One of the achievements of modern medicine is the possibility of replacing joints with artificial analogues. And although some ordinary people may be suspicious of such practices, such methods of treatment can significantly change a person’s life.
An operation during which a joint damaged as a result of injury or disease is replaced with an artificial analogue is called endoprosthetics. For some people, this type of surgery remains the only way to restore mobility to the leg.
This technique is used only when all other methods of restoring impaired joint functions have not had the desired effect. This is usually caused by too much wear and tear on the joints due to congenital abnormalities or injuries.
Hip replacement surgery becomes relevant due to the impact of the following diseases and injuries:
It is worth noting that previously endoprosthetics were performed mainly on older people. But, thanks to the development of technology, hip replacement surgery has become relevant for young people. New prostheses that can withstand large, stable loads allow people after surgery to lead an active lifestyle without noticeable limitations.
If a joint replacement is needed, some comorbidities may make surgery problematic. We are talking about patients who suffer from Parkinson's disease, diabetes, or have suffered a stroke or heart attack. Problems with the cardiovascular system can also lead to significant complications after hip replacement is performed. Surgery may not be appropriate even in the case of pronounced muscle weakness in the patient.
It is important to take into account contraindications, since if they are present, the risk of damage or dislocation of the artificial joint increases. When the patient's health condition can be defined as poor and the chances of developing infectious complications are high, there is a possibility that the operation will not be carried out successfully.
This type of intervention is performed in cases where there are serious indications. Such prosthetics involve an operation that affects a large surface of the joint.
Features of this type of surgical intervention include complete removal of the femoral head. In some cases, the neck of the bone is also partially removed. These joint elements are replaced with artificial analogues. The components of the prosthesis are usually made of special metal alloys or bioceramics. Special pins are also inserted into the bone. This is necessary in order to give the implemented structures high strength.
This type of intervention can be described as minimal. Its essence boils down to removing the cartilaginous layer from the acetabulum of the pelvic bone. Next, instead of the removed surface, a special articular bed is fixed. In this case, the head of the femur is ground to fit a special metal cap. After the operation is completed, the installed surface of the acetabulum and the new cap begin to slide almost perfectly against each other.
This type of intervention differs from others in that it is extremely radical and most effective. This type of hip replacement involves a complete replacement of its surface. This means that cartilage tissue is removed from the pelvic bone and a ceramic or metal bed is installed in its place.
To ensure the necessary mobility and fixation of the implant, a high-strength metal or bioceramic pin is installed. One part of the artificial joint is firmly embedded in the femur, and the second serves as the articular head (made of metal or ceramic). Due to the fact that the metal pin is fixed inside the femur, the entire structure is strong and stable. One of the most popular artificial joint options is a titanium prosthesis.
It is worth noting that there are several types of endoprosthesis fixation:
Before the operation is performed, the patient undergoes a diagnostic process, after which the presence of contraindications or their absence is determined. If a decision is made to implant a hip joint prosthesis, the patient is prescribed a number of preparatory measures:
The patient must arrive at the hospital one day before the operation. The endoprosthesis itself can be performed either under spinal or general anesthesia.
Joint replacement surgery is divided into several stages:
A drain is placed to drain blood and fluid that may accumulate at the incision site. The operated part of the thigh is covered with a soft bandage. The operation may take longer than usual if significant blood loss necessitates a transfusion.
After a hip replacement has been performed, the patient’s rehabilitation involves his hospital stay for 10-12 days. Moreover, this period does not change, even in the case of partial joint replacement.
In order to maintain the water-salt balance after joint replacement, special solutions are introduced. Discomfort in the incision area is relieved with painkillers and antibiotics. If you have difficulty urinating after surgery (a side effect of anesthesia), a urinary catheter is temporarily inserted.
Also during the postoperative period, patients undergo the following measures:
Recovery from a hip replacement can take several months. Moreover, in the case of prosthetic replacement of the joint head, full load is possible from the first day after the operation. When doctors allow the patient to get out of bed, walking along the corridor and stairs with the help of crutches becomes possible.
