hip arthroplasty performed in clear violation of its features, such as worn or serious injuries.During the operation to complete joint replacement, damaged its surface changed to compatible design to ensure a painless, progressive movement of the joint.In some cases, this operation should be carried out?
Indications for surgery on the hip joint
Some people who suffer from hip disease require surgery.However, instead of having to make the joint replacement, for many years, patients suffer severe pain, loss of life in every way.This often occurs for two reasons - lack of awareness of the patient or because of fear of the operation.Meanwhile, some kinds of surgery with minimal impact allows to keep the head of femur.
Indications for surgery for hip replacement:
- hip fracture in the elderly.
- Severe hip osteoarthritis.
- impossible to restore the glenoid cavity after fracture.
- Certain types of head or hip fractures, which occurs due to insufficient blood supply to the fragments, leading to necrosis.
- tumor in any part of the joint, requiring resection.
- Pathologic fractures arising from bone defects such as osteoporosis and others.
- Ankylosing spondylitis.
- Osteonecrosis of the femoral head or a false joint of his neck.
Preparing for operation of endoprosthesis
just a few weeks before the operation begins training, which is a medical examination and obtain a permit for hip replacement.An examination of the doctor will examine you, after which you will pass a number of tests and X-rays pass.When you are admitted to hospital, the anesthesiologist will decide what type of anesthesia will be used.
Before hip replacement is necessary to identify all the other existing illnesses you.This survey is conducted in parallel with the examination before admission - only by having full information about the patient's health, doctors will be able to influence the course of prosthetics and recovery process.For example, upon detection of a chronic disease that requires treatment, doctor appointments optimizes the circuit with a colleague who specializes in this disease.
hip replacement involves special training, which includes:
- Conducting special training under the supervision of a physician.Good physical shape facilitate rehabilitation after joint replacement.Thus, strengthening the muscles in the arms and torso to simplify the use of crutches, and strengthening exercises for the legs will reduce the time needed to recover from a hip replacement.
- weight control.In the presence of excess fat deposits, it is necessary to reduce weight - this will reduce the load imposed on the prosthetic hip joint, and hence it will last longer.Training
- walk on crutches.This skill will help to recover faster and get up early to start walking.
- visit to the dentist.Despite the fact that the infectious complications after replacing TBA (hip) are rare, the risk is still there.If any part of the body has a center of infection, it is likely that the bacteria get into the bloodstream.Protect yourself by making all dental procedures (tooth decay cure, seal the teeth).
- Before prosthetic hip turn in the blood, if the doctor suggests that you need a blood transfusion during surgery.
- Quit smoking.This will reduce the risk of post-operative problems with the respiratory system, improve the healing process, reduce the possibility of complications.
- Stop taking certain medicinal products.Your doctor will tell you which medicines should not be taken before the hip replacement.Call the surgeon all means, including non-prescription, you are taking.Certain funds may cause lymphatic complication.
How is the procedure for replacing the joint
Replacement TBS carried out under anesthesia (general or local).The duration of operation is not less than 45 minutes and not more than 3 hours.The patient lies on his side or back, the joint is opened through the buttock, lateral or peredbokovoy access.Fascia and muscles apart clamp, the doctor cuts the joint capsule and resecting it.The head of the femur is removed, cleaned acetabulum (to remove cartilage).If the prosthesis should be fixed with cement on the surface of the acetabulum solution is applied, after which this part is installed an artificial hip.
Cup prosthesis can be fixed by special screws.Further there is a trial installation of the distal region of the prosthesis, at this time it is checked whether it is suitable cup.With the positive outcome of the doctor conducting the selection of the medullary canal.It is inserted into the leg of an artificial hip, the head of which is introduced into the acetabulum or cup.The wound is sutured in layers, with a parallel installation of subcutaneous and subfascial drainage.The ending of the operation becomes a limb immobilization.
How long rehabilitation after surgery
After discharge from the hospital, the doctor for the patient develops a rehabilitation program that includes several stages.During the recovery period, the patient becomes accustomed to the new joint, learning to walk, move and gradually restores the load on the legs.When can I go after replacing the TBS?The rehabilitation period lasts for a couple of months.However, in some cases (such as the elderly patient) recovery period may take up to 5-6 months.Move around with the help of crutches may be already in the first week after surgery.
Rehabilitation after joint replacement
On the first day after replacing TBA better to stay in bed.If you want to make certain medical procedures (changing dressings, checking vital signs, measurement of temperature and pressure), you will be taken on a gurney.Your doctor will tell you how to behave in the recovery period of the thigh.Rules to be observed in the first days after hip replacement and before the end of the rehabilitation period.Here are the basic tenets of post-operative:
- To prevent dislocation of the hip joint, it is necessary to adhere strictly to the rules of the right angle.Do not cross your legs, do not bend them more than 90 degrees, do not squat.Hop on this furniture, in which the bending of the joint will be at right angles.
- Lying on the bed, do not try to pull up to the top of the blanket, located in the legs.Ask someone for help or use of any device.
- Not Buy Shoes without a spoon.
