I. Can the back and leg activities return to normal after the artificial hip replacement (THA) surgery? Through rehabilitation training, patients can basically return to the normal level of activity after artificial hip replacement, that is, they can do all kinds of activities in life. However, there are certain prerequisites to achieve this result: 1. The disease that caused the hip replacement is not some special disease. If the patient needs hip replacement because of rheumatoid arthritis, ankylosing spondylitis and other diseases, then even after the joint replacement, the patient may have multiple joint deformities because these diseases existed before the surgery or continue to develop, and some patients may even have spinal deformities, such as anterior arch, retroflexion and scoliosis. These spinal and joint deformities will to a certain extent affect the use of the artificial hip joint, which in turn will prevent the patient from returning to the normal level of activity; 2. If the hip joint lesion is caused by common femoral head necrosis, femoral neck fracture and other diseases, these patients should ensure that no hip joint dislocation occurs within six weeks after the artificial hip joint replacement. Once hip dislocation occurs, timely reset and restriction of activities are required, and if repeated dislocation is also considered, such as secondary revision, even after rehabilitation training, it will take longer to recover to reach the level of normal human activities. For the above two prerequisites, the first point cannot be changed by the patient after surgery because of the nature of the disease, so there is nothing that can be done. However, for the second point, the patient is capable of doing so. To prevent artificial hip dislocation, patients should try not to sit on a low stool or a shorter sofa until six weeks after surgery, although they can do such movements as sitting and standing. In addition, do not do stilts or cross-legged movements within six weeks, and every time you turn over, you need to hold a pillow between your legs if the affected side is on top. For squatting, it is generally recommended to do it after three months or six months after surgery, and especially not within six weeks after surgery. In addition, there are certain requirements for the time that patients should walk after surgery: within six weeks after surgery, patients can walk slowly with the help of a walker three times a day, morning, noon and night, but they only need to walk for about 15-20 minutes each time before sitting down to rest; after six weeks after surgery, this time can be extended to about half an hour each time. If the patient walks for too long each time, it will increase the pressure on the artificial hip joint in a short time. At the same time, edema of the affected limb may easily occur, and muscle pain may be caused by the long activity time, which will affect the recovery process after surgery. Second, artificial hip joint replacement (THA) post-operative rehabilitation: six weeks is the dividing line Do not rush to carry out rehabilitation training after artificial hip joint replacement surgery. Because the hip joint is a ball and socket joint, it has a stabilization process when fitted with an artificial hip joint. In order to prevent dislocation of the artificial hip joint, in principle, do not do too many activities within six weeks after surgery, you can walk slowly with the assistance of a walker, and the real rehabilitation exercise should start after six weeks after surgery. How to prevent blood clots within six weeks after surgery? 1. Use plantar IV pump (usually done in the hospital): Generally, you can start using plantar IV pump on the second day after surgery and insist on it for a week to effectively prevent blood clots. Because although patients can go down to the ground soon after surgery, they still need to restrict their activities, and when they do not go down to the ground, the plantar vein pump can help patients do contraction activities to squeeze the veins and increase blood return, thus preventing blood clots, which can be said to be a kind of passive contraction training. 2, calf muscle contraction training to promote blood circulation. The specific training method is: the affected limb is placed on the bed as straight as possible, the toes are stretched to the head side of the back to the maximum, the muscles on the leg as tight as possible, adhere to 5-10 seconds, and then relax, and then continue to practice, each time to carry out 20 groups, 2-3 groups per day. This is an active contraction training to prevent blood clots. 3, flexion and extension activity training of the axis, mainly including active bedside sitting gravity natural dip and passive CPM machine assisted training, etc. Six weeks after surgery, how to rehabilitate Waiting for six weeks after surgery, the real rehabilitation training begins. Patients need to do abductor training, which is the most important training after hip arthroplasty. The abductor muscles of the hip joint include the vastus lateralis, gluteus medius and gluteus minimus. These muscles can not only abduct the hip joint, but also play a stabilizing role in weight-bearing sports, especially when walking to stabilize the pelvis and maintain body balance. To exercise the abductor muscles, mainly rely on side leg raising exercises, lying on the side in bed or standing position can be. The specific method is: the patient lies on his side, the affected limb is on top, first of all, the affected limb is abducted, that is, the leg is lifted, the ankle and toe are hooked upwards, and the other leg is at 45 degrees, on this basis, then the affected limb is stretched to the back side, insist on 10 seconds, then relax for 10 seconds, and then continue the training. Daily 10-20 times in the morning and 10-20 times in the afternoon. Usually after 6 weeks of training, the pain will be significantly relieved and the walking limp can be improved. At the beginning