Surgery a hip replacement (arthroplasty), and rehabilitation
Who needs a hip replacement — rehabilitation after surgery
The formation of the hip joint (TC) attributable to common synovial, with the participation of the two mating bones – the iliac and femoral.
Cup-shaped recess with the outer side of the pelvic bone (acetabulum) and the ball shaped bone of the femoral head together form the hip joint, which is a kind of articulated design.
The femoral head associated with the femur neck, which the common people call «hip». The inside of the acetabulum and the femoral head covered by layer of articular cartilage (hyaline).
Cartilage is elastic and at the same time, durable and smooth layer in the joint. Sliding in the joint, highlighting the joint fluid, distributes the load movement and the required amortization.
Around the head joint located the capsule, consisting of a very dense and durable fibrinoliticescoy tissue.
The attachment of the joint occurs using:
- Ligaments. External attached at one end to the femur, the pelvic. And the internal ligament of the head of the pelvic bone connects the head with the very vertline deepening of the pelvic bone.
- Muscles. They surround the hip joint – gluteal and back of thigh front. The better developed muscular frame joint, the less traumatic load on it when running, failed jumps and movements of heavy objects. More important is the fact that a good amount of strong working muscles with the blood delivers sufficient nutrients to the joint.
Using the hip joint provided at the same time these functionalities:
- the stability of the body (support, balance);
- a variety of movements.
Why affected joint
For obvious reasons, a matter of defeat are injury. Examples include a hip fracture, dislocation of the TS or subluxation.
It is not obvious – diseases (infectious and there is no arthritis, osteoarthritis, inflammatory processes in the joint and periarticular tissues).
At the same time develop various complications, which are expressed in damage of the pelvic components of the joint cartilage, capsule, bone.
Consider the main:
- inflammation of the pelvic joint is usually caused by arthritis of different etiology, bursitis, synovitis, etc.;
- pathology of deviation of the joint – dysplasia;
- necrosis in the head of TS in some areas of the bone marrow – non-infectious necrosis (avascular).
When and who needs a hip replacement
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Pain occurs in the hip joint is a signal that you should seek professional help to establish its causes. On the initial stage should undergo x-ray examination of the vehicle.
Solution for worn or permanently injured joint can be a hip replacement, which can be shown in such cases:
- not fused fracture of the head of the vehicle;
- fractures of the femoral neck or acetabulum in patients of advanced age;
- aseptic necrosis;
- tumor disease the vehicle;
- deforming arthrosis of the third stage;
- congenital dislocation of the hip, etc.
What types of surgery offers medicine
In modern medicine to patients according to the type of prosthesis, there are three kinds of operations:
- Replacement vehicle surfaces – removal of the layers of cartilage of the acetabulum with the artificial material and turning of the femoral head with her donning the metal cap. Slide, thanks to a replacement of the articular surfaces, is achieved close to natural.
- Partial dentures – replacement, for example, the head of the pelvic joint with part of the neck of the femur, the articular bed.
- Full dentures – removal of the entire hip joint and replacing it on EP (endoprosthesis).
Types of implants
In modern medicine there is more than six dozen modifications of implants. They are classified according to the method of fixing and the material. Ways of fixing today are three:
- cementless fixation is due to the fact that the bone grows into the joint surface EP;
- cement – prosthesis is fixed using special bone cement;
- mixed (hybrid) – the Cup is fixed without bone cement and stem – cement.
Modern combination of materials used to make dentures, are selected depending on the patient’s disease, his age and lifestyle. They can be as follows:
- metal – to-metal;
- metal – the plastic is very high quality;
- ceramic – on-ceramic;
- ceramic – on- plastic.
Preparing for surgery
All the necessary information for the preparation of the operation will be outlined by your doctor.
However, there are times that the patient will have to prepare in advance (especially those who are lonely).
Since the rehabilitation after replacement arthroplasty continues at home, you should prepare your home for post-operative recovery period:
- to acquire special equipment in the form of a Walker or crutches, special toilet seat and so on;
- to stop taking certain drugs (aspiranturas, anti-inflammatory);
- if you need to reduce your weight;
- physical education;
- to visit the dentist;
- give up bad habits (Smoking).