If you feel slight pain during the exercises, do not be upset - this is a normal postoperative phenomenon. When a patient is discharged from the clinic, he needs to adhere to certain recommendations:
Make sure that the skin in the incision area remains clean and dry. In this case, the dressings should be changed according to the doctor’s recommendations. During the three months of rehabilitation, it is important to sit correctly. This means that you do not need to use low chairs; if possible, choose chairs with armrests that allow you to redistribute the load and not stay in one position for a long time.
Of course, hip replacements can have different costs depending on the specific clinic where the surgery is performed. But the average level of prices can still be determined. For surgery on the hip joint, taking into account tests, anesthesia, hospital stay and food, you will have to pay from 105 to 110 thousand rubles. It is worth remembering that it is necessary to purchase the endoprosthesis itself, without which the hip joint cannot be replaced. The price ultimately consists of the cost of the operation and the prosthesis.
As for the amount that will have to be paid for the endoprosthesis, it directly depends on the type of implant:
The cost information provided above for surgery such as hip replacement, which can vary significantly in price, is approximate. Therefore, you need to carefully study the conditions and prices of a particular clinic.
Many patients who have been diagnosed with serious problems with the hip joint cannot afford to purchase an endoprosthesis and undergo surgery in particular. Therefore, such a topic as hip replacement surgery under a quota is relevant for many ordinary people.
According to the order of the Ministry of Health and Social Development of the Russian Federation “On the provision of high-tech medical care at the expense of the federal budget,” this type of treatment, such as the installation of implants, is available free of charge. To do this, you must have Russian registration and a compulsory insurance policy.
More detailed information about the conditions for providing free medical high-tech care can be obtained on the website of the priority national project “Health”.
Those who are interested in quality treatment will, of course, be interested in knowing where hip replacement surgeries are performed. Both in Russia and in other countries you can find many clinics where similar operations are performed. But in any case, it makes sense to give a few examples:
If you study patient reviews under the topic “Hip Replacement,” you can come to an obvious conclusion: this operation can significantly help many people who cannot move normally. It is important to undergo high-quality diagnostics. It will help you avoid possible complications and approach the joint replacement process more competently.
Scientific and technological progress never stands still, so operations that were not performed in the 90s are now carried out easily and quickly. All this is achieved thanks to advanced technologies in medicine.
Knee replacement is a fairly simple and effective operation, which is performed according to indications after a detailed examination.
This operation is not one on which the patient’s life depends; it is an orthopedic operation, which is the process of replacing the knee joint with a prosthesis.
Knee replacement (arthroplasty) is intended to relieve the patient of pain and restore the functions of the knee joint that have been impaired as a result of a serious illness. During knee replacement surgery, the surgeon removes damaged bone and cartilage from the femur, tibia, and kneecap. Then the joint is replaced with an artificial one, made of metal alloys, high-quality plastic and polymers.
There are some indications and contraindications for this surgical procedure. Note that in 95% of cases the operation has a successful result.
Diagnosis: Rheumatoid arthritis 20 years.
Over the past 10 years, more acute problems have begun, the pain has become more severe. My knees were affected and I began to walk poorly. At times I could not get out of bed due to severe pain. At rest the knee did not bother me, but when I moved I experienced severe pain. And in addition to the pain, my knee sank and I began to fall onto my left side. Accordingly, gait and posture changed. I stopped going out on my own. As a result, my muscles weakened and I felt that every day it was getting worse and worse. Then I found the company Artusmed. After examination, it became clear that surgery was needed.
As for the operation. The anesthesia is absolutely painless, like a regular injection. I felt warmth in my legs and don’t remember anything else. Many thanks to Lera, who was present in the operating room. Her gentle words that she was nearby did not leave any excitement. After the operation, I did not experience much pain; I was given painkillers.
I have the most enthusiastic impressions about the doctor! I didn’t expect at all that the next day of the operation I would already be on my feet. I expected this to be a much longer process. I’m not even three weeks from the operation yet, but I can already say that I’m walking almost like a normal person.
The only thing was that the first days after the operation were painful. But then somehow, little by little, everything passed.
Rehabilitation began from the first day. Twice a day, various exercises: extension and flexion, stretching, all kinds of physical activity on the leg. On the one hand, this is all painful and difficult, but the result makes itself felt. I am very grateful to the people who took care of me. The attention to me was simply unlimited.
