Surgery

Rehabilitation at home after knee arthroplasty

Replacing the knee joint is not such a simple matter. Your life after prosthetics will never be the same. Rehabilitation after knee arthroplasty - what should it be?

Rehabilitation - the second half of the success of knee arthroplasty

To make a joint replacement operation is not all.

  • It will take a difficult program of medical exercises for the joint
  • The load on the joint will have to be limited, as well as some types of exercises:
    • on convolution
    • jog and jump
  • Many sports (light and heavy athletics, wrestling, downhill and water ski, parachute, etc.) will have to be abandoned.
  • You will need to be seen by a doctor for several years after surgery.

It may seem that after surgery you will have to spare and protect the sore knee in every possible way. This is not quite true:

A sparing mode for several days will certainly be there, but the first exercises will have to be started on the second day. And then the load will only increase.

It will take a long time to develop a joint after surgery, and even more nerves and patience. Have to work through overcoming pain. How else?

Rehabilitation is necessary to:

  • There were no contractures, and the prosthesis was bent and rotated with approximately the same amplitude as the once healthy joint.
  • The risk was not in vain (operation is always a risk) and funds spent

What determines the success of rehabilitation

Half of success depends on the skill and skill of the surgeon, and the second half only on the patient:

  • Will he be able to complete the entire rehabilitation program?
  • Do not relax after a few weeks and even years
  • Will do as it should, not only in a rehabilitation center, but also at home

When performing the rehabilitation program, the patient is not alone:

  • The patient should not guess:
    • will not be dangerous or undesirable exercises that hurt him
    • Will there be any side effects?
  • He does not need to make his own choice of exercises.
  • There is no need to purchase mechanical simulators (they must be in a rehabilitation center)

    Special treadmill in a rehabilitation center

    All these issues are decided by the attending physician and rehabilitologist.

    Surgeons are aware of the main dangers of the early postoperative period:

    Risk of blood clots:

    You can suspect signs of thrombosis by pain, swelling and redness below or above the knee

    The risk of developing infectious inflammation:

    Elevated temperature, blood cell levels going up in blood can be alarming symptoms.

    To prevent postoperative complications, coagulants (blood thinners) and antibiotics are prescribed.

    A rehabilitologist visits the patient within a few hours after the operation and shows the first necessary exercises that he will need to perform.

    After discharge, the question of a rehabilitation center is usually raised, but classes there are not cheap, and therefore many patients decide to do the restoration themselves.

    But if a person does not intend to undergo rehabilitation at all (nowhere - either in the center or at home), then it is better to refuse the operation itself altogether.

    Is self-rehabilitation possible at home?

    Probably, yes, because the impossible is really nothing.

    But in practice, it is difficult to restore the joint independently and for a long time after prosthetics:

    Mechanotherapy is practiced in orthopedics - a method of passive rehabilitation, when the movements of a patient limb are carried out by mechanical simulators, which are always in the rehabilitation center.

    Early Operational Exercises

    These exercises are necessary to prevent thrombosis and muscle atrophy and to maintain the functions of the musculoskeletal system

    The first two days after surgery

    Hand exercises

    • Squeeze and unclench fists
    • Bend and unbend arms in elbows
    • Rotation fists in both directions
    • Similar elbow rotation
    • "Boxing" with the separation of the blades from the bed
    • Straight and cross "scissors"
    • Pull up

    Exercises for a healthy leg

    The goals of such exercises are to combat thrombosis and muscular atrophy.

    • Ankle Circular Motion
    • Squeezing and unclenching
    • Knee bend
    • Raised straight leg
    • Leaning on the heel and elbows, lift the buttocks
    • We begin to sit down with the help of a handrail, first without lowering the legs to the floor, and on the second day, we lower them

    Exercises for a sore leg

    • Squeeze and unclench fingers
    • We pull foot on ourselves and from ourselves
    • Alternately, bend and unbend the legs while lying and sitting
    • In the sitting position, we put our feet on the bench, raise and lower them without lifting the heels

    The gymnastics of the first two days is performed at a slow pace:

    • Three to five minute breaks are taken between several exercises.
    • Some exercises combine with a breathing rhythm.

    After it turned out to sit on the bed with your legs down, you need to learn to stand on crutches or walkers

    Walking on walkers or crutches

    Walking with aids is made on the second day. Walking on crutches is somewhat more difficult, since more physical strength is required. For older people, walking on walkers is preferable not on crutches.

    It is easier, of course, to see or experiment with crutches before the operation, but the general technique is simple:

    Walking on crutches with the help of an instructor is done on the second day.

    It is necessary to get up, holding the handrail with one hand, the other with the handle of a crutch or walker, supported by a healthy leg

    Walking on crutches and on walkers is built on the same principle:

    • They serve as additional support for the body:
      We rely on crutches in the armpits, and on the walkers with our hands
    • Initially, we are moving forward, at a small step, both crutches or walkers
    • With a healthy foot, we take a step and tighten the operated leg with a sliding movement on the floor.
    • Sore foot should first touch the floor with the heel, and then you can lower the entire foot.

