenous anesthesia routinely receive postoperative nebulizer inhalation to encourage sputum excretion and prevent lung infection. Drink more water and eat more coarse fiber and multivitamin food to prevent constipation.
Eight, daily life precautions
1.How to squat?
Straighten the chest and waist, do not bend the trunk excessively.
2, how to wear shoes and socks?
Stretching your legs helps to put on shoes and socks, but be careful to avoid this action in the early postoperative period to avoid affecting the effect of surgery.
Sit on the bed and put on shoes and socks with the foot on the bed and hip flexion.
3.How to go up and down the stairs?
Going up and down the stairs requires sufficient strength and flexibility.
At the beginning, you will need to use the stair handrail, and each step can only be one step.
There are also rules about which leg to use to go up and down the stairs. To make it easy for you to remember, let’s use a phrase: “Healthy legs go to heaven (good legs first when going up the steps), affected legs go to hell (affected legs first when going down the steps).” It is best to be assisted by someone else until you feel you have sufficient strength and flexibility for assurance.
Going up and down stairs is a great exercise for muscle strength and body balance. Be careful not to go up the stairs too high, not more than 25 cm per step.
Pay attention to the handrail of the stairs.
IX. Functional exercises after non-cemented artificial hip arthroplasty
1.In the first week after surgery, lie in bed and perform muscle isometric training of the affected limb.
2.From the second week onwards, use a passive joint mobilizer (CPM) to move the operated side of the hip joint
3.From the 3rd week onwards, practice sitting up, sitting on the edge of the bed, sitting in a chair, practicing hip flexion and knee flexion
4.From the 4th week onwards, practice holding the crutches and walking without dropping the affected limb. However, you should not go up and down stairs to avoid falling out of control.
5.From the 6th to 7th week onwards, the affected limb should be partially weight-bearing and walking with the help of crutches
6.After the 12th week, abandon the crutches