I simply have no words to see the result of the operation. It seems to me that the result was achieved very quickly. And the fact that I walk normally and practically do not limp is simply unrealistic. Considering that before that I walked with a fairly serious limp for three years.
All patient reviews after surgery are available here.
Like any medical operation, knee replacement has some indications when a surgeon is needed. There is often no urgency in its implementation; it should be carried out after preoperative preparation under the supervision of a specialist. Let's look at some indications for surgery.
As a rule, the main reasons that force one to abandon conservative treatment at a certain stage in favor of endoprosthetics are significant dysfunction of the joint and severe pain, leading to a limitation of daily activity and a decrease in the patient’s quality of life, regardless of their etiology.
The most common indications for endoprosthetics are:
Only a qualified orthopedic surgeon can correctly determine the indications for endoprosthetics in each specific case.
This takes into account:
Total knee replacement can be effective at any age: from young people with juvenile arthritis to older people with deforming arthrosis.
The following factors may be prerequisites for the development of diseases that may lead to the need for knee replacement surgery:
Previously, the doctor can prescribe such therapeutic and preventive procedures as massage, taking medications, physical therapy and others. If such procedures do not change the patient’s condition, then there is a high probability that there will be an indication for surgical intervention.
Endoprosthetics is an operation that is not vital; it can improve the patient’s condition and change his quality of life, but it is not mandatory. Only a specialist in the field of orthopedics can determine that it makes sense to carry out it, but only the patient himself has the right to decide and weigh the pros and cons. It is worth noting that there are some factors and situations when even an experienced specialist will not take on the responsibility of performing prosthetics. We will get acquainted with them further.
All of the above factors are contraindications for knee replacement surgery; they either do not make sense or can lead to irreparable or particularly complex consequences. Even if the patient or his relatives have assessed all the risks and are ready for surgery, a qualified specialist will never take on such responsibility and will not perform the operation.
Before carrying out an operation, it is always necessary to carry out a risk assessment, of which there are different types. There is a possibility that complications, such as infection, may occur during surgery. So, before a planned operation, it is necessary to reduce these risks in every possible way and reduce them to a minimum.
It is also worth noting that the doctor’s experience in the field of joint replacement largely plays a role in the success of the operation and rehabilitation. More experienced specialists can perform the operation so that further rehabilitation will take place without complications. So it would be a good idea to familiarize yourself with the work history of the specialist under whose knife you are going to go.
The issue of the cost of the operation is also important, since, in principle, it is not necessary to carry out it. Its price can vary over a very wide range, this is influenced by many factors.
The operation can be performed abroad, for example, in Israel. There, an operation to replace the knee joint of one leg, including preoperative preparation, the operation itself and rehabilitation, costs approximately 23.5 thousand dollars.
The ankle joint ranks first among joints in terms of injury rates. At the same time, prosthetics are used fifty times less often than knee ones. On the one hand, this is explained by the wide possibilities of its reconstruction; on the other hand, there are many limitations for endoprosthetics.
Methodology for minimally invasive hip replacement
One of the tangible advantages of joint replacement in the Czech Republic is the lower cost of such interventions compared, for example, with arthroplasty in clinics in Western Europe or Israel
Endoprosthetics, or joint replacement, is an orthopedic method of treating joint diseases when there is irreversible destruction of articular cartilage, interfering with the normal functioning of the joint. The essence of the arthroplasty method is to replace the articular surfaces of the bones that form the joint with an orthopedic prosthesis made of special ceramic alloys. This method of treatment is used when other conservative or surgical methods are ineffective, in case of severe joint damage, severe pain that is not relieved by analgesics. Currently, joint replacement is most often performed for diseases of the knee and hip joints, but in some cases joint replacement can be performed for damage to the elbow or shoulder joint.
The history of endoprosthetics dates back to 1939, when an American surgeon
Stephen S. Hudack, began experiments on joint replacement in animals. In 1948, at the New York Orthopedic Hospital, with the assistance of the Office of Naval Research, he began performing joint replacement surgeries on patients.