    The first walk with additional support should be short and be performed with the help of an instructor

    Two to seven days after surgery

    The patient by this time independently sits in a bed, having lowered legs to a floor, and itself goes on crutches.

    We repeat all previous exercises in the prone position and sitting, but more actively and in large amplitudes.

    The number of repetitions increases

    • keeping the foot extended
    • keeping the straight leg raised to 20-30
    • extension of the limb with a roller under the heel
    • isometric exercises with tension of the gluteus and quadriceps
    • bends and turns of the trunk with outstretched hand
    • imitation of walking
    • exercises in the supine position (on a healthy leg) with a roller between the legs

    Starting from the second day, the development of the knee joint with the help of mechanotherapy begins - passive flexion-extension of the knee joint on a mechanical simulator with a gradual increase in speed, angle and duration

    Passive flexion-extension of the knee joint on a mechanical simulator: such exercises begin two days after the operation

    Day nine after surgery

    Exercise in a sitting position - leg moves

    The dynamics of exercises for the operated leg increases:

    • Lying on the side bend and unbend the leg in the ankle
    • Pull the sock up and lift the leg by 10 cm (specialist help is allowed)
    • We make small moves with a sore foot.
    • Added exercises with a focus on the handrail standing:
      Swing forward and lift your feet to a small angle

    Extract usually occurs in two weeks.

    Crutches will last an average of six to eight weeks, although some patients refuse them earlier.

    At home, you will repeat all the exercises that you did in the hospital in all three positions, plus they will add:

    • abdominal exercises
    • squats
    • rises on tiptoe

    It is also necessary to repeat the passive mechanotherapy: at home, this can be done with an ordinary elastic tape.

    Passive exercises for the knee with elastic tape

    The task of home exercises:

    • Do not allow contracture
    • Restore knee function
    • To improve the trophism of soft tissues of the lower leg and thigh

    Late recovery period

    It begins 1.5 months after surgery.

    The objectives of the late recovery period - the restoration of the functions of the diseased limb

    Exercises with support and load on a sore leg are added:

    • Mahi standing on a sore leg
    • Walking on bent legs holding onto handrails
    • Exercises "scissors" and "bike", etc.

    Late rehabilitation period

    This period is usually considered a period of more than two months after surgery. However, for all their time.

    The tasks of this period are mainly adaptation:

    • Sick learn to walk with a cane
    • Performs exercises with weighting
    • Begins on a stationary bike

    In the photo below - exercises with a knee joint to develop:

    Exercise with a knee joint

    How long should I recover

    Checkups at the doctor after arthroplasty are performed every year.

    In fact, concern for the joint will last a lifetime. It is impossible at the end of rehabilitation immediately forget about the prosthesis.

    • Six months after the operation, it is necessary to carry out a control examination of the knee at the surgeon.
    • Then visit the doctor annually.
    • For several years, you need to do active therapeutic exercises every day.
    • Then you can simply perform daily gymnastics, maintaining your normal weight.
    • 10 years after the operation, it is necessary to conduct an especially thorough examination, since the prosthesis resource could come to an end.

    Video: Rehabilitation after knee arthroplasty

    If you have conceived a knee joint endoprosthesis replacement operation, familiarize yourself with the full methodology of the Federal Center for Traumatology, Orthopedics and Endoprosthetics:

    • How is the preparation for the operation
    • Full set of exercises after knee arthroplasty in different periods of rehabilitation

    1. The main types of rehabilitation
    2. The main stages of recovery
    3. Null
    4. The first
    5. Second
    6. Third
    7. The quieter you go, the further you'll get
    8. Important Tips

    The recovery period after replacing the knee joint on the endoprosthesis on average takes up to six months. However, it must be understood that for each patient rehabilitation has its own meaning. For some, recovery is the ability to move without pain, for others to return to the normal rhythm of life without the use of crutches, to do everyday things like going to work, driving a car.

    The recovery period is affected by the technique by which the operation was performed. With minimally disabled technology, the reabidiation period is shorter.

    Even knowing and taking into account all the statistical data, it is difficult to determine the exact time of recovery for each patient individually. The average patient aged 55-60 years a week after discharge from the hospital is able to return to a more or less normal life. But in this case we are talking about patients who did not delay with surgical intervention.

    Recovery from a total prosthetic knee joint can last up to two to three months, provided that the patient’s preoperative condition was assessed as normal, i.e. the pathological process was not at the stage of global destruction of the native joint. Thus, the period of rehabilitation may be different and depends on the general condition of each patient.In general, if all the recommendations of the doctor are followed and the recovery takes place in a specialized center, the patient’s motor activity returns to normal much faster.

    Previously, knee replacement was performed exclusively for people over 60 years old. It was believed that low activity in old age does not stress the artificial joint, and it lasts longer. Today, this operation is successfully performed on the joints of young people who are active. New designs of endoprostheses withstand significant loads, wear out after 20-25 years.

    With a one-mile replacement, the recovery rate is about a week or two.

