Knee endoprosthetics rehabilitation

Surgical intervention is undoubtedly a very important point in the treatment of diseases of the knee joint. However, the rehabilitation period is an equally important stage.

It is from him that the future life and condition of the operated patient will depend.

We will learn more about how rehabilitation goes after knee replacement.

A few words about the operation and the importance of recovery after it

Endoprosthetics, that is, replacing a worn knee, is the only alternative to a wheelchair. Most of the load falls on the legs, so the likelihood of injury is huge.

As a result, complex pathological processes develop, which can be eliminated only by performing surgery to replace the knee joint.

Depending on the area of ​​damage, these types of arthroplasty are distinguished:

  • total – the knee joint is completely replaced by an artificial endoprosthesis, an operation is performed if the knee is damaged by more than 70%;
  • partial – the joint is damaged by less than 50-60%, only some part is replaced with an implant, this type of surgical intervention is more gentle, unlike the previous one.

The causes of damage to the knee joint can be many – excess weight, a jump from a height, a blow to the knee, etc. All these factors lead to impaired blood flow in the tissues.

Rehabilitation after surgery involves several stages. One of the most important is physical therapy (physiotherapy exercises), physiotherapy, drug therapy (if necessary).

The recovery period begins immediately after knee replacement.

A rehabilitation program is developed for each patient individually, depending on his physical data, neglect of pathology, concomitant diseases, etc.

After discharge, the rehabilitologist will give the patient a detailed list of gymnastic exercises that will need to be performed without fail.

Rehabilitation after prosthetic knee resists:

  • contracture – restriction in movement, inability to bend or straighten a limb in the knee or complete immobility of the joint;
  • with a strong load on the knee after surgery or, on the contrary, restriction of movement, the prosthesis is deprived of the opportunity to receive good nutrition, as a result of which its thinning develops, which in most cases leads to repeated surgical intervention;
  • further development of pathology;
  • synovitis – excess flu >

If you carefully follow all the recommendations of the doctor and responsibly approach the exercise, then this is almost a one hundred percent guarantee of the restoration of the knee joint.

Quality rehabilitation period

After surgery on the knee, the patient will feel pain. This phenomenon is absolutely normal. Thus, the body adapts to the new design.

After surgery to replace the joint, swelling and fever are not ruled out. To the question of when they will fall, doctors respond differently. Postoperative symptoms, on average, disappear by 3-7 days.

What stages the rehabilitation period consists of is indicated in the table.

StagesPeriodWhat are the goals?
Stage 1 – occurs immediately after the operationUp to 3 weeksTaking medications to prevent infection and
helping to relieve pain. Addictive to walking with crutches.
Stage 2 – earlyUp to half a yearStrengthening the muscles of the legs and partial restoration of motor activity of the joint.
Stage 3 – RemoteUp to one yearComplete restoration of movement and preparation of the patient for a full active life.

Next, we consider each stage in more detail:

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Postoperative stage

The postoperative stage begins as soon as the patient has withdrawn from anesthesia. Only under the supervision of medical personnel can you begin to move your foot.

In the early days it is recommended to conduct gentle gymnastic exercises. Appointed by a doctor or physical education physiologist.

Similar exercises may be prescribed:

  • Simultaneous flexion and extension of the fingers of both limbs and alternating. The exercise is repeated 10-15 times. Every day their number increases;
  • Pulling the toes toward you (in this case, pain should not be allowed). The exercise is repeated 4-5 times;
  • Bending and straightening the legs at the knees at a slight angle;
  • Tension of the gluteal muscles and their relaxation.

These simple manipulations are considered effective at the first stage of the rehabilitation period. First, it is recommended to develop the leg while lying down, then sitting.

It is impossible to independently perform the specified set of exercises at the postoperative stage. The development of knee joints in the first days after prosthetics is carried out only under close medical supervision.

What goals are being pursued at this stage?

  • Get up and go to bed on your own;
  • Learn to walk with support structures;
  • Sit on a chair, on a bed;
  • Independently raise and lower legs;
  • Prepare for physiotherapy exercises.

Important: At first, doctors recommend sleeping with a pillow or cushion under the knee. You need to rest only on a healthy side.

Early stage

During this period, the patient undergoes rehabilitation at home. Unfortunately, once in a familiar environment, many relax and ignore the prescriptions of doctors.

Such neglect of your health can lead to dangerous consequences.

How to develop a knee joint at this stage?

Doctors recommend exercising such elements of gymnastics in a sitting position:

  • bend and unbend your toes at the same time;
  • rotate in stops clockwise and counterclockwise;
  • raise your leg without bending your knee (angle – 45 degrees);
  • “Chat” with your limbs in the air for several seconds.
  • Lie on your stomach. Bend your knees;
  • Lie on your back. Make a bar with support on the shoulder blades and a healthy foot.