Previously, two popular forms of intervention on joints with severe lesions were: intrapositional arthroplasty, in which skin, muscle, tendon, and fascia tissue was inserted between them to separate the inflamed articular surfaces, and excisional arthroplasty, in which cartilage and bone tissue were excised to replace gap with scar tissue. Other types of arthroplasty that were also used by orthopedists of that time were resection arthroplasty, cartilage replacement arthroplasty, metal cap arthroplasty, cup arthroplasty, and silicone arthroplasty.
Over the past decades, endoprosthesis replacement has become the most successful and popular method of treating severe lesions of large joints. For example, when the hip joint is affected by osteoarthritis, so-called total endoprosthetics is performed. In this case, both the acetabulum and the femoral head and neck are replaced. The purpose of such an operation is to relieve pain, improve joint mobility, and return the ability to walk.
Such an intervention is a full-fledged surgical operation, which requires preparation for it - carrying out general and biochemical blood and urine tests, ECG, assessment of the function of internal organs, radiography, etc., as well as determining the blood type and Rh factor. Preparation also includes x-rays of the affected joint, selection of the design of the prosthesis for the joint, and selection of size.
Currently, such operations are also carried out in the format of minimally invasive interventions, in which the patient can be discharged home after a few days, followed by a rehabilitation period that takes several weeks. Over the course of several months, strength and endurance gradually return.
Early patient mobilization is key to reducing the risk of complications such as venous thrombosis or pneumonia. In modern orthopedics, early mobilization of the patient after endoprosthetics is used. Depending on which joint was operated on and what the patient’s preoperative status was, hospitalization time can range from 1 day to 2 weeks, with an average of 4-7 days.
In the postoperative period, physiotherapy methods are widely used to speed up the healing process and improve the effect of the operation. It includes exercise therapy, special exercises to increase joint mobility and strengthen muscles and ligaments.
+7(495) 740-58 05 — joint replacement in Moscow and abroad
Joint nose replacement surgery is an elective procedure that can improve mobility and quality of life for people with painful toe problems. Rheumatoid arthritis, osteoarthritis, or direct trauma to the big toe can cause ongoing discomfort and make daily activities difficult. The procedure involves removing damaged bone and cartilage tissue and placing a plastic or metal artificial joint in place. The most common site for finger joint replacement is the metatarsophalangeal (MTP) joint, a structure at the base of the big toe. Most patients who have surgery are able to make excellent recoveries and return to normal activity levels within a few months.
Not all MTP conditions require surgery, and the podiatrist will usually try to treat problems without surgery first. Anti-inflammatory drugs, arthritis medications, and splinting are typical first-line treatment options. If a person still cannot walk comfortably, a podiatrist can explain joint replacement and answer any questions about the procedure. Most podiatrists are qualified to perform the procedure in their own offices, although the patient may be referred to a specialized surgical center.
Before replacing a joint, the surgeon usually injects local anesthesia into the leg. The top of the toe is shaved and washed, and the incision point is selected along the base of the MTP joint. The surgeon makes a small cut and examines the extent of damage to the cartilage and bone. When possible, only half of the joint is removed and replaced with a metal prosthesis, while the other end is simply smoothed out and reattached. Total joint replacement is a more complex procedure that involves installing an artificial joint while avoiding accidental damage to tendons, nerves and blood vessels.
Once the joint is in place, the orthopedic surgeon closes the surgical wound and assists the patient to the recovery room. The nurse dresses the scar and ensures that the anesthesia wears off before the doctor returns to examine. He or she is confident that the joint remains in place and that the patient is in minimal pain. You may need to wear a splint, hard sheet, or special protective sock for a few weeks to give it time to heal. Most people are advised to use crutches and avoid bearing weight until it is time to remove the casting.
Once the toe is treated, the podiatrist can arrange physical therapy sessions. The patient is instructed to perform stretching and bending exercises for flexibility and to become accustomed to the feel of the prosthesis. After about two months, most patients can walk and run comfortably again.
The hip joint is the largest joint in the human body, without which it is difficult to imagine such familiar actions as walking, squatting, running, and maintaining an upright body position. Experiencing enormous stress, it is very susceptible to various kinds of pathological changes, which bring not only pain, but also disruption of its function. In such cases , replacing the hip joint with an artificial endoprosthesis becomes the only way to return the patient to his former activity and normal lifestyle.
