Disease guidelines & Preoperative preparation & Postoperative rehabilitation for hip replacement

JUST College is committed to the multi-dimensional popularization of precautions for daily use of joints, correct understanding of joint diseases, pre-operative preparations and post-operative rehabilitation. Through the way of entertaining and entertaining, patients benefit a lot.

Disease guidelines

Reasons for hip replacement

1. Classification of hip joint diseases With the continuous development of medicine, the research of joints continues to penetrate into the clinic, and the treatment of certain joint diseases by joint replacement has been paid more and more attention. Hip replacement can be roughly divided into the following reasons:

1) Old femoral neck fracture (femoral head and neck damage, pain affecting function)

2) Avascular necrosis of the femoral head

3) Comminuted fracture of the femoral head and neck

4) Degenerative arthritis

5) Rheumatoid arthritis

6) Hip joint stiffness

7) Chronic hip dislocation

8) Arthroplasty

Preoperative preparation

Preparing for hip replacement surgery

1) Exercise (under the guidance of a doctor)

The best physical condition is an important condition for the success of the operation: strengthening the upper limb muscles will help you to use crutches after surgery. Enhancing the muscle strength of the lower limbs will help Sudan recovery time.

2) Medical examination

Before the operation, you need to do a medical examination to determine your physical condition and find some negative factors that are not conducive to the operation or recovery. For example, dental treatment-although the chance of infection after hip replacement is very low, bacteria can still be transmitted through the bloodstream. Therefore, any dental treatment should be performed before surgery.

3) Delay taking some drugs

The doctor will tell you which drugs (including prescription drugs) must not be taken before surgery.

4) No smoking

Avoid lung problems after surgery and promote early recovery.

5) Control weight

For obese patients, weight control will reduce the pressure on new joints.

6) Routine inspection

Routine blood and urine, cardiac ultrasound, chest X-ray, and chest X-ray are the items that must be checked before surgery.

7) History of allergy

Any possible allergic reactions, including allergic history of drugs, metal fibers, etc., must be notified to facilitate further in-depth preoperative examinations and to decide on alternative drug treatments or other types of replacement surgery.

Postoperative rehabilitation

Rehabilitation training after hip replacement   

Points of postoperative rehabilitation   

On the day of surgery: The special position of the affected limb should be maintained: supine position with pillows between the knees, knees and toes upward to prevent hip adduction and internal rotation. When the patient’s vital signs are stable, the semi-sitting position should be adopted as soon as possible; the patient should be instructed to initiate active contraction of the quadriceps, calf triceps, and tibialis anterior muscles to accelerate venous return and prevent deep vein thrombosis. Give ice packs for 24 hours to relieve pain, keep the airway open, encourage patients to breathe deeply, cough, and prevent lung infections.

The first day after surgery: Remove the plasma drainage tube and urinary tube in the morning, and use a walker to guide the patient to get out of bed and walk. In the afternoon, guide the patient to get out of bed again, and teach the patient to get out of bed, go to bed, and move correctly. Strengthen the muscles of both lower limbs. At the same time, patients should be given psychological support. The higher the enthusiasm of the patient, the faster the recovery.

1) Ankle dorsiflexion: Active maximum flexion and extension of the ankle joint and resistance training. Hold each action for 5 seconds, repeat 20 times/group, 2-3 groups a day.

2) Quadriceps training: do static contraction of the quadriceps, hold for 5 seconds each time, every 20 times/group, 2-3 groups/day; at the same time, the patient can do straight leg raising exercises on the bed, no The height is required to be raised, but there must be about 5 seconds in the air; slowly bend the knee and bend the hip to slide the heel of the affected limb to the hip, keeping the toe upward to prevent the hip from adduction and internal rotation. 

3) Resistance training: resistance adductor and resistance abduction isometric training, each movement is held for 5 seconds, repeated 20 times per group, 2 to 3 groups per day.

On the 2nd to 3rd day after operation: the patient should be more active, while strengthening the ankle dorsiflexion, plantar flexion and quadriceps training. On the 4th to 14th day after operation: the patient's fluid infusion was stopped, and the focus was on muscle strength exercise and increased joint activity. At discharge, hip flexion reached 70°～90°, abduction of 15°, and external rotation of 10°. Teach patients to walk with crutches and arrange a rehabilitation training plan after discharge. During this period, you should also perform supine straight leg elevation and knee flexion hip flexion training. And strengthen posture transfer training and joint mobility training. 2nd to 3rd weeks after operation: In addition to the above training, strengthen hip flexion, abduction, and external rotation. The training method must be correct to prevent joint dislocation. Train patients to walk on crutches. 4 weeks to 3 months after surgery: daily functional training should be carried out, and patients should be taught how to go to the toilet, put on and take off shoes and socks, ride in a car, and go up and down stairs. Patients who have not had a greater trochanteric osteotomy should abandon crutches and walk around 6 weeks. At the same time, patients should be asked to review regularly to prepare patients for their return to society.

Special note: The range of motion of the new joint is limited. Patients need to pay special attention to avoid joint displacement, including:

*Avoid crossing your legs and knees when sitting, standing, or lying down.

*Keep your feet 6 inches apart when sitting.

*Keep your knees below hip level when sitting. Avoid sitting in chairs that are too short. You can sit with pillows to keep your knees below hip level.

*When standing up from the sitting position, slide to the edge of the chair, and then stand up with a walking frame or crutches.

*Avoid bending over. Patients may consider buying long-handled shoe flaps or soft shoes so that they can put on and take off their footwear without bending over.

*When lying down, place a pillow between your legs to keep the joints in place.

*Use a special abduction bracket or splint to fix the hip joint in place.

* Raise the toilet position so that the knee is kept below the hip when going to the toilet.