    It must be remembered that implant placement is an operation. And, like any surgical procedure, it sometimes causes complications. Therefore, a certain period of rehabilitation is established after replacing the knee joint. It is also important as the operation itself. It is not by chance that many endoprosthesis replacement clinics pay special attention to the recovery stage. Its duration is set individually. A special comprehensive program is drawn up from various procedures (medication, massage, physiotherapy) and physical exercises. This is done in order to return the patient full motor activity.

    In the early days after surgery, and this is 1-5 days, the patient begins to sit on a chair, get out of bed, do passive physical exercises without the help of the medical staff. At this time, you must begin to practice climbing and descending the stairs, on two or three floors. At the moment, any physical activity may be accompanied by pain and discomfort, but, as a rule, they should already be less pronounced. Also during this period, walking should begin with support on crutches, on average, you need to walk from 50 to 100 meters. If necessary, you can take short breaks and relax. For an average patient aged 50-60 years, walking 100 meters in the first days after the operation will not be a big deal.

    Second period

    , which falls from the 5th to the 20th day after the joint replacement, suggests an increase in the distance to 1000 meters. At the same time it is necessary to continue to practice going down and up the stairs.

    Third stage recovery, which is approximately 4-10 weeks after the endoprosthesis, includes the transition from two crutches to one. At this phase of rehabilitation, the patient must quietly move from 2 km to 3 or even more.

    Not only the age of the patient, but also his condition before the prosthetics is of great importance for the rehabilitation process and the timing of recovery. Naturally, patients who lead a passive lifestyle before replacing the joint, recover much longer, since the muscles are weakened. More active people, whose muscle tone is much higher, the rehabilitation process is easier and faster.

    With adequate physical activity of a person before prosthetics, a complete rejection of the use of crutches can occur in 6-7 weeks, return to the usual way of life, for example: you can drive a car or go to work after 12-14 weeks. As for any nagging or aching pain, discomfort, their complete disappearance should be expected in 3-6 (7) months.

    The main types of rehabilitation

    • stationary - medical support in the restoration of limb health,
    • homemade - carrying out preventive measures independently.

    For a sustainable positive result, it is important to consistently complete the entire period of rehabilitation after replacing the knee joint. The patient is in the trauma department from 4 to 7 days. During this period, there are events that are impossible at the level of the city clinic.After that, the patient is discharged and sent to observe the doctor at the place of residence.

    The main stages of recovery

    There are four recovery stages that involve different solutions to the tasks and the degree of load:

    Null

    It is performed on the day of the operation as soon as the anesthesia “disappears”. The patient performs several exercises in the supine position, contributing to the improvement of blood flow, the prevention of stagnation (blood clots), the development of the joint, the activation of cell nutrition processes, stimulating the cardiovascular and respiratory systems, the elimination of pain and discomfort. After anesthesia, there is a strong hunger, so six hours after surgery you are allowed to drink water and eat a toast.

    Someone needs to be around when they come out of anesthesia, because the patient’s reactions can be unpredictable. But most often everything is in order.

    It starts from the second day after the postponed surgery and lasts until the 5th day. In this state, a person should observe the following doctor's recommendations:

    1. First Exercise must be done while still in bedAfter all, exercise is needed from the first day after the operation.
    2. In the first few days after the procedure, the patient need to sleep on your back and not roll over on your stomach.
    3. All exercises during the first stage of rehabilitation should be performed under medical supervision. At the same time, they themselvesmovements should be smooth, avoiding sudden movements and overstressed muscles.
    4. Gymnastic Exercise can cause discomfort and is perfectly normal.however, in case of a sharp pain, they do not need to be continued.
    5. The first steps after surgery, you can perform on the second or third day after the procedure. At the same time, a person must move with the help of crutches and exert a metered load on the leg.
    6. To prevent seam divergence, practice active withknee bending can be no earlier than a week later after operation.

    The main objectives of the first stage of rehabilitation after the replacement of the knee joint are:

    • elimination of the edema of the operated limb,
    • the gradual resumption of physical activity, however, is still in its initial form,
    • training a person on crutches (only on flat surfaces),
    • development of the knee joint and improving muscle tone,
    • normalization of blood circulation in the sore knee.

    In addition to the physical functions of the body, one of the main tasks of this period is psychological. The patient should feel full and see that recovery is not far off.

    In order for the restorative exercises to actually have the expected results, you must follow the following doctor's advice:

    • perform exercises with a certain regularity (2-3 times a day),
    • a set of exercises should be chosen individually for each patient (taking into account the patient's age, the complexity of his operation, the presence of chronic pathologies, etc.),
    • repeating the whole complex of exercises is necessary not only during the hospital stay, but also after leaving home (during the late rehabilitation period),
    • It is important to avoid overstressing the muscles and make all movements with the foot gently.

    The main exercises to be performed during the early recovery period are:

      Lying in bed, slowly move your foot up and down. You can also make circular movements, while maximally straining the muscles of the calf.

    You can perform without time limits.

    Sit on the bed and slowly try to bend and flex the knee, while holding the muscles in tension. Repeat ten times.

    It is done both sitting on a chair and on the bed.