Exercises in standing position:

  • Lean on a chair. Bend your knees first forward, then back. Repeat 10 times;
  • Get up on your toes 10-15 times with support on a chair or headboard;
  • Walking up the stairs;
  • Lunges back;
  • “Sliding” along the wall;
  • Roll from toe to heel.

During this period, the patient can already walk with a cane.

Do not forget that hypothermia, overstrain, immobility and overheating are the wrong actions during rehabilitation after prosthetics.

If you are not sure that at home you will manage to recover properly, it is better to undergo treatment in a special rehabilitation center.

The cost of such treatment will be quite high. However, there you will be offered treatment procedures – physiotherapy, massage, individual exercise therapy complex, mud therapy, hydrotherapy, exercise on stationary bikes, etc.

All medical measures will be carried out only under the supervision of medical personnel. Therefore, there will be no opportunity to relax in such an institution.

All forces will be aimed at restoring the work of the knee joint and returning to a full life.

Where to go for rehabilitation, your doctor will tell you depending on the complexity of the diagnosis.

Remote stage

This period is intended to return a person to a normal and full life.

It lasts up to 1 year (sometimes longer). 2 times during this time, the operated person undergoes a full examination with MRI of the knee joint.

The load on the knee increases. It is allowed to visit the gym (in the presence of a personal trainer), to engage in any sport with moderate loads.

Most preferred are walking, cycling, swimming, rowing. It is also useful to attend yoga sessions, go for treatment in a sanatorium.

Be sure to perform the following exercises daily:

  • “Scissors”, “bicycle”;
  • Walking on bent legs, holding on to a support.

Do not engage in competitive sports, weightlifting, running, boxing, wrestling, etc.

In addition, doctors recommend not to drink alcohol, smoke, eat too high-calorie foods.

Complications after knee replacement

Unfortunately, in some cases, complications develop after an endoprosthetics operation:

  • Endoprosthesis displacement;
  • Vein thrombosis due to stagnation of blood;
  • Contracture;
  • Synovitis.

Another common complication is infection. It is treated by taking antibacterial drugs.

An infection is introduced, as a rule, during endoprosthetics (due to non-observance by the doctor of hygiene standards and the use of non-sterile instruments).

The main symptom of infection is a feeling of a “hot knee”, fever, and pus in the suture.

The development of the knee joint after surgery is very time consuming. And you need to be prepared for this.

The most important thing in this case is not to relax and unquestioningly follow the recommendations of the rehabilitation doctor. After all, your future life will depend on the recovery period.

Rehabilitation after replacing the knee according to Bubnovsky in the video

Rehabilitation after knee replacement

The main indication for surgical intervention to remove part of the joint or the entire joint is complex damage or rapidly developing destruction of the knee, regardless of the causing cause, not amenable to other methods of therapy, and bringing a person discomfort in the form of intolerable pain and a decrease in the main function of this area – movement. Restoring the functionality of connecting the bones in the region of the largest joint of a person using internal replacement with prostheses is called knee joint replacement, rehabilitation after surgery, in this case, will be important.

Modern medicine has accumulated enough experience to carry out this kind of surgical intervention, which is performed at a high technological level. The design of dentures has also been constantly improved. Present-day surgery can perform this manipulation on other bone joints, but it is in the formation of the knee and pelvis that it is most common and practiced.

Rehabilitation Stages

The design, which is built into the leg, has a service life of 15 to 20 years. After replacing elements in the limb, patients can return to physical activity. But for this it is necessary to comply with all the requirements for a period such as rehabilitation after knee replacement. It can consist of several months (from three to six) and is divided into stages.

The first stage: lasts the first few hours, immediately after surgery. The patient is under intensive control at this time. Also, blood and cardiac activity are monitored.

The second stage: lasts the first two to three days. At this time, the patient can be transferred to a regular room, designed for further stay with special conditions: a functional bed with holders for hands, additional devices for the ability to move around, matte flooring. This indicator of time depends on the response of the body to the invasion, most often on the first day the patient comes to his senses, and can even sit down. Already on the 10th day the seams are removed. From this moment, constant gymnastic exercises are carried out. Pain may appear, but it can be reduced with anti-inflammatory drugs. The use of analgesic components can be carried out at night. This is due to the fact that performing movements can cause discomfort, and painkillers will reduce sensitivity.

The third stage: recovery after knee replacement lasts from three to four months. At this stage, some patients may be discharged from an inpatient stay. But the first two months, nevertheless, it is recommended that the patient be operated on in the hospital. This is due to the fact that the correctness of the execution of any movements can be achieved only under the supervision of a medical specialist. Individual preparation of a gradual increase in load allows you to increase the volume of movement. This approach allows you to properly form weakened muscles and normalize ligaments. The total time for a quality result of training will be one year. The qualitative result in this case means sufficient freedom of movement in the recovery zone.