of the training, if the strength of the abductor muscle is very poor, you can only train standing first, lifting the leg to the side; after training for a period of time, the muscle strength will increase, and then gradually switch to lateral recumbent exercises. It is worth noting that after knee replacement, patients are often asked to do quadriceps exercises for straightening and raising the leg, but such exercises are not recommended after hip replacement because they tend to put a lot of pressure on the hip joint. Straightening and lifting the leg requires the thighs to exert force, so the raised leg is equivalent to a prying lever, using the weight of the whole leg to pry the newly replaced hip joint, which is very dangerous. Therefore, it is not recommended to do straightening and leg lifting after artificial hip replacement, and just do the exercise of hooking the foot without lifting the leg when lying flat in bed. Third, THA rehabilitation training pain, two conditions are normal Post-operative rehabilitation training of artificial hip arthroplasty helps patients to return to normal activity level as soon as possible, however, pain will inevitably occur in the rehabilitation training, then the emergence of pain need to terminate the training? In fact, no matter what kind of training a patient does at home after surgery, the intensity of the training will basically lead to leg pain or wound pain. If the pain disappears after stopping training, you can resume training. The intensity of training should be the same as before, do not reduce the intensity of training because of pain. However, it is worth noting that if the pain does not disappear after stopping training, but continues, it is necessary to seek medical attention. In addition, after artificial hip replacement, many patients have similar experiences: the bones hurt when they walk a little. In fact, it is quite normal to experience this phenomenon within three months after surgery. This is because patients with artificial hip replacements do not start training their muscles until six weeks after surgery, which often results in the patient’s muscles not being as strong as they could be. A joint without muscle protection is like losing a lubricant, and two hard objects can come together, causing a sensation of collision and sometimes pain. Therefore, after the replacement of the artificial hip joint, patients often have the feeling that “the bones hurt when they walk around”. However, if the pain is not relieved after more than three months, it is necessary to go to the hospital to check the blood sedimentation, C-reactive protein and other items to consider whether there are other problems. Fourth, after hip replacement surgery, what kind of movement is considered moderate? After the artificial hip replacement, some patients do not pay attention to the protection of the new joint and think that the joint will be replaced and they can rest easy; some patients are overly concerned about the new joint and are careful about everything they do. So, after artificial hip surgery, what kind of exercise and diet is “moderate”? 1, within six weeks after surgery, it is not recommended to do squatting, shoes and socks; six weeks after surgery, shoes, socks, walking, jogging, swimming and other behaviors can be carried out. If some patients are unsure and think that six weeks after surgery is too early, they can also postpone it to three months later; 2. After artificial hip replacement surgery, it is not completely impossible to “stilt” or cross your legs. It is just that these behaviors should be done only after the patient has recovered well for three months after surgery. If you do “stilts” or cross-legged actions within six weeks after surgery, it is likely to lead to hip dislocation, which is very dangerous; 3. Patients should not sit for a long time after surgery, because sitting for a long time is a test for the hip joint and lumbar spine. Generally speaking, this “long time” refers to more than 30-40 minutes. In other words, it is recommended that patients sit for 30-40 minutes and then stand and walk for a period of time; 4. When going up and down stairs after surgery, patients should pay attention to “good up and bad down”, that is, the leg on the healthy side goes up first when going upstairs and the leg on the operated side goes down first when going downstairs. In addition, within three months after surgery, patients should try to hold the handrail when going up and down the stairs. On one hand, the joint may not be very stable after hip replacement; on the other hand, patients may fall after surgery due to muscle weakness. However, three months after the surgery, if the patient has recovered well through the side leg lift exercise, there is no need to be so careful; 5. If the femoral head necrosis is caused by alcohol consumption, and then the hip joint replacement is needed, it is still recommended to quit drinking or reduce alcohol consumption even after the new joint is replaced. This is because continued drinking after surgery may lead to necrosis of the femoral head on the opposite side (the good side) and may also cause damage to the liver and kidneys; 6. There are not many cautions in terms of diet after artificial hip replacement, and there is no need to avoid eating because of surgery. Fifth, how to sleep after artificial hip replacement For patients who have only one side of the artificial hip replacement, they often feel confused, can they sleep on their side after the joint replacement? Will sleeping on your side “crush” the new hip joint? In fact, patients can sleep without any worries 1-2 days after the surgery, not necessarily 6 weeks or 3 months after the surgery. The body has natural “protective measures”, such as the muscles and synovial fluid around the joint, which protect the joint at all times. In addition, hip replacement surgery should be fixed very firmly during the operation. If the hip is not fixed properly, it can go wrong even if you do