    Place a cushion under the knee and strain the thigh muscles. Slowly straighten the leg and hold it in that position for a few seconds.

    You can perform without a roller, or put a towel.

    Become straight or lie on your side and, without bending your leg, take it to the side.

    "Sick" leg is always at the top.

    Second

    When walking on the steps and on a flat surface, you should always place the “sore” leg between two crutches so that the leg has two additional points of support.

    It continues from the 5th to the 20th day after the endoprosthesis. You can move, leaning on one crutch, one distance up to 1000 m, slowly climb and descend the stairs. At this time, it is already possible to completely transfer body weight to the operated leg.

    The features of physical activity for patients during the second stage of rehabilitation are:

      A person is recommended to perform physical therapy exercises, which are based on bending the legs, as well as counteracting it when using an elastic band (tension of the leg muscles when throwing a band on the foot),

    Very carefully, do not overdo it.

    very good effect on muscle recovery massage, which can be practiced at home or use the help of a specialist,

    Massage the seam gently, you can use petroleum jelly or other means without fragrances.

    Toward the end of this stage of recovery, the patient is allowed to perform half-squats, as well as lifting on tiptoe, which will perfectly train the muscles of the entire leg.

    If it is difficult to perform the half-seat, do this exercise, it is an imitation of climbing steps.

    Attention! The second stage of rehabilitation is the most productive, because it was during him that people literally learn to walk anew. If all medical recommendations are followed and perseverance, the patient will be able to move without additional support by the middle of the second recovery period.

    Third

    The late rehabilitation period, as a rule, passes already after the patient is discharged home. For this reason, accordingly, a person will have to perform most of the exercises independently, without medical supervision. That is why he should be extremely careful not to damage his joint when he is too hasty or not performing a certain exercise.

    The main objectives of the late recovery period are:

    • full restoration of motor functions of the diseased leg,
    • adaptation of a person to normal movement, even over long distances, in order to be able to go to work again,
    • improving the trophic muscles of the leg,
    • normalization of the functions of the knee endoprosthesis.

    During such a period, the load on the diseased leg increases, and becomes almost the same with a healthy leg. In this case, a person is recommended to perform the following types of exercises:

    1. Sticking to the rail, walk on half-bent legs.
    2. Lying on your back, perform swinging legs like "scissors" and "bicycle".
    3. Relying on the sore leg, the second to swing.
    4. Put weights on the foot, and then perform the bending and lifting of the limb.

    It is also very useful for people in this period to practice walking on a treadmill and practice on a stationary bike.

    In general, in this period, you can confine only exercises on the exercise bike, this is the best projectile for those who have undergone joint replacement surgery.

    General image of activity for late rehabilitation involves following:

      A person is recommended to regularly conduct long walks and avoid congestion in the joint, since, as a rule, this contributes to limping, weakness in the legs, swelling and pain.

    To walk, walk and walk again.

    The permitted types of physical activity after replacing the knee joint are swimming, table tennis and hiking. You can also play golf and ride a bike.

    If you can not swim, hold on to the side and do the exercises with your feet in the water.

  • Active dances, running, jumping and active types of ball games (football, etc.) are contraindicated in a patient after this type of endoprosthesis.
  • You can not stand in one place longer than half an hour, so as not to overstrain the legs.
  • The operated leg at the knee can be bent up to 90 degrees. Sometimes this possibility may be greater or lesser. It largely depends on the volume of the operation and the specific model of the installed endoprosthesis.
  • The ability to drive a car will depend on the quality of the course of rehabilitation after the replacement of the knee joint. Check with your doctor. You can return to your previous work earlier if it is office work, and later if it is related to physical labor.

    If you had an operation to replace the knee joint, it is strongly recommended to make friends with the exercise bike forever. This is the ideal load on the operated joint.

    After three months will need to move to more dynamic exercises. However, it is not advisable to run, play tennis, football, volleyball, basketball, ski or wear gravity. This creates an extra burden on the knee. Allowed to walk, ride a bike, dance, swim, go to the bowling center.

    The quieter you go, the further you'll get

    Replacing a joint implies a change in lifestyle and certain habits. Leg with implant inside requires careful treatment. Injuries can turn into serious trouble for her. We will have to observe a benign regimen for the first six months, so that the body will accept a foreign body, get used to it and consider it “native”. Problems with the survival of endoprostheses today do not arise, as they are reliable and biologically compatible with the human body.

    Important Tips

    1. Is always follow the instructions of the attending physician and physiotherapist. This will be an important condition for successful recovery and a return to active life. Daily perform the full range of exercises, because this is directly dependent on the state of the muscles and the quality of functioning.
    2. Daily perform the full range of physical exercisesBecause the state of the muscles and the quality of the functioning of the artificial joint directly depend on this.
    3. Avoid Negative Impact on the articular components during sports, work, participation in recreational activities.
    4. Monitor cardiovascular health, respiratory and lung, do not catch cold. After all, for cells and tissues is important a good supply of oxygen and nutrients. Train your lungs with special exercises to avoid developing pneumonia.
    5. Keep pain under control. Take painkillers. If the pain does not subside, go to the doctor.
    6. During the postoperative period, the soft tissues will swell slightly at first. Make cooling compressesand when you are asleep, place a cushion under your foot so that it is in a raised position.
    7. remember, that rest is an important part of treatment and recovery.