Important: When rehabilitation is performed after knee replacement, exercises should be performed not only by the limb on which the reconstruction was performed, but also by a healthy limb. This is necessary so that there is no reflex transfer of load to the leg on which the muscles are developed, i.e. on the operated side.

For the patient, the beginning of the entire recovery process is considered the initial examination of the state of his body. The tactics of the patient management plan will depend on the data obtained from the time of the preoperative period to its return to everyday behavior. The ability to bring the operated limb to the restoration of lost physical functions depends on the correctly constructed complex pre- and postoperative plan and its implementation. Indications for the preparation of a rehabilitation program complex will be data on the state of work of all human organs and systems.

Getting up for the first time from the bed should be carried out in the presence and support of medical personnel. Lean and become possible only on the non-operated side. After the seams are removed, it is necessary to begin to perform light gymnastic exercises. In this period, mechanisms for the restoration of hard tissues have not yet been launched, but to help the body move to the next stage, when regeneration processes start, it is recommended that the movements begin early, which will allow bringing the limb functionality to the desired result much earlier. For the correct exit from stressful conditions (operations), preventive measures of possible complications (pressure sores, impaired respiratory function, worsening of local blood circulation, muscle atrophy) should also be carried out. For this, the patient can perform isometric exercises, and breathing exercises. After 4 weeks, the patient can move with crutches. Such movement is controlled with particular attention. Attention is drawn to the uniform distribution of body weight.

Before performing the first movements and getting up, the limb on which the internal invasion was carried out must be extended and not bent. This will require some skill. It becomes possible only on the other leg, which for the first time will be support. At the first attempt to stand on his feet, a sick limb can only touch the floor, but not transfer the center of gravity and do not stand on it. Movements must be very careful. The increase in their volume should occur every day without interruptions, so as not to reduce the results achieved. Exercise should not occur while standing. And even later, during gymnastics, you can’t become or lean on your knees. You can not make sharp active movements. The compound is being developed by a physician.

Monitoring the recovery period

Throughout the recovery period, the patient performs a gymnastic pattern based on tests for the effectiveness of the exercises. Control magnetic resonance imaging will be required to assess the condition of soft periarticular tissues or radiography to assess the position of the replaced elements.

Rehabilitation after knee replacement at home is also carried out under the patronage of medical personnel. It can begin with passive performance of movements. An individually selected complex can be performed with extensor movements at the site of bone formation (from 3 to 5 repetitions) and tension of the front and rear muscles in the femoral zone, as well as the gluteal region (hold tension from 2 to 5 seconds).

From the side of the affected leg, lifting up and leading to the side and back of the straightened limb are performed (hold the leg for up to 5 seconds). The angle should not exceed 45 degrees.

You can not do exercises that can exceed the allowable load on the limb, namely it is impossible: to run, jump, push off from the side of the operated leg.

Complex medical measures in this period are supplemented not only by physical therapy, but also by massage. To enhance local blood flow and stimulate the improvement of muscle condition, electrophoresis with anti-inflammatory drugs is performed. It is also recommended that physiotherapy be carried out on a healthy leg in order to reduce the impact of the load on it.

After performing an artificial restoration of the function of movement, patients return to an everyday lifestyle, but adhere to some recommendations.

Rehabilitation after knee replacement (exercise)

The operation to replace the bone joint is a crucial step, deciding on which the patient should be aware that his life will never be the same.

Rehabilitation after endoprosthetics is of particular importance. A person who has undergone surgery needs a specially designed exercise program. At the same time, the patient will have to refuse many sports, due to the need to reduce the load on the knee joint.

The next few years after surgery, the patient must certainly be under the supervision of the attending physician.

There is an opinion that after arthroplasty the patient should spare and protect the knee. However, this statement is only partially true.

The need for a gentle regimen, for the first time after the operation, of course, exists, but the first exercise can be started on the second day. Further, the load during exercise will gradually increase. Consider what types of exercise therapy during rehabilitation will help to quickly repair a damaged knee after an injury or surgery.

The benefits of exercise therapy for rehabilitation after knee replacement

In order to develop a joint after surgery, a patient needs a long work. Its task is to perform the recommended set of exercises, despite pain and possible discomfort.

The success of the recovery process depends not only on the actions of the doctor during the surgical intervention, but also on the efforts that the patient spent on the rehabilitation program.

The patient’s performance depends on the following factors:

  • Will he be able to fully undergo rehabilitation;
  • Will he give up training after some time;
  • Will she conduct classes with the same zeal not at the center of the rehabilitation center, but at home.

