I. Within three days after surgery.
1. On the day of surgery, after waking up, do ankle pump exercise to promote blood circulation and prevent blood clots in the lower limbs. That is: actively flex the ankle upward and downward with moderate force, maintain 5-10 seconds of sustained force each time, do 30 per group, and do more than 200 times a day. Alternate bipedal exercise. Do hip and thigh muscle slight contraction exercises; do bilateral calf muscle gentle massage.
You can do bilateral hip and knee passive flexion and extension exercises. The angle of hip and knee flexion on the surgery side does not have to exceed 60°. Lie flat, support the bed with the calf of the non-operated side every hour, lift the low back and buttocks, and do gentle massage care of the buttocks. Pay attention to various infusion line care. Do not eat on the day of surgery, and only drink a small amount of water intermittently after 6 hours after surgery to avoid abdominal distension.
2. On the first postoperative day (the day of surgery does not count), continue the ankle pump exercise. Continue gentle massage of the lower back and lower limbs.
The head of the bed can be shaken up 3-4 times, about 45°-60°, the duration varies from person to person; do deep breathing to prevent cardiopulmonary complications; drainage tubes and urinary catheters can be removed in the afternoon; urinary catheters can be removed on the next day for frail patients.
Those who are in good health can sit at the bedside for a few minutes to avoid postoperative postural hypotension.
3. On the second day after surgery, continue the ankle pump exercise. Continue gentle massage of the lower back and lower extremities.
Increase the number and time of sitting up. Remove the urinary catheter. Pay attention to perineal care after urination and defecation (keep clean and dry). Should sit at the bedside with the help of accompanying relatives in the morning and afternoon, with both lower legs hanging down, and perform adaptive exercises for the cardiovascular system and lower limb venous system.
II. Third postoperative day to three weeks.
Continue ankle pump exercises. Continue gentle massage of the low back and lower extremities. With pain control, relatives help can practice side lying (turning to the non-operated side). Continue to sit on the bedside and practice knee extension (progressively). Stand down on crutches and practice walking with crutches. The lower limb on the operated side should not be on the ground or can only be placed on the ground (free from weight-bearing) Can go to the toilet on crutches with the help of accompanying relatives, with special emphasis on perineal care for girls. The lower limbs on the operated side can be swung slightly forward and backward to do hip and thigh muscle exercises.
Third, three weeks to six weeks after surgery.
Should be able to complete indoor activities on her own with double crutches, dressing, getting up, going to the toilet, walking around indoors, etc.
Continue to use crutches, the lower extremity on the operated side can be slightly dropped to the ground with slight force (not more than 1/3 of body weight strength).
Strengthen quadriceps strength exercises, knee extension in standing position (for 10-15 seconds, 30-100 times/day), outward leg lift exercises in standing position, backward leg extension and forward leg lift exercises.
IV. Six weeks to twelve weeks after surgery.
Mainly straight leg raising exercises on the operated side (quadriceps strength exercises), straighten the knee joint in the horizontal position and raise it to 40° (for 10-15 seconds, 30-100 times/day); side lying, side leg raising exercises (gluteus medius strength exercises), lying on the side on the non-operated side, straighten the knee hip joint on the operated side and raise it upward about 15° (for 10-15 seconds, 30-100 times/day). Backward leg extension exercises in prone position (gluteus maximus strength exercises).
Lie flat on the bed, perform hip mobility exercises, hip flexion and knee holding exercises (10-20 times/day)
Walking on crutches, gradually increase weight-bearing on the lower limb of the operated side (1/3 – 1/2). Some young patients aged 13-20 years old, if there is no obvious pain, can perform single crutch walking exercises after ten weeks.
V. Twelve weeks to six months.
Continue to perform strength exercises for the quadriceps, gluteus maximus, and gluteus medius. If necessary, add 1-2 kg sandbags (rice bags, salt bags are available), tie them to the ankle and perform leg raising exercises.
According to the review of the film, if there is a large amount of bone scab growth, you can perform single crutch exercises for 4 weeks and gradually remove the crutches; if the bone scab growth is less, continue to use double crutches for 4-6 weeks and postpone the corresponding functional exercise for 4 weeks.
If there is no obvious pain and discomfort after removing crutches, you can practice squatting (3-5 minutes/time, 3-4 times/day,). Walking up and down stairs (3-5 minutes/time, 1-2 times/day).
Special emphasis on walking posture exercises, walking process of both feet landing time gradually the same, correct swaying, limping, shoulder crooked and other bad posture.
VI. After 6 months postoperatively.
You can perform simple walking for 30 minutes-1 hour, jogging for 15 minutes, swimming, cycling and other less intense sports. Although climbing, running, playing ball and other sports can be performed; to avoid aggravation of joint wear and tear, it is not recommended to participate in such activities for many times, and it is not recommended to participate in intense sports. It is recommended to maintain a moderate weight, appropriate lighter exercise, lighter physical work, avoid carrying heavy objects, etc., to help the long-term use of one’s hip joint.