    Read reviews of patients who have been treated abroad. In order to obtain information about the possibility of treating your case, leave us a request for treatment at this link.

    Be sure to consult a doctor before treating illnesses. This will help to take into account individual tolerance, confirm the diagnosis, ensure the correctness of treatment and eliminate negative drug interactions. If you use prescriptions without consulting a doctor, this is entirely at your own risk. All information on the site is presented for informational purposes only and is not a medical aid. All responsibility for the application lies with you.

    Knee arthroplasty is a reconstructive surgical intervention that aims to replace the femur, tibia, and the patella with artificial ones.Knee surgery will help reduce pain, restore joint mobility and full leg work.

    Indications and contraindications for knee arthroplasty

    Its main advantages over other types of interventions are the rapid restoration of the movable joints of the bones and the high efficiency of the results. 10 years after installation, the functionality of the endoprosthesis is 95-98%, after 15 - 90-95 and 85-90% after 20. This figure largely depends on the quality of rehabilitation and compliance with the doctor's recommendations, medical procedures.

    Endoprosthetics are recommended for deforming arthrosis, osteoarthrosis, aseptic necrosis of the head, its fracture, progressive rheumatoid arthritis, dysplasia, in the case of a tumor and after injury. The absolute contraindications are: an infection in the joint less than 3 months before the intended operation, vascular disease of the lower extremities, inability to move, heart disease, the absence of a bone marrow channel in the femur.

    Preparation for surgery

    A week before the operation, it is necessary to stop taking blood thinners.

    At the initial stage, the patient is recommended to undergo a full examination, eliminating the risk of chronic, acute inflammation. There should be no skin lesions on the body. If there is a fever on the eve of a fever, a viral illness or indigestion will begin, everything will be canceled. At least 14 days before replacing the joint, the patient should stop smoking and alcohol.

    In endoprosthetics, doctors use general or spinal anesthesia. The intervention lasts 1.5-2.5 hours. The evening before the operation, the doctor must prescribe a drug that prevents the formation of blood clots.

    Tip: 1-3 months before the replacement, doctors recommend to undergo a course of therapeutic physiotherapy. This will help to learn the necessary exercises and learn how to walk on crutches, simplify rehabilitation.

    Knee replacement technology

    The essence of the procedure is to remove the worn articular surfaces of the bones and install special components from polyethylene, metal. This allows you to restore the desired range of motion, to eliminate the deformation of the limb. Total knee arthroplasty provides for a complete replacement of the bone joint. The prosthesis consists of artificial hip, tibial joint components and a special element from a metal plate, a polyethylene liner. If the ligamentous apparatus is damaged, doctors use a complex loop prosthesis. Fixation can be cement (choose bone cement - polymethyl methacrylate) and cementless, when the desired element is mechanically fixed.

    Knee prosthesis

    Prosthetic limbs after amputation are many times more complicated and expensive. Rehabilitation of such patients requires mandatory psychological support.

    During the operation, the orthopedic surgeon removes the cartilage from the surface of the femur and tibia and corrects the axial position of the joint. Then replaces and strengthens the endoprosthesis. To fill the bone defects using the tissue of the patient or donor. At the final stage, the doctor should check the strength, stability of the established prosthesis. To do this, he makes movements in the knee under different degrees, evaluates their smoothness.

    What is endoprosthetics?

    Problems with the normal functioning of the knee joints occur in most people. The reasons for this can be completely different: overweight, sedentary, or, conversely, too active lifestyle, injuries, and extreme sports.

    However, the operation itself will not give you full leg health. After this surgical intervention, long-term rehabilitation is necessary, and the entire success of the case depends on the correct implementation.The process of postoperative recovery must be prepared before surgery. We will tell you in detail how to do this.

    Features of the rehabilitation period

    On the first day after endoprosthetics, the accumulated blood is removed through a drainage tube, it is still impossible to get out of bed, but leg movements are not limited. If the patient feels good, you can sit, stand up on crutches, hang your legs out of bed. If necessary, before going to bed the patient is injected with painkillers or sleeping pills. First, the skin in the area of ​​the joint may have a fever, suffer from edema. If these symptoms worsen and an infection is suspected, doctors will puncture the knee joint.

    The early load on the operated leg should be moderate

    An individual program of postoperative rehabilitation, including exercises and physiotherapy, is a physiotherapy physician. Early activity is useful and will contribute to the rapid recovery of the body, the development of strength and the correct amplitude of movements in the joint. But it is also impossible to overload the operated leg.

    To reduce the load, you can use a walker. They will help maintain balance, move safely, avoid unnecessary stress. When the muscles after the replacement of the joint get stronger, the patient can use crutches. Movement starts up with a healthy leg, and down - with the operated.

    Tip: during the intervention, doctors will restore movements in the knee joint, but at first they will be painful. To overcome the discomfort, it is recommended to do a special gymnastics.