Physical therapy after total prosthetics of the knee joint contributes to:

  • Improve blood circulation;
  • Muscle strengthening;
  • Fast recovery of a diseased knee;
  • Strengthening the regeneration process;
  • Increase the overall tone of the body.

Complex of exercises

The rehabilitation period can be divided into three main stages:

StagesPeriodWhat are the goals?
Stage 1 – occurs immediately after the operationUp to 3 weeksTaking medications to prevent infection and
helping to relieve pain. Addictive to walking with crutches.
Stage 2 – earlyUp to half a yearStrengthening the muscles of the legs and partial restoration of motor activity of the joint.
Stage 3 – RemoteUp to one yearComplete restoration of movement and preparation of the patient for a full active life.

Postoperative period

Consider the gymnastic exercises recommended for performance in the postoperative period. Such exercises prevent thrombosis, muscle atrophy, and support the functioning of the musculoskeletal system.

In the first few days after surgery, the following set of exercises is prescribed:

  • The patient makes movements with his fingers, clenching and unclenching his fists. The number of repetitions at the initial stage is 12-15. In the following days, under the supervision of a doctor, the load will gradually increase;
  • Next, you need to pull the toes to yourself, while avoiding pain during the exercise. The number of repetitions from 4 to 5 times;
  • The patient produces actions that contribute to the bending and extension of the legs in the knee, repeating 3-4 times;
  • The final stage of rehabilitation is tension and relaxation of the gluteal muscles. Performing 4-5 repetitions in the postoperative period will be quite enough.

The use of the above manipulations is considered effective at an early stage of rehabilitation. Initially, you need to develop the leg in a supine position, after which you can go into a sitting position.

Physical therapy in this period has the following tasks:

  • Help the patient get up and lie down without help;
  • Learn to sit down on a chair or bed;
  • Take the first steps using supporting structures;
  • Prepare for other gymnastic exercises.

Early stage

Unlike postoperative, the early rehabilitation period is carried out at home. There are frequent cases when the patient, having fallen into the familiar environment, neglects medical prescriptions and stops working to restore the functions of the knee joint.

At this stage, the knee can be developed in three positions: sitting, lying, standing.

Gymnastic exercises in a sitting position:

  • The patient with his toes produces bending and unbending movements. The number of repetitions from 10 times;
  • Then he needs to rotate each foot first, and then counterclockwise;
  • The patient lifts the leg without bending it in the knee joint (at an angle of 45 degrees). The action is performed 10 times in one approach;
  • Then you need to perform a series of swaying limbs in the air. Exercise when performing gymnastics of the knee joint lasts several seconds.
  • The patient lies on his stomach, bending his knees. To achieve the desired effect, 7 repetitions are required;
  • Having settled down on his back, a patient undergoing a rehabilitation course performs a bar with support on his shoulder blades and a healthy leg. The number of approaches 5-10 times.

Gymnastics in a standing position:

  • Man makes a “slide” on the wall
  • Performs a roll from foot to foot
  • Walks up flights of stairs
  • Standing on socks, resting on a chair or bed;
  • The patient rests on a chair, bending his leg in the area of ​​the knee joint, first forward, then back.

Exercises are performed until the patient feels pain in the injured limb.

At the moment, the person should already be moving, using a cane or other device for additional support.

Examples of possible exercises

Remote stage

This period of rehabilitation is necessary so that the patient can return to his normal full life. Recovery at this stage and the rehabilitation time after replacing the knee joint take about 12 months. At the same time, every six months the patient undergoes a full examination with the mandatory appointment of an MRI for a sick knee.

Examples of possible exercises

The distant stage involves an increase in the load on the operated joint. A visit to the gym is welcome, where a person trains, getting moderate exercise.

The most preferred types of physical activity for developing a prosthetic total joint are: swimming, rowing, walking, cycling.

To achieve the desired result, you can also do yoga or go for a while to the sanatorium for complete rehabilitation.

Mandatory exercises are now considered such exercises as:

For the patient, competitive sports, such as running, wrestling, boxing and weightlifting, are still prohibited.

At this stage, experts also recommend giving up bad habits, not smoking and not drinking alcohol. In addition, it is undesirable to eat foods that are high in calories.

On the Internet you can find many videos for the rehabilitation of the knee joint, where the whole order of sequential actions is clearly and correctly shown.

Contraindications

When compiling a rehabilitation program after knee replacement, specialists pay attention to some factors that are a contraindication for the appointment of exercise therapy. First of all, these include physical abnormalities and mental disorders. Also, previously diagnosed chronic diseases can become an obstacle to performing exercises.

The following ailments can entail a risk of injury:

  • Osteoporosis;
  • Aneurysm of the heart and aorta;
  • Weak bone marrow.

Restrictions on the use of therapeutic physical culture, as a rule, are not permanent, and are removed in the presence of appropriate conditions.

