On the day of surgery.
A special position of the affected limb should be maintained: supine position with pillows between the knees and both knees and toes upward to prevent internal rotation of the hip. When the patient’s vital signs are stable, the patient should be placed in a semi-sitting position as soon as possible; the patient should be instructed to start active contraction of the quadriceps, triceps and tibialis anterior muscles to accelerate venous return and prevent deep vein thrombosis. Ice bags were given for 24 hours to reduce pain, keep the airway open, and encourage the patient to breathe deeply and cough to prevent lung infection.
First postoperative day.
In the morning, the plasma drain and urinary catheter were removed, and the patient was instructed to get out of bed and walk with a walker. In the afternoon, instruct the patient to get out of bed again and teach him/her to get out of bed, go to bed and take steps correctly. Strengthen the muscle strength exercise of both lower limbs. At the same time, the patient should be given psychological support. The more enthusiastic the patient is devoted, the faster the recovery.
1. Ankle dorsiflexion: Active maximum flexion and extension of the ankle joint and resistance training. Hold each movement for 5 seconds, repeat 20 times/group, 2 to 3 groups per day.
2.Quadriceps training: do static contraction of quadriceps, hold for 5 seconds each time, 20 times/group, 2-3 groups/day; at the same time, the patient can do straight leg raising exercise on the bed, not requiring the height of lifting, but having a lag time of about 5 seconds; slowly flex the knee and hip to slide the heel of the affected limb towards the hip, keeping the toe upward to prevent internal rotation of the hip.
3, resistance muscle strength training: resistance adductor and resistance abductor and other long muscle strength training can be carried out, hold each action for 5 seconds, repeat 20 times/group, 2 to 3 groups/day.
Postoperative day 2 to 3.
Patients should be more active, while strengthening dorsiflexion, plantarflexion and quadriceps training of the ankle joint. Postoperative days 4 to 14: The patient’s infusion should be stopped, and the focus should be on muscle strength exercise and increasing joint activities, with hip flexion reaching 70° to 90°, abduction 15° and external rotation 10° at discharge. Teach the patient to walk with a double crutch and arrange a post-discharge rehabilitation training program. During this period, supine straight leg raising and knee and hip flexion training should also be performed. And strengthen the postural transfer training and joint mobility training. Postoperative week 2 to 3: In addition to the above training, strengthen hip flexion, abduction and external rotation exercises, the training method must be correct to prevent joint dislocation. Train the patient to walk with a single crutch. Post-operative week 4 to 3 months: the patient should be trained to perform daily life functions, taught how to go to the toilet, put on and take off shoes and socks, sit in a car, go up and down stairs, and the patient who did not have a large rotor osteotomy should give up the crutches in about 6 weeks. At the same time, patients should be asked to have regular review to prepare for their return to society.
Patients who are discharged from the hospital after undergoing artificial hip arthroplasty should still pay attention to the following issues in their daily life: 1.
1.Sitting position: the sitting time should not be too long in the first month after surgery to avoid hip edema, which can also be improved by applying cold compresses and elevating the affected limb, keeping the knee joint lower than or equal to the hip, not sitting on chairs or sofas that are too low, not crossing legs and ankles, not bending forward more than 90 degrees, and leaning the body backward with the legs stretched forward when sitting.
2.Toilet: use a raised homemade toilet seat to go to the toilet, or lean back with the assistance of the affected leg and stretch forward to go to the toilet, pay attention to keep the knee joint higher than the hip.
3.Fetching things: Don’t bend down to pick up things on the ground within 2 weeks after surgery, don’t suddenly turn around or reach for the objects behind you, and it is advisable to put the rice bowl in front of you when eating.
4.Ride: sit with your hips positioned forward, lean your body backward and stretch your legs forward as much as possible.
5.Shower: After the wound has healed, the auxiliary hold can reliably take a shower, because there is a certain danger of standing in the shower, so you can sit on a high stool, the nozzle is a removable hand-held nozzle, and prepare a bath sponge with a long handle so that it can reach the lower limbs and feet.
6.Put on and take off shoes and socks: ask someone to help or use shoe plugs, choose elastic shoes without laces, loose pants, and carry shoes medially for those with lateral incisions after the line and laterally for those with medial incisions before the line.
7.Physical activities that can be performed after full recovery: walking, gardening, cycling, bowling, table tennis, swimming, dancing, and maintaining proper weight. Avoid activities that produce excessive pressure on the new hip joint causing wear and tear, such as jumping, fast running, skiing, water skiing, tennis, etc.
Special considerations: The range of motion of the new joint is limited. Patients need to pay special attention to avoid joint displacement, including.
1. Avoid crossing the legs and knees while sitting, standing, or lying.
2. Keeping the feet 6 inches apart in the seated position.
3. Keeping both knees below hip level when sitting. Avoid sitting in chairs that are too short. You can sit with pillow cushion to keep both knees below hip level.
4.Rise from a sitting position by sliding toward the edge of the chair and then stand up with a walking frame or crutches for support.
5.Avoid bending movements. Patients may consider purchasing long-handled shoe paddles or soft shoes so that they can put on and take off their shoes and socks without bending over.
6.When lying down, place a pillow cushion between the legs to keep the joints in the proper position.
7.Use a special abduction brace or splint to fix the hip joint in the proper position.
8.Raise the toilet seat so that the knee is kept below the hip when using the toilet.