    The main components of the early rehabilitation period are

    1. Therapeutic exercises for:
    • strengthening leg muscles (raising a straight limb, its retention at the moment when muscles are tense, rhythmic lifting and lowering of the foot),
    • extension of the lower limb at the knee joint,
    • flexion (lying, sitting with or without support).
    1. Lymphatic drainage (apparatus massage for outflow of fluid),
    2. Cryotherapy (cold treatment), electrotherapy,
    3. Walking on steps, a flat surface (it helps to develop endurance and strength).

    Shower and bathing

    Experts recommend to take a warm shower for 6 weeks after surgery. At the entrance, you must first put a healthy leg, and then the patient. Exiting the sequence needs to be changed.

    Tip: the patient should remember that movements in the operated joint should be uniform, smooth, and their amplitude gradually increases.

    What is important to remember during rehabilitation:

    • 4 to 12 weeks after the replacement, you need to wear compression stockings to support the leg muscles and reduce the risk of blood clots,
    • therapeutic exercises need to be done systematically, every day,
    • before full restoration of support ability, it is necessary to use crutches, a cane.

    Tip: if you feel severe pain, fever, discharge from the wound, you need to urgently consult a doctor.

    In order to prolong the endoprosthesis life, it is impossible to lift heavy things, walk long steps and overload the joint, you should not allow the appearance of excess weight. You should also avoid those sports that are very stressful joints of the bones: running, aerobics, skiing, jumping.

    It is important to know that the operated joint is easily infected. Therefore, for colds, surgical procedures, urinary infections, you need to take broad-spectrum antibiotics according to the doctor’s scheme.

    Risk factors, complications

    Deep vein thrombosis

    Knee arthroplasty is a planned operation that requires a thorough examination and examination of the patient's health. This largely eliminates the risks, but it is impossible to fully insure yourself against them.Complications during the intervention are due to the anatomical features of the joint, the general state of health, and after the operation - lifestyle, illness or injury, ignoring strengthening exercises. During intervention, heart failure, breathing problems, impaired blood circulation in the brain due to anesthesia, vascular damage, nerve damage, a fracture or bone fracture, or different lengths of the limbs may occur.

    Complications of the early operating period:

    • wound discrepancy, its inflammation,
    • deep vein thrombosis, blood clot formation,
    • dislocation of the patella or prosthesis components,
    • allergic reactions to anesthesia, medications,
    • acute insufficiency of the respiratory, cardiovascular system.

    To avoid them, you need to follow all the recommendations of doctors, not to create traumatic situations and be sure to make test samples for new medicines.

    Late complications after arthroplasty can manifest itself in the form of:

    • displacement of the prosthesis (it is also called technical loosening),
    • temporary crunch when moving the patella, which must pass during rehabilitation,
    • contractures of a joint when its mobility is limited during flexion or extension),
    • formation of excess scar tissue near the endoprosthesis, bone fracture in the area.

    Endoprosthetics makes it possible to forget about the pain and live a full life. Physical therapy and regular examinations will help to quickly restore the body and minimize the risk of complications.

    We advise you to read: hip arthroplasty

    Attention! Information on the site is provided by experts, but is for informational purposes only and cannot be used for self-treatment. Be sure to consult a doctor!

    The procedure for complete replacement of the knee joint with a prosthesis in some cases becomes the only way to get rid of excruciating pain and preserve the mobility of the limb. She is very complex and responsible. After endoprosthetics, the patient must constantly develop the damaged area and maintain muscle tone. Rehabilitation occupies a no less important place than the operation itself, an important part of the recovery is therapeutic gymnastics.

    Exercise therapy is a necessary rehabilitation element after prosthetic knee joint, they can not be neglected!

    Serious operations are performed only in specialized clinics, where the specialist in physiotherapy exercises also works. For each patient, he develops an individual training program based on age and health. Complexes are always based on common actions - these are the basic exercises and the rules for their implementation in this article.

    This is what you should strive for during the first 2-3 weeks after the operation - being able to walk at least a little without crutches.

    What exercises after knee arthroplasty are recommended?

    It is important to know! Doctors are in shock: “An effective and affordable remedy for joint pain exists ...” ...

    Physical therapy is a central part of rehabilitation after surgery and the installation of an endoprosthesis. Its content varies depending on the stage of recovery - the whole period is divided into five steps:

    Endoprosthetics

    The operation of endoprosthesis replacement is prescribed to patients in the case when other methods of treatment are already powerless. Replacement of the knee joint may be complete, or partial, depending on the degree of damage.

    In endoprosthetics, the damaged areas are replaced with an endoprosthesis, whose material is almost identical to the natural bone tissue. The endoprosthesis is fixed with the help of bone cement.

    The operation also involves undamaged ligaments of the knee joint, performing the function of stabilizers. Instead of cartilage, plastic pads are used in the endoprosthesis.

    Rehabilitation

    The period of rehabilitation after the replacement of the knee joint may depend on the individual characteristics of the organism, but, most often, full recovery occurs in 10-12 weeks, subject to compliance with all recommendations.