The list of general contraindications includes the following diseases and conditions:

  • metastases;
  • Thrombosis and embolism;
  • Intoxication;
  • High body temperature;
  • Arterial hypertension;
  • Pronounced pain;
  • Malignant tumors;
  • Poor mental state;
  • Threat of internal or external bleeding;
  • The presence of infectious and inflammatory processes in the acute stage.

Rehabilitation after knee replacement: stages of recovery

A lot of people are faced with problems in the functioning of the knee joints, which is associated with constant loads on the lower extremities, a sedentary lifestyle, and various infectious diseases.

Severe pain and limitation of motor activity in the knee are the main indications for the appointment of surgical intervention – endoprosthetics, the essence of which is to replace the affected areas of the joint with artificial implants.

The success of the operation and the normalization of gait in the future depend on the correct rehabilitation after knee replacement and compliance with all stages of recovery.

Replacing a damaged joint with a prosthetic device returns the shape to the deformed knee, thereby normalizing movement.

Subject to medical recommendations, within half a year after the operation, most patients return to their usual way of life and their professional activities.

The article was written following an interview with a representative of the Artusmed clinic – official site msk-artusmed.ru

Patient recall after metal removal after osteosynthesis and TBS endoprosthetics

What is the operation for knee arthroplasty?

Endoprosthetics is an expensive procedure, but despite this, this treatment is indispensable for a variety of joint pathologies that result in the destruction of bone and cartilage tissue structures.

The operation requires the high professionalism of a specialist surgeon and thorough preparation of the patient.

The preoperative period consists of the following activities:

  • comprehensive examination: laboratory tests, consultation of specialists of a narrow profile (depending on concomitant pathologies), x-ray examination, if necessary, MRI and CT;
  • the doctor selects the type of prosthetic device;
  • the treatment of chronic diseases present, infections of the oral cavity, in particular caries;
  • diet table correction;
  • exercises on simulators using walkers or crutches.

After preparation, the doctor prescribes the day of the operation, as a rule, the procedure is performed in the morning.

Before the operation, bandaging of a healthy limb is performed, this allows to reduce the load on the vessels and prevent thrombosis.

For anesthesia, general anesthesia and spinal anesthesia are used (introducing the drug into the subarachnoid space using spinal puncture).

The duration of the operation varies from 1,5 to 4 hours.

Surgical intervention consists of several stages as follows:

  1. In the center of the knee, the surgeon performs a longitudinal incision, patches of skin are pulled apart and fixed with special tools.
  2. Having gained full access to the joint, damaged areas are extracted.
  3. Implants are initially attached to the lower thigh and upper tibia. After that, an experimental device is installed to test the functions of the joint. In the absence of problems, the test device is replaced by an endoprosthesis, which will subsequently last from 15 to 20 years.
  4. After the operation, the surgeon sutures the cut tissue, sets the drainage.
  5. After applying the bandage, the patient is transported to the ward.
  6. The very next day, rehabilitation measures are scheduled.
  7. After 14 days, the stitches are removed.
  8. In order to prevent thrombosis, elastic bandages are used.

What is the difficulty?

The operation itself is performed by experienced specialists, which reduces the likelihood of consequences.

The difficulty lies in the pain syndrome that develops after the procedure and persists for some time.

To relieve pain and improve the well-being of the patient in this period, anesthetics are used.

Stages of rehabilitation after surgery for knee replacement

The initial stages of recovery begin a few days after the endoprosthesis replacement operation, the main purpose of the prescribed measures is the resumption of normal movements of the knee joint.

The first few days, the patient must observe bed rest, getting out of bed is excluded, but sitting, hanging legs and performing light bending-unbending techniques is allowed.

Rehabilitation measures are drawn up for each patient separately, taking into account his well-being. The greatest attention is paid to medical gymnastics, massage and a sparing diet.

Also, patients are advised to undergo a full rehabilitation after surgery for knee replacement in a specialized sanatorium.

First (initial)

The early stage begins in a medical institution a few days after the endoprosthetics.

All exercises are performed under medical supervision.

Exercises

Exercise therapy in the first few weeks:

  • rotation, flexion and extension of the leg in the ankle and knee – initially performed 4-6 times, daily increasing the amount to 20 times (until minor painful or uncomfortable sensations);
  • in the supine position, the diseased limb is carefully pressed to the surface for 5 seconds, then the leg is bent at the knee and, applying force, press the heel down – from 7 to 15 times.

Second

After removing the stitches, the rehabilitation program is supplemented by other exercises with increased load and a wide range of movements.

