Artificial hip replacement is one of the greatest breakthroughs in orthopedic surgery in the 20th century. It replaces worn out or otherwise damaged joints with an artificial joint device, which not only effectively relieves the patient’s hip pain, but also restores the normal function of the affected joint, thus greatly improving the patient’s quality of life. The success of artificial hip joint replacement surgery requires doctors’ excellent skills and rich experience on the one hand, and the active cooperation of patients after surgery, timely and effective functional exercises and avoiding various dangerous movements on the other.
(a) Functional exercises in different periods after surgery (choose any 1-2 kinds of the following exercises for the same part).
1 to 3 days after surgery.
Isometric contraction training of the quadriceps muscle of the affected limb.
a dorsiflexion of the ankle joint, tensing the leg muscles for 10 seconds and then relaxing them, tensing them again, relaxing them again, and so on, for 5 minutes/group, 5-6 groups/day.
b Flexion and extension of the ankle joint 5 sets/day, 20 times/set, each movement lasting 5 seconds.
c rotate the ankle joint 3 to 4 times/day, each repetition 5 times, each movement lasts 8 seconds.
d Hip and knee extension and flexion on the healthy side, 1 set/3 hours, 30 times/set, each movement lasts 8 seconds. At the end of each group, the affected limb should wear anti-rotation shoes and keep the affected hip in 25° abduction and neutral ankle position.
During this period, the affected hip is in edema and pain is obvious, so you should take pain medication under the guidance of the doctor to reduce the pain and facilitate the smooth progress of functional exercise.
Four to seven days after surgery.
At this stage, the patient can eat, the indwelling urinary catheter can be removed, and physical strength is gradually recovered, so training is aimed at enhancing muscle strength and restoring hip joint activities.
a Life skills training: mainly practice bed mobility, which can be done with the help of others, using the healthy limb and pillow as support, and avoiding inward retraction and rotation of the affected hip during the movement.
b Active hip and knee flexion and extension training on the affected side: 3 to 4 times a day, 10 times each time, always keeping the toe of the affected limb facing upward.
c Hip abduction exercise: give a certain amount of resistance, 3 to 4 times/day, 10 times each time.
d Posterior hip extension training: flex the hip and knee on the healthy side with the palm of the foot supported, suspend the hip in the air, 1 group/2 hours, 5 times/group, each time for 10 seconds.
8 to 13 days after surgery.
In this period, the main focus is to increase muscle strength and joint mobility, so that the active flexion of the affected hip is close to 90°.
a Ankle joint resistance training: assisted by a companion, give the affected person enough confrontation to practice flexion and extension exercises, 4 sets/day, 20 reps per set.
b Active flexion and extension of the affected hip and knee, 20 repetitions each time, 5 to 6 times/day.
c straight leg raising exercises, keeping the affected limb straight and with the toes pointing upwards, 5 sets/day, 10 reps per set, the slower each movement is completed, the better.
d Sitting up exercise: move to the bedside of the operated side parallel to the pelvis, move to the bedside of the healthy side with the healthy limb first off the bed, bend the knee, bend the hip and lift the upper body with the assistance of a companion to sit up, for about 30 minutes, 5 times/day.
Postoperative period: 14 days to 3 months.
During this period, the stitches have been removed, and the patient can be discharged from the hospital usually 2 weeks after surgery.
a Virtual bicycle exercise: supine position, empty bicycle exercise for both lower limbs, keeping the affected hip flexion less than or equal to 90°, 10 groups/day, 20-30 times/group.
b Bed and bed exercises: get out of bed in the same way as sitting up exercises, with the leg on the healthy side first leaving the bed and landing on the foot, then slowly move the affected limb out of the bed and stand up with the double canes, and go to bed in the opposite direction, and instruct the correct use of the double crutches.
c Walking with crutches: choose crutches that are 5 to 6 cm lower than the axillae, with no or partial weight bearing on the affected limb. First move the crutches forward 1 foot distance, then make the center of gravity over the line of the crutches, support under so that the healthy side forward over the line of the crutches 20 ~ 30cm, and so on alternately, 3 ~ 4 times / day, 5 ~ 20 minutes / time. Standing with the affected limb in front and the healthy limb behind.
d Walking up and down stairs: most patients can practice 21 days after surgery. When going up stairs, the healthy leg steps up first, then the operated side steps up; when going down stairs, first move both abductors to the lower step, then the operated side steps down, and finally the healthy side steps down.
e Daily living ability training: Encourage patients to perform self-care activities in bed, such as washing, combing, dressing, eating, etc.
(ii) Activities to be avoided.
The physician should give detailed discharge instructions to the patient at the time of discharge and inform him/her of the precautions to be taken in daily life. Patients should keep the following in mind :
(i) For 3 months after surgery, it is prohibited to lie on the side, cross-legged, sit on a low bench or a low sofa (bending the hip over 90° is prone to posterior hip dislocation) and use a higher sitting toilet as much as possible to prevent dislocation of the hip joint.
②For 3 months after surgery, light physical activity is allowed, but patients should avoid extracting and transporting heavy objects. Patients who enjoy sports before surgery do not have to give up sports completely after surgery. Suitable sports activities include: swimming (backstroke), cycling and various types of gymnastics. Sports that are not suitable include: jumping sports, climbing and some ball games, etc., because these sports activities can increase the load on the prosthesis and cause it to loosen.
③If you have a cold, sore throat, etc., you should consult a doctor and take medicine under the guidance of a doctor to avoid causing hip infection.
④ If you need to do CT, MRI and other examinations, you should tell the doctor that you have replaced the artificial total hip joint so as not to affect the judgment of the result.
⑤ Timely follow-up after 1, 3, 6 months and 1 year after surgery in order to understand the rehabilitation situation and adjust the rehabilitation plan.
If there are other activities that may affect the function of the hip joint, it is best to consult a specialist in time.