not press on the joint. On the other hand, if the hip joint is firmly fixed, it is very unlikely that you will have any problems with it even if you press on it. It is important to know that after hip replacement, the artificial joint will be used for 20-30 years, or even longer, and it is impossible for the doctor to let the joint loose after a sleep. However, it is worth noting that within six weeks after the artificial hip replacement, if the patient sleeps on his or her side, he or she must add a pillow between his or her legs if the affected side is on top, so as not to let the two legs come together; while the affected side is on the bottom, instead of adding a pillow, he or she can sleep without any worries. Sixth, after artificial hip replacement: teach you how to insoles Unlike knee replacement, hip replacement involves the length of the two legs, most of the patients have a leg longer or shorter after surgery. If the affected leg is longer after surgery, insoles should be placed on the healthy side, and vice versa. If the difference in the length of the bilateral limbs after surgery does not make the patient feel uncomfortable, there is no need for insole treatment at this time. If the difference in the length of both lower limbs after surgery makes the patient feel uncomfortable, insoles can be chosen. Seven, artificial hip joint replacement wound pain after surgery to find the cause before treatment artificial hip joint replacement, many patients have reflected that although the doctor said the surgery was successful, but the wound has been pain. So, is this pain caused by the surgery? What should be done? In fact, a large incision is needed to remove the “bad bone” and put in a new joint. It is impossible to have such a large operation without any pain in the wound afterwards, but this pain should be treated differently in each case. If the wound is painful within six weeks after surgery, the patient should not be overly stressed. Because this pain is the tissue damage caused by the surgery, causing an inflammatory response, only some non-steroidal anti-inflammatory analgesics are needed. For patients with stomach disorders, drugs that are less irritating to the stomach can be considered. In addition, some blood-activating drugs can also be used appropriately. In conclusion, most pain within six weeks is sterile inflammatory pain and can be solved by taking medication. However, if the patient thinks that it is just a minor problem and that he or she can carry it on his or her own without taking any medication, the untreated inflammation may further damage the patient’s joint, with unimaginable consequences. Six weeks after the artificial hip replacement surgery, the wound and the joint capsule should have basically healed and functioned well. If the patient is still experiencing wound pain at this time, an active search for the cause is required. Generally, there are several reasons for pain more than six weeks after surgery: 1. Pain caused by infection. If the patient still has recurrent pain after more than six weeks or three months after surgery, especially if there is obvious intermittent pain and night pain, infection needs to be excluded first. At this time, it is necessary to actively seek medical attention, review the two indicators of blood sedimentation and C-reactive protein, and ask the attending surgeon for diagnosis and treatment; 2. Pain caused by muscle training. Six weeks after the surgery, the patient needs muscle strength training. If the training is poor, the patient will feel soreness in the hip joint or soreness near the outer hip joint after walking for a little time. At this time, the pain can be relieved by abductor exercises; 3. Pain caused by other reasons. If you have sudden pain more than six weeks after surgery, or if you have joint locking (i.e. the joint suddenly gets stuck during the activity and cannot be extended or flexed, then there is usually sudden pain), you need to consider whether there is hip dislocation or fracture due to trauma, then you need to actively seek medical treatment. What should I do if there is swelling after hip replacement? After the artificial hip replacement, many patients will have swelling of the lower limbs for a long time. The reason for the swelling is that in the process of hip replacement, the doctor has to loosen the tissues and muscles around the hip joint so that the muscles can be relaxed to facilitate the surgery, which will inevitably hurt some small blood vessels that are not very important. When the blood vessels are affected, the blood circulation becomes poor and the venous return is not good, which will lead to swelling of the lower limbs. In particular, the hip joint is in a more important position, and the blood flow to the lower extremities has to pass through the hip joint, so the lower extremities are more likely to be swollen after surgery. Usually, patients will have obvious swelling of the lower extremities during the afternoon and evening hours after rehabilitation, and the swelling of the extremities will disappear after a night of lying down and resting. After six weeks or three months after surgery, if swelling of the lower extremity still occurs, especially compared with the other leg, the swelling of the affected leg is more obvious, it is recommended that the patient go to the hospital for a venous ultrasound of both lower extremities to exclude the possibility of lower extremity venous thrombosis. It is important to know that the typical symptom of lower extremity venous thrombosis is swelling of the limbs, and if left untreated at this time, it may lead to pulmonary embolism due to dislodgment of the thrombus. Therefore, at this time, if there is venous thrombosis in the lower extremity, this is the time to treat the thrombosis. If the ultrasound is done and it is determined that it is not a lower extremity vein thrombosis, in order to eliminate the swelling, the patient can use some drugs that have a decongesting effect on