Exercises

General rehabilitation of the second stage after knee replacement involves the following exercises:

  1. initial position (I. p.) – lying on your back, flexion and extension of the affected limb in the knee (15-20 on each leg);
  2. and. n. on the back – pelvic lift (12-15 times);
  3. and. p. on the back – imitation of cycling;
  4. and. n. sitting – slowly and smoothly pull the knee to the stomach and return to and. P.;
  5. and. n. standing, holding on to the support – pulling the bent leg in the knee to the body, forming an angle of 90 °.

The entire gymnastic complex takes no more than half an hour, is carried out daily in the morning and in the afternoon.

The third

The final stage of rehabilitation lasts from 3 to 6 months, in some cases up to a year.

Exercises

Gymnastics is performed in accordance with the second period, in addition, the recovery period is supplemented by such measures:

  • long walks (3-4 times a day for 30-40 minutes);
  • 3-4 times a week classes in the pool;
  • training in the gym (exercise bike, orbitrek);

Performing continuous gymnastics for 2-3 months allows you to completely abandon orthopedic appliances.

Home Recovery

Home rehabilitation is one of the main stages for the restoration of knee functionality after joint replacement.

Performing gymnastics with increased load continues, periodic courses of therapeutic massage are conducted, cycling, Nordic walking are recommended.

Patients of advanced age do gymnastics under the control of relatives.

Conclusion

Endoprosthetics is successfully used in clinics of European countries.

To date, in Russia, this technique is the only option that allows you to move normally for people with serious pathologies of bone and cartilage tissue structures.

High-quality and proper implementation of all medical recommendations allows you to return to normal motor activity after surgery within 6 to 12 months.

Video: Rehabilitation after knee replacement

Knee joint – rehabilitation after arthroplasty

Even an ideally performed operation by the best team of endoprosthetics specialists implies only a 50% successful result. A huge role is given to high-quality rehabilitation, a patient’s positive attitude, perseverance, determination and integrity. Intervention for endoprosthetics lasts only 1,5-2 hours, and the rehabilitation period can last a lifetime. If recovery goes according to plan without complications, patients quickly return to their usual way of life. How to recover? What should you pay special attention to during the rehabilitation period? And is it possible to effectively recover from arthroplasty at home? This article will be devoted to the coverage of these issues.

What is the purpose of rehabilitation after arthroplasty?

  1. Avoid side risks and complications.
  2. Help bond the implant to the bone.
  3. Normalize and strengthen the muscles and tendons of the affected joint.
  4. Restore joint function.
  5. Return the patient to an active lifestyle.

Preoperative preparation for the recovery period

Proper rehabilitation begins even before endoprosthetics. The doctor at the preoperative stage tells about its main points, the importance of each of them. After communicating with the patient, the surgeon assesses the side risks, analyzes the condition of the person preparing for the operation and gives certain recommendations for the preoperative period:

  • if the person is unsportsmanlike, he is offered to strengthen the muscles of the legs and arms; strong arm muscles (especially triceps) are necessary for stable walking on crutches after surgery, and trained muscles and ligaments of the joint will support its work; muscles can be strengthened with the help of physical exercises (but without excessive zeal), water aerobics, swimming, Scandinavian walking and exercise on stationary bikes;
  • if the patient has extra pounds, he needs to reduce his weight before surgery;
  • the surgeon reminds that after the operation, the patient may need compression hosiery (stockings or elastic bandages), which minimizes the risk of thrombosis and the appearance of trophic ulcers, and tells how to use it wisely;
  • the patient should learn respiratory gymnastics and begin to practice it in advance;
  • the doctor stipulates the possibility of using a postoperative knee brace and will show all possible options for orthoses, pay attention to their pros and cons;
  • the doctor (or nurse) gives detailed instructions on how to choose the right crutches and conducts a lesson on learning to walk on crutches (later, before the operation, the patient trains at home himself);
  • the patient must master the basic exercises of exercise therapy;
  • a large role is given to a safe home environment, which must be taken care of in advance – non-slip floor, good lighting, the absence of wires and excess objects on the floor, acute traumatic corners, rickety designs, slippers that ensure foot stability, etc .;
  • pronounces the height of the bed at home, it is desirable to increase it due to another mattress, so that it is easier for the patient to go to bed and get out of bed.

Before the operation, the doctor’s task is to explain the importance of each item to the patient, thereby motivating the patient to recover. Based on the collected data, carefully analyzing all the information, specialists develop an individual patient recovery scheme, which, if necessary, is amended after surgery.

Early rehabilitation after knee replacement

The early recovery period begins almost immediately after withdrawal from anesthesia. The operation lasts about two hours, after which the patient is usually brought to the intensive care unit and his condition is monitored for several hours. The patient is prescribed special medication (anticoagulant, analgesic, anti-inflammatory), the wound is treated, bandaged, and cold applied. But the first place among rehabilitation measures belongs to physical therapy, which is signed from the first day after implantation of an artificial knee.

