A successful artificial total hip replacement surgery is the first step for a patient to become a healthy person, and recovery time remains a challenge for post-operative patients. In order to better assist hip patients in their post-operative recovery, we have consulted with experts on post-operative recovery exercises for hip replacements. By following the exercises described in the picture, 2-3 times a day for 20-30 minutes each time, you can restore the freedom of the hip joint as soon as possible if you persist.
Early post-operative exercise in flat position
Early exercise plays a very important role in promoting blood flow to the affected limb and preventing the formation of venous embolism in the lower limb. It is also very crucial for the recovery of lower limb joint function. When the surgery is over and the patient is awake, the following exercises can be performed.
When doing the exercise, the patient should lie on his back with both lower limbs separated.
Foot movements: gradually flex and extend the ankle, which can be done every 5 or 10 minutes for one session, and can be done immediately after surgery.
Ankle rotation movements: move the ankle first to the other foot and then to the opposite external rotation, several times a day, 5 times each time.
The following 3 to 4 movements are performed 3-4 times a day, 10 strokes each time (Figure 1-3).
Press the bed to bend the knee: press the foot to the bed and slide the knee to bend it less than 90 degrees. Lean the heel toward the hip, which can be done repeatedly, but the lower limb must not be internally rotated.
Contraction of hip force: tighten the hip muscles, maintain the count from 1 to 5, and then relax.
Abduction action: Slide the lower limb outward as far as possible, and then retract.
Contract the muscles in front of the thighs: contract the thigh muscles by straightening the lower limbs, maintaining them for 5 to 10 seconds each time, and do it 10 times in 10 minutes, until you feel slightly fatigued.
Straight leg elevation movement: contract the thigh muscles, know your lower limbs in bed completely straight in the case of contracted muscles, from under the bed to raise the lower limbs a few centimeters, maintain to 5-10 seconds, repeat until slightly feel fatigue. (Do this exercise after 21 days)
Post-operative rehabilitation of hip joint replacement
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, inform the rehabilitator and make it clear to the patient.
II. Rehabilitation during hospitalization
Early postoperative rehabilitation procedures
1.When carrying the patient after surgery, bind the triangular pads between the knees so that the hip joint is abducted 10~20 degrees to prevent dislocation when carrying.
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. On the first day after surgery, remove the lower limb cushion and 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; isometric contraction exercises for quadriceps and gluteus.
Day 4-7 physical therapy program
1.Hip joint straightening exercises, do active hip straightening on the operated side, or put a pillow under the hip to fully stretch the hip flexors 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 internal and external rotation and extension position.
Rehabilitation from one week after surgery
1.Bed exercises
Do 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 in which 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 armrest, add cushion, back up, watch the position, hold steady with both hands and sit down slowly.
Hip flexion should not exceed 90 degrees, and sit in a higher chair.
3.How to get down to the ground
From 3 days to one week after the operation, the patient can go down to the ground for rehabilitation exercises on the 3rd day after the operation because the prosthesis is cemented and it is the first hip arthroplasty and there are no bone graft or fracture during the operation.
In the case of the porous surface bone growing-in prosthesis, walking exercises cannot be started until at least 6 weeks after surgery. In patients with large trochanteric osteotomies and intraoperative femur fractures, walking exercises should be delayed even more until at least 2 months postoperatively, depending on the radiographs.
Place the walker next to the leg on the surgical side and move the body toward the bedside.
Move the surgical leg under the bed to prevent external rotation of the surgical hip.
Move the healthy leg under the bed in the same direction, turn the body upright and hold the walker to stand.
4.How to stand up exercise
Posteriorly extend the lower limb on the operated side, lift the head and chest, and stretch the hip capsule and hip flexor muscle group.
Abduct the lower limb on the operated side, stretch the hip joint adductor and abductor muscles.
Hip flexion exercise, raise the affected limb, put it on a stool, and lean forward with your upper body.
5.How to walk with a walker
First, use the walking frame to assist walking, and when the center of gravity is stable, switch to the bilateral axillary cane. First place the walker 20 cm in front of the body, take the operated leg first, then the non-operated leg to follow. So on and so forth.
6. How to go up and down the stairs.
When going up the stairs first step the healthy limb up the steps and then step the operated limb up the steps.
When going down the stairs, first move the crutches to the next step, then move the operated limb down the step, and finally move the healthy limb down the step.
7.How to walk with the crutches.
III. Discharge plan
For patients with initial artificial hip arthroplasty, discharge is required to achieve.
1.Patients should have the ability to take care of themselves after discharge, and they should be able to walk on their own without the help of others and sit up independently.
2. There is no sign of any early postoperative complications.
3.The patient and family members have mastered or understood the post-discharge rehabilitation plan and can implement it well.
Post-discharge precautions
1.Crutches must be used until there is no pain and limp before abandoning crutches.
2. Avoid sexual intercourse for 6 to 8 weeks after surgery.
3.Avoid heavy physical activities and participation in sports such as disco dancing that require a wide range of strenuous activities of the hip joint to reduce the occurrence of joint dislocation, fracture and prosthesis loosening.
4.Avoid placing the hip joint in a position that is prone to dislocation.
5.Avoid walking on unsmooth and uneven surfaces.
6.Keep the lower limb in neutral position and do not flex the hip more than 90 degrees within 6-8 weeks.