The hip joint connects the legs to the pelvis. The articulation involves the head of the femur, immersed in the acetabulum of the bony base of the pelvis. To ensure movement, the articular surfaces are covered with cartilage tissue, and the joint itself is surrounded by a good muscular frame and strong ligamentous apparatus.
A healthy hip joint is involved in tilting and turning the body, bending and rotating the legs, and ensures correct gait and posture. We don’t think twice about performing these actions, but any change in the joint leads to severe discomfort and loss of usual functions. Both excessive loads and lack of movement can contribute to changes in joint elements; various types of injuries, inflammatory processes, and infections can lead to irreversible consequences when surgery is required.
Indications for hip replacement are:
Arthrosis is the most common reason for surgery. In case of damage to the hip joint, they speak of coxarthrosis. This condition represents changes of a degenerative-destructive nature, in which cartilage is destroyed, bone surfaces are deprived of their protective layer and are deformed. The discrepancy between the load and the capabilities of the affected joint leads to worsening changes, pain and limited mobility. Cartilage tissue is not able to recover, and the process is irreversible. Osteoarthritis is promoted by chronic injuries and malnutrition of the joint.
Wear and tear of the hip joint occurs in old age due to overload with movement, body weight, and heavy lifting. Over time, the nutrition of the joint elements is disrupted, the cartilage becomes more fragile and brittle, and the joint ceases to play the role of a shock absorber. In such cases they talk about “age-related wear.”
Trauma is also a common cause of hip dysfunction. Injuries in this area often result in a fracture of the femoral neck, which is considered a common pathology of the musculoskeletal system in older people. Elderly women, who suffer from osteoporosis and brittle bones due to age-related hormonal changes, are especially susceptible to hip fractures.
Already existing in old age, secondary changes in articular elements, impaired nutrition of cartilage and bone tissue lead to the fact that the fusion of bone fragments is almost impossible. Patients are forced to lie down, and walking is out of the question. Such bed rest is in many ways more dangerous than the fracture itself, since it contributes to the exacerbation of chronic pathology of the lungs, heart and blood vessels. Bedridden patients after a hip fracture have an increased risk of stroke, thromboembolic complications, bedsores, and pneumonia are likely, so they need hip replacement surgery. It allows not only to avoid serious complications, but also to save the patient’s life.
In the case of other injuries, accompanied by damage to the ligamentous apparatus, cartilage tears, dislocations, post-traumatic coxarthrosis , due to which there is a need for surgical treatment.
If the formation of a joint is disrupted in the prenatal period or early childhood ( dysplasia, congenital dislocation ), trophic disorders and degeneration of the osteochondral base are inevitable. Early arthrosis develops, pain appears, and movements become difficult.
Inflammatory processes can be caused by rheumatoid arthritis, gout, systemic connective tissue diseases, and injuries. All of them lead to destruction of articular elements and the need to replace them with artificial ones.
Other reasons why endoprosthesis replacement is necessary include aseptic necrosis of the femoral head due to closure of the feeding arteries, excessive load on the joint due to obesity, trophic disorders due to diabetes mellitus and other metabolic diseases.
The listed conditions cause irreversible damage to the joint, so the solution to preserve the ability to move is surgery to replace it. You shouldn't be afraid of her. Of course, the intervention is not simple; it will require certain efforts from the patient both in preparation and at the rehabilitation stage, but this is the only opportunity to eliminate pain and return to previous motor activity.
When it is clear that surgery cannot be avoided, it is important for the doctor to assess the possible risks and contraindications to the intervention, because most patients are elderly people with a “whole bunch” of concomitant diseases.
So, can be considered contraindications to hip replacement:
Acute arthritis of the hip joint can prevent normal implant healing and is dangerous due to the generalization of inflammation, so it should be treated conservatively.
If the patient suddenly falls ill with an infectious pathology during the period of the planned intervention (ARVI, pneumonia, intestinal infection, etc.), then the operation will have to be postponed until complete recovery.
Chronic foci of inflammation, even sluggish and sometimes unnoticeable, like a carious tooth or an abscess on the skin, must be eliminated. Surgery is a serious stress that can lead to the spread of infection throughout the body.