The leg after the operation will be in an elevated position in a compression stocking or elastic bandage, but already during this period the patient should as often as possible:

  • bend and unbend toes simultaneously and alternately,
  • rotate in circles in one direction and the other,
  • stretch the feet on yourself, in, out,
  • strain the buttocks, thighs,
  • do breathing exercises;
  • clench and unclench fists;
  • use hand expander;
  • bend and extend your elbows
  1. Second day

On the second day, the patient, in addition to already mastered exercises, can with a gradual increase in amplitude in the presence of medical staff during the day:

  • smoothly bend the legs in the knee at a slight angle (you can bend the legs in the knee only after 7-10 days);
  • slowly lower and raise the straightened leg;
  • take the direct limb to the side and bring it to its original position, sliding it on the bed;
  • fingering in the air;
  • turn on a healthy side (there should be a cushion or pillow between the legs);
  • raise the pelvis (“half-bridge”), resting on hands and a healthy leg
  • to sit in bed yourself;
  • stretch the elastic tape with your hands, strengthening the muscles of the shoulder girdle;
  • sit on the bed without lowering the feet to the floor
  1. Third day

By this time, the drainage drainage from the wound will be removed, this will give greater freedom of movement. In addition to the old exercises, he masters new actions:

  • confidently sits down on the bed;
  • rises from a sitting position, rises on crutches or rises, holding on to a walker;
  • in the standing position, holding on to a chair imitates steps;
  • begins to move on crutches or walkers;

On the third day, the patient can move on a walker. The patient takes the first steps with the help of a nurse, then she insures the patient, controlling his movements.

The motor load increases gradually, according to an individual schedule drawn up by a doctor. All movements should be slow and accurate. You can not make jerks, make sharp lunges and strain muscles. The patient’s well-being is monitored daily: throughout the day, vital signs are monitored – pulse, temperature, respiration, blood pressure. If the condition improves, and the patient becomes stronger, then physical activity is increased.

Discharge from the hospital

By the end of the early postoperative period, the patient feels quite well. By this time, he should:

  • walk on walkers (crutches) yourself;
  • use the toilet without assistance;
  • independently (only with the help of crutches-walkers) get out of bed and lie down on it;
  • know and be able to do the basic exercises of physiotherapy exercises

On the 5-7th day, as a rule (with a satisfactory condition and the absence of complications), the operated person is discharged home. By this time, it is still impossible to fully rely on a sore leg, it can withstand only 10-15% of its normal load.

When transporting home, you need to get into the car correctly – first sit on the seat and only then tighten your legs. It is better to sit in the front seat, and before boarding, make sure that it is raised to the optimum size and pushed back as far as possible.

Rehabilitation in a specialized center

For many operated patients, the ideal option is rehabilitation in a specialized center, since it is quite difficult to recover on your own, especially if the patient is elderly or not completely motivated. Many at home are prevented from organizing self-pity, laziness, fear of overcoming pain and disorganization.

In rehabilitation centers, the recovery process continues, aimed at the proper functioning of the knee. The patient will have to go to massage sessions, physiotherapy, exercise therapy, water aerobics. Every day he will be scheduled in minutes, the organization of procedures and their effectiveness are the responsibility of qualified specialists, who can adjust appointments at any time if necessary. Nursing staff supports the patient, takes care of him, stimulates active pastime. Classes can be group and individual. If necessary, a psychologist will work with the patient.

The centers are equipped with modern simulators and the latest physiotherapeutic devices. Mechanical simulators carry out passive flexion-extension of the affected limb, activating muscles and ligaments, supporting joint functions. Each time, the bending angle and speed increase. Usually in the centers hydrotherapy is widely practiced – relaxing and tonic herbal baths, hydromassage, Charcot’s shower, pool. Therefore, if there is an opportunity to undergo rehabilitation in a specialized center, you must use it. Strengthening the musculoskeletal system is necessary not only for better engraftment of the new joint, but also for the healing of the whole organism.

Home rehabilitation after knee replacement

Home rehabilitation seems to be the most important, since the patient is left to himself, by and large, and the result will depend only on his perseverance and conscientiousness. Many patients at home relax and stop doing exercises. Not only should you not expect positive dynamics from such behavior, but a careless attitude to your health will nullify all previous efforts of doctors and can cause serious complications and negative consequences.

Surgeons and rehabilitologists do not tire of repeating that a good effect from the operation is possible only with the active participation in the recovery process of the patient himself.

What gives rehabilitation after knee replacement

Knee replacement: rehabilitation involves the fulfillment of certain requirements for a successful outcome. Of course, the operation is technically difficult, therefore only specialists of the highest category are engaged in joint replacement, but much depends on the patient. The fact is that all recovery procedures are aimed primarily at eliminating traumatic risks in the future, as well as to improve motor activity of the operated leg.