the blood vessels. At the same time, the intensity of rehabilitation training such as walking should be moderately reduced, and the affected limb should be elevated to promote blood circulation and smooth venous return. Nine, artificial hip joint replacement infection is a disaster after surgery After artificial hip joint replacement, patients need to be especially careful about joint infection, because once the infection occurs, patients have to face another or even multiple operations, which can be a catastrophic consequence. Nowadays, the minimum infection rate after artificial hip replacement is basically controlled at 1‰-2‰ worldwide; in China, the post-operative infection rate is basically between 2‰-5‰. Generally speaking, the following three groups of people are prone to infection: 1, patients with poor resistance; 2, patients with preoperative diseases such as diabetes and anemia, resulting in poor function of other organs; 3, patients with poor skin conditions and a history of trauma before artificial hip replacement; 4, patients taking hormones or immunosuppressive drugs for a long time. In addition, it is worth noting that the rate of postoperative infection varies for artificial hip replacements due to different etiologies. Among them, patients who need artificial hip replacement due to inflammatory arthropathies such as rheumatoid arthritis or ankylosing spondylitis have a postoperative infection rate 2.7 times higher than those due to femoral neck fracture and femoral head necrosis. Therefore, it is recommended that such patients use antibiotics prophylactically for 1-2 days before surgery; use antibiotics for a slightly longer period of time after surgery; more than two years after surgery, if there are foci of infection in other parts of the body, such as skin infection, urinary tract infection, pneumonia, etc., antibiotics must also be used to escort the patient. X. How long can the artificial joint be used after total hip replacement? How long can the new joint be used after the artificial hip replacement is a great concern for patients and their families. In fact, with the widespread use of new technologies and materials, the service life of artificial hip joints has been greatly improved. For example, ceramic technology has evolved from the first generation to the fourth generation, and polyethylene lining has evolved from ordinary polyethylene to cross-linked polyethylene, to the use of highly cross-linked polyethylene now, which is increasingly wear-resistant. It was found that the wear condition is less than 0.1 mm per decade. It is safe to say that with the use of new materials, the rate of prosthesis failure due to friction has become lower and lower. In addition, the design of artificial hip joints is becoming more and more consistent with human anatomy and physiology. For example, technology now allows the patient’s own bones to grow inside the artificial hip joint, so that the fixation between the hip joint and the bones is more secure, ensuring the longevity of the new joint. From the latest literature, as well as many registry systems, such as the Swedish registry system, the American registry system, and the British registry system, it is found that the excellent rate of artificial hip joints after 15-20 years of use is 90-95%, except for factors such as infection and trauma. In other words, 20-30 years after the artificial hip joint is installed, 85-90 out of 100 patients can still continue to use it. Eleven, three cases of hip replacement immediately after surgery With the continuous development of technology and the continuous improvement of surgical techniques, artificial hip replacement, patients need to be hospitalized for a much shorter period of time, many post-operative rehabilitation training and care, are gradually transferred to complete at home. However, patients are often hesitant to seek medical help because they are not professionals and they are afraid that they will have a big problem if they do not seek medical help, but they are afraid that it will be a false alarm. In fact, if a patient has the following symptoms, he or she needs to seek immediate medical attention: 1. dislocation of the hip joint. You should know that even if it has been many years since the artificial hip replacement, the hip joint may be dislocated due to improper posture or trauma. If you find that the wound is red and starts to flow pus and water after surgery, then you should highly suspect infection and need to seek immediate medical attention; 3.Persistent pain after surgery. Patients can feel pain all the time after surgery, even if the pain increases, it is also necessary to promptly seek medical attention. Twelve, artificial hip joint replacement post-operative consultation guide For patients with artificial hip joint replacement, after the joint is replaced, it is not easy to rest, regular review and monitoring of the joint is essential. Generally speaking, in the first year after the artificial hip replacement, you need to visit your surgeon for four times, six weeks, three months, six months and one year, respectively; after one year of surgery, patients can review once a year according to their recovery. The post-operative review does not require a new X-ray or other examination every time. Generally, the six-week post-operative review does not require X-ray, blood sampling, etc. This time requires patients to come to the hospital, mainly to check the healing of the wound and the presence of other uncomfortable symptoms, such as whether the wound feels painful. And in the three reviews, three months, six months and one year after surgery, patients are required to have X-ray examinations. It is especially important to note that for patients with artificial hip joint replacement, they need to stand up for each X-ray examination in order to ensure the effect of the examination. As for blood sedimentation, C-reactive protein and other tests, it is recommended that they be done when infection is suspected.