    Rehabilitation after replacing the knee joint is divided into two stages: early and late. In each of the rehabilitation periods, certain exercises must be performed that speed up the healing process and bring healing closer. Recovery actions after endoprosthetics:

    1. Give leg muscles the necessary strength
    2. Make the knee joint more mobile
    3. Give the new joint security,
    4. Allow the patient to return to the usual rhythm of life.

    Early stage

    Often, the patient can bend the operated leg in the knee immediately after surgery. With independent rising and walking, things are different: the operated joint is still too weak to bear the weight of the body.

    In the first days after arthroplasty, the hospital staff helps the patient to get out of bed, later he learns to walk with the help of crutches. Also, in the hospital, qualified specialists teach patients who have undergone surgery to handle the new knee prosthesis: stand up, bend your knee, stand, sit, and perform other actions familiar to healthy people.

    • First day in the hospital. The patient learns to perform the exercises necessary to strengthen the femoral muscles and increase the number of movements of the new joint. In many clinics of the modern type for the initial rehabilitation after replacing the knee joint, a specialized mechanical apparatus is used, which itself bends and extends the patient's leg. Additional exercises on the first day of rehabilitation are sitting on the edge of the bed, the first attempts to get up with crutches, trying to take a few steps, and also go to bed on your own,
    • The second day in the hospital. Doctors-therapists gradually increase the patient's workload: they offer him to walk around the ward with the help of a cane or crutches, to visit the toilet on their own, and also to go down or up the stairs,
    • The third day in the hospital. An increase in the patient's physical activity is observed. All the above steps are easier. On the third day, in the absence of complications, the survivor can be discharged from the hospital.

    Late stage

    The discharge field, doctors strongly recommend continuing rehabilitation. The process leads to a speedy recovery and the resumption of the usual life cycle. In the framework of late rehabilitation, patients undergoing arthroplasty are shown physiotherapy with the concurrent use of painkillers (strictly on prescription).

    In addition to painkillers, pain relief in the operated knee can be reduced with the help of cooling compresses, which are applied daily for 10-15 minutes. In addition to getting rid of pain, applying cold will help reduce swelling.

    Subject to medical recommendations, patients after arthroplasty return to normal after a few months after surgery.

    Want to get the same treatment, ask us how?

    Rehabilitation after arthroplasty is of paramount importance for ensuring smooth joint function and improving the patient’s quality of life. The operation to replace the knee joint is indicated for the treatment of painful and disabling pathologies caused by various forms of arthritis and severe injuries. The orthopedic surgeon performs a full or partial replacement of a worn joint with its anatomically exact copy.

    Artificial implant consists of metal and plastic elements that are absolutely safe for the body.To re-teach the operated limb to move correctly, to expand the range of available movements, it requires massages, visits to the physiotherapy room, and a set of exercises.

    The term of rehabilitation, as well as its success, depends on the severity of the patient's condition, his diligence, adherence to medical recommendations, willpower, the desire to achieve success.

    Recovery time: when can I walk?

    It is important to know! Doctors are in shock: “An effective and affordable remedy for joint pain exists ...” ...

    This question is often asked among visitors to specialized forums dedicated to endoprosthesis replacement issues. Progress is purely individual, a full return to normal activities is possible within 3-6 months after the procedure, during which you will rebuild your own life, learn the most ordinary things.

    Most implants allow the knee to bend, but not more than 110 degrees.

    The difficulty of the recovery process is that people with arthritis live with exhaustive pain for years. During this time, they develop preferred postures for sitting, standing, moving, becoming inactive and some muscles atrophy. These same habits, called abnormal neuralgia, do not go anywhere even after you wake up in the postoperative ward. The process of getting rid of them is complicated, thorny, it is desirable to undergo it under the supervision of a rehabilitation physician.

    In degenerative articular diseases patients are entitled to disability benefits. For its registration it is necessary to collect the necessary results of the survey, confirming the inability to move independently.

    Rehabilitation after endoprosthetics can also be a reason for obtaining a similar status if, as a result of the operation, you are not able to do your usual work. Such social assistance is provided within 12 months.

    How to increase the effectiveness of rehabilitation?

    If all medical recommendations are followed, an increase in the available range of movements and relief from pain can reach 90% of patients.

    The recommendations of a specialist, depending on the method he practices, the type of procedure transferred may vary. Usually they include the following items:

    • early physical activity is the key to successful rehabilitation,
    • already on the second postoperative day, you must begin to sit down and get up, using special handrails as a support,

    Get out of bed and go to the toilet in the first days after surgery - this can already be called rehabilitation.

    conquer the stairs will have on the fifth day. And the first step is necessarily a healthy foot,

    And the sore leg is always between two crutches.

    an increase in physical activity occurs gradually, so as not to damage the implant,

    This can happen if you are in a hurry. This is a dislocation of the knee implant.

    after being discharged home, you can only squat on high chairs, and it is forbidden to lift objects without assistance or special devices,

    A good example of the first time prohibited provisions.

    constant weight control

    If you are overweight, then just lose weight - it will give you a big head start in the recovery process.

    sleep on the side or back is allowed only with the use of a special roller placed between the legs,

    This requirement is more suitable for the hip joint, but the knee should also be secured in this way.

    you can only drive a car 8 weeks after the procedure

    Sit and go out of it should be a special way.