First of all, the patient must independently learn to get out of bed and go back to bed. In addition, you need to choose the right posture for sitting, learn to stand and walk with improvised means (crutches, walkers). And, of course, you need to do special gymnastics.

important points

To quickly restore and heal all the tissues located near the implant, you must follow all the recommendations of your doctor. Only in this way can a positive result be obtained. Always watch for pain so that it does not interfere with your activities. If the pain interferes, then it is necessary to inform the doctor about this and he will prescribe the corresponding painkillers. Be sure to monitor the condition of the knee so that there is no excessive swelling and swelling. Remember, edema is allowed small. To avoid this, you need to use a roller or pillow, which are placed under a sick limb.

A very important role is played by breathing exercises, although many people underestimate this. In fact, the body urgently needs extra oxygen. After all, the level of blood circulation depends on this, and it, in turn, affects the speed of healing. In addition, without normal microcirculation, the blood will stagnate in the veins, therefore, a blood clot may form.

IMPORTANT! Endoprosthetics of the knee joint in Russia are developed quite actively, so our specialists already have sufficient experience to conduct surgery and rehabilitation measures. Therefore, no need to worry.

First time after surgery

The attending physician will certainly tell you about the rules of conduct for the patient after surgery, but you must remember that in the absence of complications you need to get up on your own. But this can only be done at a slow pace. It is allowed to sit in bed and rise according to certain rules. From the position: lying down you need to get up slowly, resting first on the elbows, and then the palms.

In the first days after surgery, an elastic bandage is necessarily applied, or special stockings are put on. This is necessary to exclude blood clotting. You can stand for 2-3 days, depending on the complexity of the operation. As a rule, a rehabilitation specialist with whom you will be engaged in exercises helps to fully rise and walk.

IMPORTANT! As after any operation, in this case, rather unpleasant sensations in the prosthesis area and dizziness can be observed. Do not worry about this, as this condition is considered the norm. But you definitely need to overcome all your own fears.

Mandatory Rules

Replacing a joint with an artificial prosthesis can be total or partial. In the second case, a small element of the implant is installed, but in the first case, almost the entire joint. It is total knee replacement that requires special care and caution, because a significant amount of a foreign body enters the body. Therefore, there is a risk of rejection of the prosthesis. To avoid this, always follow the doctor’s requirements. So, there are basic rules:

  1. You can not get up and lean on the operated leg.
  2. Before lowering the legs they are kept in a straightened position.
  3. At the time of rising, keep the limb with the implant upright.
  4. It is unacceptable to walk on a slippery floor surface, otherwise you may get injured.
  5. In the first week, the sore leg should slide on the floor, so it is strictly forbidden to step.
  6. Physical activity should not be intense and only with the permission of a doctor can they be gradually increased.

The main complex of exercises

Since rehabilitation after knee arthroplasty includes physiotherapy exercises, then the exercises should be specific. They are made to restore muscle tone and develop a prosthesis. But you need to do exercises not only with a sick limb, but also healthy. So, the main exercises:

  1. Flexion / extension of the ankle joint: 5-7 times.
  2. Tension of the muscles of the thigh and buttocks for a few seconds.
  3. Alternately lifting straightened legs.
  4. Holding straight legs at an angle of 20-30 degrees, literally 3-4 seconds.
  5. Flexion / extension of the knees. Make sure that the bending angle does not exceed 90 degrees.
  6. In a standing position, the operated limb can be straightened back and to the s >

You should know that approximately 50-70 days after the operation, you need to do a control radiography. If the result is positive, then you will be able to move independently without the help of improvised means. Remember, the attending physician should monitor the patient throughout the entire recovery period and adjust the gait so that physical activity is distributed correctly.

As you know, the prosthesis is designed for 10-15 years, so after this time, it is necessary to replace it with a new one. This planned operation is called revision knee replacement.

As you know, the prosthesis is designed for 10-15 years, so after this time, it is necessary to replace it with a new one. This planned operation is called revision knee replacement.

Disability after surgery

According to the legislation of our country, pathologies that destroy the articular and skeletal system are equated with disability. After all, a person becomes unable to perform some work fully. In order to get disability after knee arthroplasty, you need to submit all the certificates, pictures, a doctor’s opinion confirming the inability to move normally. Of course, when the implant takes root and the patient is able to walk freely, disability will be lifted. Therefore, it is necessary to draw up it precisely in the rehabilitation period. The allowance is issued for a period of 12 months, after which the examination is again carried out. If it turns out that a person is not able to fully work, then disability is extended.

Shishkevich Vladimir

Shishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews. It specializes in the treatment of diseases in orthopedic, traumatological, vertebrological profiles

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