If the patient suffers from severe diseases of the internal organs in the stage of decompensation, then surgery is contraindicated for him. In such cases, if possible, the condition is brought to a stable state. For example, they adjust the insulin dose for a diabetic, select effective antihypertensive drugs for a hypotensive patient, restore the heart rhythm in case of arrhythmias, etc. If doctors manage to compensate for the pathology, then the operation may become feasible.
Young patients are a special group of patients. Usually the question of endoprosthetics arises in the event of injuries. If in the case of old age the indications are completely definite, then for young people the operation will be prescribed only if all possibilities for restoring their own damaged articulation using organ-preserving techniques have been exhausted.
Proper preparation for surgery is an important component of the entire treatment, which also determines the final result. It is important to conduct a maximum study of the function of vital organs, prevent exacerbation of chronic diseases, normalize weight and activate muscles.
Preparing for a hip replacement should begin several weeks before your planned surgery. It includes:
All of the above studies can be done in the clinic where the operation is planned, but it is more advisable to carry them out on an outpatient basis in your clinic and come to the doctor with ready-made results, on the basis of which the method of anesthesia will be chosen.
An important point in preparation is obtaining permission for the operation from the therapist. Many patients, especially the elderly, suffer from chronic pathology, which may worsen or serve as a contraindication to intervention. Before endoprosthetics, blood pressure is adjusted to consistently normal values, blood sugar levels in diabetics, and weight loss in case of obesity is desirable. If caries is present, it should be treated by a dentist, since it is a source of chronic infection.
During the recovery stage, muscle condition plays an important role, so it is advisable to start training at the preparatory stage. A doctor or exercise therapy instructor will help you learn exercises to strengthen the muscles of your arms, torso, and legs.
Patients who have undergone prosthetics will need to use crutches or a walker to move around, so you can try using them in advance.
Smokers should, if possible, give up the bad habit if they do not want to face complications from the lungs and prolonged wound healing.
If you are taking blood thinning medications, you should notify your surgeon and stop taking them at least a week before surgery. By the way, some aspirin-based drugs may not be canceled (thrombo-ass, for example), but only a doctor should give such a recommendation.
When all the necessary procedures have been completed and permission for the operation has been received, the patient is sent to the clinic, placed in a ward, the anesthesiologist talks with him about the preferred method of pain relief, and the surgeon plans the course of the upcoming intervention. The patient fills out a questionnaire and consents to the operation after a conversation with a doctor, who informs about possible complications and risks.
On the eve of the operation, eating is prohibited from seven o'clock in the evening, and from midnight - both food and water. This condition is very important to ensure safe anesthesia and prevent dangerous side effects (vomiting, for example). You should take a shower and put on clean clothes, try to get enough sleep and not worry, relying on the experience and knowledge of the staff.
Immediately before the operation, the healthy leg is bandaged with an elastic bandage to prevent thrombosis, and a catheter is inserted into the bladder, which will be removed the next day after endoprosthetics.
As a hip joint endoprosthesis, various structures are used, consisting of inert materials (metal, ceramics, polymers) that are strong enough to perform movements with their help. The endoprosthesis must best match the joint being replaced and is selected individually in size.
A hip implant is a hinge consisting of a rod that is fixed into the femur, an acetabulum that is pressed into the pelvic bone, and a metal or ceramic replica of the femoral head that is embedded in an artificially created acetabulum.
The materials used to make prostheses are inert, do not cause a reaction from surrounding tissues and take root well. Many patients wonder whether it is possible to conduct such a popular study as MRI after endoprosthetics. Titanium alloys and synthetic components of the prosthesis are paramagnetic, do not shift or heat up in a strong magnetic field, therefore such research is not contraindicated after surgery.
Prostheses are fixed to the bones in several ways:
The intervention takes about 2-3 hours, preference is given to minimally invasive approaches that provide the least amount of tissue trauma. Hip replacement is a high-tech procedure that requires highly qualified and experienced surgeons, on which the outcome of the intervention depends.
The patient is placed on his side, the leg is bent and fixed. The operation is carried out in several stages:
The operation can be performed under general anesthesia or epidural anesthesia. With the second option, the patient can sleep if there is such a desire. The choice of anesthesia method is determined by the presence of concomitant pathology and the desire of the patient.