Exercises after joint replacement are needed to normalize the blood circulation of feet and protect them from blood clots.Medical articular gymnastics is needed in order to develop and strengthen the hip muscles of the legs.Some exercises will seem difficult feasible, but they are necessary for the prompt restoration of the legs and reduce postoperative pain.If the doctor did not say otherwise, do recreational exercises three times a day.
- Exercise "pump."Lying on a bed or sitting on a chair, slowly lower down and lift up the foot.Repeat the operation with the feet every 10 minutes.Exercise should be done before full recovery.
- Exercise "Rotation".Carry out the operated leg foot circular motion clockwise and back.Apply only the ankle, not knee.Repeat step five times in both directions.
- Charging for 4 head thigh muscles.Tighten the front part of the foot, trying to straighten the knee as much as possible.During the exercise, try to push the back of the thigh to the bed.Hold 7-10 seconds of muscle tension.Repeat the operation for each leg 10 times.
- Bending knees.Slide the heel on the bed up to the side of the buttocks, bending the knee.Stop when the knee joint angle is 90 degrees.Repeat the exercise 10 times.
- voltage gluteal muscles.It is necessary to reduce and hold them for 5 seconds in suspense.Repeat 12-15 times.
- Leads legs.Maximum take aside operated leg and return it to its original position.Repeat the exercise ten times.
- Raise straight legs.Fully straighten lying to his feet and begins to raise them one by one by a few centimeters up from the bed bed.Repeat 10 times for each leg.
electromyostimulation and massage
During rehabilitation after replacing TBS, along with charging procedures are carried out to strengthen the muscles of the legs and the normalization of trophic tissue.For this purpose, carried electromyostimulation muscles of the buttocks and thighs, as well as therapeutic massage the feet.Active-passive gymnastics, in which the patient is involved in the procedure, is considered the most effective.The man further reduces thigh muscle simultaneously with the electrical impulses.The procedure takes 15 minutes and is performed several times a day.It helps to mobilize the central nervous system and activate the metabolism in the muscles of the legs.
Another effective means during the recovery of the hip is considered a massage.It is highly recommended, since 3-4 days after joint replacement.Massage is shown at a 2-sided lesions of hip joint when severe stress faced by the healthy leg, can stimulate decompensation and violation of its support ability.Starting with the third week (after removal of sutures) should start to massage the operated limb.And Careful massage techniques are applied without causing the patient discomfort or pain.
Possible complications and how to live
- Thromboembolism.Blood clot breaks away and blocks a blood vessel.This complication is rare.If the patient does not do the prescribed exercises, moves little, he formed blood clots, which can lead to swelling of the legs, stroke or heart attack.For the prevention of thromboembolism, doctors prescribe anticoagulants - anticoagulant drugs.
- Zagnoenie incision.Infection - a rare but serious problem with TBS replaced.It may require the Audit prosthetics.The doctor advises special procedures that reduce the risk of infection of the hip joint prosthesis.
- dislocation of the head of the prosthesis.To prevent, follow the rules listed above (not cross your legs, keep the right angle in flexion).When dislocation of the hip joint, seek medical attention immediately.
- wear or loosening of the hip prosthesis.The symptoms - pain, limiting movement of the prosthesis in the bone resorption area.In such cases, revision surgery is required.
- Different length of the legs.It is not always possible to align the length of the legs, the problem is particularly relevant for patients with coxarthrosis.To compensate for this condition, patients are advised to use special pads for shoes.
- Pain in the groin - a relatively common problem in patients undergoing replacement of TBS.The reason usually is a side diseases as lumbar osteochondrosis.The patient in this case is necessary to address to the neurologist.
approximate cost of replacement
How much does the surgery for a hip replacement?
- Plank replacing TBA (without the cost of the prosthesis) - about 42 000 rubles.
- Operation Birmingham-technique (without prosthesis) - 50 000 rubles.
- Primary replacement TBS (without prosthesis) - 50 thousand rubles.
- revision surgery on the hip joint - 85-90 thousand rubles.
Olga, 54 years, Samara: I have a disability on a background of rheumatoid arthritis.In 2005, the first hip ill.The pain was very strong and did not stop when you change positions.The doctor has diagnosed - necrosis of the femoral head.exit other than joint replacement surgery, I did not find, therefore, without hesitation, I decided.The pain was gone and has not yet returned, the foot has fully recovered and is functioning normally.
Svetlana, 36 years, Saint Petersburg: A month ago I had a replacement TBS.The doctor left on the long-term sick leave, saying that you have to walk on a walker for at least a month.I did not wait a week before the appointed date and easily go without them.There is a slight limp, but not more than up to hip replacement.The sooner you decide on the operation, the better.Why endure the pain, if it is possible to get rid of?
Nikolay, 34 years old: As a teenager I was a bad fall from a bicycle, which resulted in three operations on the hip joint of the right leg.As a consequence - coxarthrosis and minimum mobility of the joint.After 10 years, there were pains in the thigh area, so there was a question about the joint replacement prosthesis on.The results were positive, in spite of the possible complications.Restores 3 months, but now with the foot is all right, and the pain went away.