Hospitalization is usually 2-3 days before surgery. These days, the need for an extensive examination of the patient is a versatile blood tests, research of already existing diseases with the consultation of appropriate specialists.
Before the surgery, the patient is obliged to execute the necessary documents (transaction for cash under the contract within the insurance or quota of the Federal program of providing free high-tech medical aid); to talk to the anesthesiologist about the most favorable option of anesthesia; at least 12 hours before surgery to stop eating.
Surgery to replace the joint
Recent advances in medicine allow for as open surgery for endoprosthesis replacement of the vehicle, and minimally invasive and minimally invasive.
Today, minimally invasive surgery (MIS) are the most common because of its minimal effects on the body.
For IOS you need:
- high qualification and professionalism of the surgeon and all medical staff;
- the availability of technical capabilities (endoscopic equipment, high-tech materials).
Depending on the complexity of the operation (partial or complete dentures) time it can last from one to three or four hours:
- the installation of the catheter into the urethra (to prevent involuntary urination and control the amount of fluid produced by the body);
- cut the outer part of the thigh (or two small in the thigh and in the groin area);
- delamination and shearing of the tissues around the vehicle;
- installation of the prosthesis;
- the restoration of the integrity of the fabrics and stitching of the wound.
The video clearly shows the hip arthroplasty.
Any surgical intervention in the body can have negative consequences. Procedural complications occur most often in surgical:
- with great deformity of the joint;
- obesity or large muscle mass;
- have a number of serious comorbidities – diabetes, blood diseases, heart and the entire SSS, etc.
Joint replacement may cause the following complications:
- not the correct position of the endoprosthesis;
- damage to nerve fibres, arteries;
- disruption of postoperative wound healing;
- the occurrence of infections;
- fracture of the femur, luxation or «jumping» of the prosthesis;
- thrombosed phenomena in deep-lying veins.
Rehabilitation after surgery
Rehabilitation after endoprosthesis can be long and can take up to 6 months.
The patient needs to monitor the seam temperature of the body and its sensations. The pain in this period can pass and return, the patient should be prepared for this and to make efforts for the full restoration of impellent functions of an organism.
The first few days the patient is prescribed painkillers, anti-inflammatory.
Further rehabilitation after hip replacement is the appointment of a special light exercises and breathing exercises.
To prevent cicatricial contraction of the tendons and of the skin, to strengthen the muscle around the frame of the prosthesis, the patient is prescribed therapeutic exercise (physical therapy).
As indicated by reviews of the patients who was performed arthroplasty, it should be possible to follow the recommendations of experts and then rehabilitation will be quick and almost painless.
Experts ‘ recommendations of how to move and sit, what kind of load to allow for rehabilitation (weight training – running, jumping – to clean, to swim) will allow patients to promptly return to normal functioning.
How is the rehabilitation after surgery on the hip joint is described in detail in the video.
Where it is possible to do the surgery in Russia
Operation prosthetic TC is a high-tech process.
In 2015, the inclusion of hi-tech medical aid (VMP) in the system of mandatory health insurance is provided by the new legislative draft «On mandatory medical insurance in Russia».
So here we will not specify, who will pay for the operation – the patient or insurance company.
The price of hip replacement consists of a prosthesis and the operation itself. To date, the cost of the surgery (total hip arthroplasty) is from 210 to 300 thousand rubles (depending on the cost of the prosthesis).
Replacement hip joints are doing in Russia in the Federal budget institutions of health (FTS of traumatology, orthopedics and endoprosthesis, regional clinical hospitals, research institutes) and private clinics of the Russian Federation.
- JSC «Medicine»;
- Clinic Of Family;
- City clinical hospital No. 67 (Moscow);
- KB MSMU n. a. Sechenov;
- CDB SCIENCES;
- Multidisciplinary medical center «K+31»;
- CST im. Semashko;
- Hospital # 2 of JSC «Russian Railways», etc.