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Orthopedic diseases 2023

Care in the recoveryçã of Hip Arthroplasty

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Care in the recoveryçã of Hip Arthroplasty
Care in the recoveryçã of Hip Arthroplasty
Anonim

To speed up recovery after placing a hip prosthesis, care must be taken not to dislodge the prosthesis and have to go back to surgery. Total recovery varies from 6 months to 1 year, and physical therapy is always indicated, which can begin on the 1st postoperative day.

Initially it is recommended to do exercises that improve breathing, foot movement in all directions, and isometric contractions in bed or sitting. The exercises must progress each day, as the person becomes more capable. Find out some examples of exercises for those who have hip replacements.

In this recovery phase, foods that are easy to digest and rich in protein are recommended to speed up tissue healing, such as eggs and white meats, as well as milk and dairy products.Sweets, sausages and fatty foods should be avoided because they make healing difficult and prolong recovery time.

Be careful not to dislocate the hip replacement

To prevent the hip prosthesis from leaving the site, it is essential to always respect these 5 basic precautions:

  1. Do not cross your legs;
  2. Do not bend the operated leg more than 90º;
  3. Do not rotate the leg with the prosthesis in or out;
  4. Do not support your entire body weight on the leg with the prosthesis;
  5. Keep the leg with the prosthesis stretched whenever possible.

These care is very important in the first weeks after surgery, but they must also be maintained for life. In the first few weeks, the ideal is for the person to lie on their back, with their legs stretched out, and a small cylindrical pillow between their legs.The doctor can use a kind of belt to wrap the thighs, and prevent the leg from rotating, keeping the feet lateralized, which usually happens due to weakness of the muscles of the inner part of the thigh.

Other more specific precautions are:

1. How to get in and out of bed

To get in and out of bed

To get in and out of bed

The patient's bed should be high to facilitate movement. To get in and out of bed you must:

  • To sit on the bed: Still standing, lean the good leg on the bed and sit down, first bringing the good leg to the middle of the bed and then with the help of the hands, take the the operated leg, keeping it straight;
  • To get out of bed: Get out of bed on the side of the operated leg. Keep the knee of the operated leg straight at all times. While still lying down, stretch the operated leg out of bed and sit on the bed with the leg stretched out.Support the weight on the good leg and get out of bed, holding the walker.

2. How to get in and out of a chair

To sit and stand

To sit and stand up correctly from a chair:

Chair without arms

  • To sit: Stand beside the chair, keep the operated leg straight, sit in the chair and straighten up in the chair, turning the body forward;
  • To get up: Rotate the body to the side and keeping the operated leg straight, get up leaning on the chair.

Chair with arms

  • To sit: Stand with your back to the chair and keeping the leg with the prosthesis stretched out, place your hands on the arms of the chair and sit down, bending the other leg;
  • To get up: Place your hands on the arms of the chair and keeping the leg with the prosthesis stretched, put all your strength into the other leg and lift.

Toilets

Most of the toilets are low and the legs have to be bent more than 90º, so after placing a hip replacement, it is important to place a high toilet seat so that the operated leg is not bent anymore than 90º and the prosthesis does not move.

3. Getting into the car

The person must be in the passenger seat. Must:

  • Put the walker on the car door (open);
  • Place your arms firmly on the dashboard and seat. This seat must be set back and reclined backwards;
  • Sit down gently and bring the operated leg into the car

4. How to take a shower

To bathe in the shower more easily, without exerting too much force on the operated leg, you can place a plastic bench that is high enough so that you don't have to sit down completely.Alternatively, you can use an articulated shower bench, which is fixed to the wall and you can also place grab bars to help you sit and stand on the bench.

5. How to dress and wear

To put on or take off your pants, or put your socks and shoes on your good leg, you must sit on a chair and bend your good leg, supporting it on top of the other. As for the operated leg, you must place the knee of the operated leg on top of the chair in order to get dressed or put on shoes. Another possibility is to ask for help from another person or use a tamper to get the shoe on, standing up.

6. How to walk with crutches

To walk with crutches:

  1. Forward crutches first;
  2. Advance the leg with the prosthesis;
  3. Advance the leg without prosthesis.

It is important to avoid taking long walks and always have crutches close by so you don't fall and the prosthesis doesn't move.

How to go up and down stairs with crutches

To go up and down stairs correctly with crutches, follow these steps:

Climbing stairs with crutches

  1. Place the leg without the prosthesis on the top step;
  2. Place the crutches on the leg step and at the same time place the prosthetic leg on the same step.

Going down stairs with crutches

  1. Place crutches on the bottom step;
  2. Place the leg with prosthesis on the step of the crutches;
  3. Place the leg without prosthesis on the step of the crutches.

7. How to squat, kneel and clean the house

Usually, 6 to 8 weeks after the surgery, the patient can go back to cleaning the house and driving, but in order not to bend the operated leg more than 90º and prevent the prosthesis from moving, he/she should:

  • To squat: Hold a solid object and slide the operated leg backwards, keeping it straight;
  • To kneel: Place the knee of the operated leg on the floor, keeping the back straight;
  • To clean the house: Try to keep the operated leg straight and use a broom and dustpan with a long handle.

In addition, it is also important to distribute household chores throughout the week and remove rugs from the house to prevent falls.

Return to physical activities must be indicated by the physician and the physical therapist. Light exercises such as walking, swimming, water aerobics, dancing or Pilates are recommended after 6 weeks of surgery. Activities such as running or playing football can cause more wear on the prosthesis and therefore may not be recommended.

Scar care

Furthermore, to facilitate recovery, the scar must be taken care of, and therefore the dressing must always be kept clean and dry.It is normal for the skin around the surgery to still be numb for a few months. For pain relief, especially if the area is red or hot, a cold compress can be placed and left for 15-20 minutes. Stitches are removed at the hospital after 8-15 days.

When to go to the doctor

It is recommended to go to the emergency room immediately or consult a doctor in case of:

  • Intense pain in the operated leg;
  • Fall;
  • Fever above 38ºC;
  • Difficulty moving the operated leg;
  • The operated leg is shorter than the other;
  • The operated leg is in a different position than normal.

It is also important whenever you go to the hospital or he alth center to tell the doctor that you have a hip replacement, so that he can take the proper care.

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