Immediately after the intervention, a control X-ray examination is performed to ensure that the prosthesis is installed correctly, then the patient is sent to the recovery room or intensive care unit. In some cases, the patient may be immediately transferred to the traumatology and orthopedics department.
In the ward after surgery, the limb is covered with pillows or special cushions to prevent unwanted movements. The patient's condition is monitored by the surgeon and nurses who monitor the course of the early postoperative period.
After endoprosthetics, painkillers are prescribed, the wound is regularly examined, drainage is used, and the catheter is removed from the bladder. Antibiotics are indicated to prevent infectious complications. On days 12-14, the stitches are removed and you are allowed to shower.
When the main fears associated with the need for surgery are over, the patient has successfully survived it, it is worth immediately making every effort to rehabilitate after hip replacement.
Recovery needs to start as early as possible. Bed rest does not mean immobility, and the first exercises are performed in bed under the supervision of a doctor, slowly, 5-10 times each:
Exercises performed while standing:
The day after the operation, the patient is usually allowed to stand up and walk using a walker or crutches. During this period, it is important to avoid excessive activity and traumatic movements. It is better to go up and down stairs with outside help.
Patients should be informed that certain types of movements are strictly prohibited :
Home rehabilitation continues after discharge from the hospital (after 1-2 weeks). It includes exercises that the patient has already mastered while in the hospital, as well as new ones - with an elastic band, on an exercise bike. Walking is useful, the duration of which increases gradually, and in the early stages you need to use a cane to prevent falls.
Feedback from patients after endoprosthetics is positive, and in 95% of cases it is possible to achieve a good treatment result. Already in the first few weeks, the pain goes away, and it becomes possible to perform various movements. After one and a half to two months, it is possible to return to usual duties and activities, driving a car, and resuming work.
Possible complications are associated with thromboembolism, bleeding, infectious and inflammatory processes, and injuries after surgery. If you experience pain, redness of the skin, severe swelling of the leg, or fever, you should immediately consult a doctor.
Many patients are concerned about whether they will become disabled after a hip replacement. Since the operation is intended to eliminate the symptoms of arthrosis, pain and restore movement, it cannot be considered a reason for disability, provided that the treatment was effective. Moreover, if before the operation there were some restrictions due to significant impairment of motor and static function, then after successful joint replacement they can be removed.
On the other hand, a dangerous consequence of the operation is postoperative arthrosis, which may be the reason for establishing a disability group. An incorrectly selected prosthesis, inadequate or insufficient rehabilitation can also lead to complications and disability.
The required disability group (I-III) is established based on the degree of impairment of motor function and the severity of coxarthrosis by the conclusion of the ITU, to which the patient is referred after the necessary examinations.
Endoprosthesis replacement surgery can be performed either for a fee or free of charge. In the case of paid treatment, the price is very variable and depends on the materials and design of the prosthesis, the qualifications of the doctor, and the time spent in the hospital. On average, the cost of joint replacement in a public clinic is 45-50 thousand rubles. In private it reaches 300-400,000, in this case, in addition to the prosthesis itself, the patient needs to pay for all studies and consultations with specialists, consumables, as well as every day of treatment in the hospital.
Hip replacement is a case where you can get a quota for treatment. For an operation under a quota, it is necessary to provide the appropriate medical documents to the selected clinic, after which (if there are quotas) a “Quota Decision Protocol” will be issued, on the basis of which the patient is included in the operation plan. After that you need to wait your turn.
Hip replacement can be done in hospitals that have a trauma department. It is not so important whether it is a public or private clinic, because the result depends on the quality of the endoprosthesis and the qualifications of the surgeon. In Moscow, endoprosthetics are performed in City Clinical Hospital No. 1, State VKG named after. Academician N.N. Burdenko and others. Any public hospital with a trauma department can offer such a service, but if there is a desire and financial opportunity, the patient has the right to go to paid clinics both in Russia and abroad.
Any pathology of the hip joint with pain and limited mobility should be a reason to contact a traumatologist and resolve the issue and the need for surgery. Some patients tend to endure the pain and wait, but the changes only progress and there is no improvement. A competent specialist will help you decide on the timing of the operation, select the most suitable type of endoprosthesis and give you the opportunity to live an active life for many years.