  • Eat foods rich in iron and drink more fluids.

What does rehabilitation consist of?

Rapid intervention itself will relieve you from pain.But if your goal is getting rid of lameness, returning lost motor activity, walking without difference from other people, tune in to a long rehabilitation, and no one can name the exact recovery time.

The entire recovery period can be divided into several key stages:

Important Tips

  1. Is always follow the instructions of the attending physician and physiotherapist. This will be an important condition for successful recovery and a return to active life. Daily perform the full range of exercises, because this is directly dependent on the state of the muscles and the quality of functioning.
  2. Daily perform the full range of physical exercisesBecause the state of the muscles and the quality of the functioning of the artificial joint directly depend on this.
  3. Avoid Negative Impact on the articular components during sports, work, participation in recreational activities.
  4. Monitor cardiovascular health, respiratory and lung, do not catch cold. After all, for cells and tissues is important a good supply of oxygen and nutrients. Train your lungs with special exercises to avoid developing pneumonia.
  5. Keep pain under control. Take painkillers. If the pain does not subside, go to the doctor.
  6. During the postoperative period, the soft tissues will swell slightly at first. Make cooling compressesand when you are asleep, place a cushion under your foot so that it is in a raised position.
  7. remember, that rest is an important part of treatment and recovery.

Preoperative preparation for rehabilitation

Rehabilitation after surgery does not always go well. Surgery has its own risks of complications to which older people are more susceptible to having concomitant health problems. The patient informs the patient about this even at the preparation stage before the surgical procedure and takes measures to prevent their development.

Exercises on suspensions are a separate and large layer of postoperative recovery.

Even at the preoperative stage, they begin to affect the problem areas of the muscles, which, due to a complex disease, have hypotonia and low blood supply parameters. Why do they do it so early? Imagine what difficulties will be accompanied by rehabilitation after knee surgery, when the already weakened leg muscles become even weaker. The risk of developing contractures, atrophy, venous thrombosis and thromboembolism will then increase significantly.

The endoprosthesis is controlled by musculo-ligamentous structures, and until they return to normal, they do not gain sufficient elasticity and elasticity, the implant will not work in full.

It is advisable to start developing the muscles even before the knee joint arthroplasty, rehabilitation after the operation then will be much easier and faster. Moreover, the early period will be much easier to be perceived and transferred if the patient was previously taught the technique of walking on crutches, basic exercises of the initial phase and breathing exercises, skills of daily activity.

If you know that you will have an operation, start doing gymnastics now.

Active recovery after knee arthroplasty will be facilitated by exercises that are performed before the operation, to increase muscle tone, exercises to improve the general physical condition. It is necessary to use this type of physical training, which does not overload the affected bone and cartilage organ, and at the same time trains all the muscle groups responsible for its work. The following types of training correspond to these requirements:

  • free swimming in the pool
  • Nordic Nordic walking
  • classes on the exercise bike,
  • exercises for coordination and balance of movements,
  • walking in the water and fortifying aqua-gymnastics.

All the above classes will remain relevant after the installation of an artificial counterpart. But it will be possible to return to them in the remote periods of rehabilitation: 1.5-3 months should pass, perhaps a longer period of time.

Crutches can be completely set aside approximately 8 weeks after surgery.

To confidently use additional means of support when moving (walkers and crutches), you need strong hands. Rather, strong muscles, located on the back of the hands, which is called triceps. Strengthening the triceps helps one simple charge:

  • sit in a chair with side armrests,
  • place your arms (elbows bent) on the armrests,
  • leaning on the palms and straining the upper limbs, rise up, lifting the pelvis from the surface of the seat,
  • return to the original position
  • repeat 8-10 times.

Plan for the first 2-3 weeks after surgery

The most exciting day passed, you replaced the joint with a mechanical implant. Now the final assessment of the treatment completed depends on your responsibility and how well you will comply with the rehabilitation charter. Therefore, tune in to work hard for several months and, despite all the obstacles and do not give up.

The first days of her legs are tightly bandaged to prevent thrombophlebitis.

General program for the first period

The patient spends several hours in the intensive care unit before coming out of anesthesia, then he is transferred to the hospital. Immediately after admission to the inpatient unit, the implementation of a regimen of preventive therapy developed by specialists begins. Initial rehabilitation involves the early activation of the patient in a sparing motor mode. In the prophylactic purposes against postoperative complications and to accelerate the regenerative processes will be assigned:

  • respiratory diaphragmatic and chest gymnastics,
  • elevated operated legs
  • positioning between the limbs of the roller so that involuntary re-crossing with a healthy leg does not occur,
  • physiotherapy (UHF, magnetic therapy, electrophoresis) and exercises to stimulate the lymph and blood circulation, to start the healing mechanisms, to remove the edema and painful phenomena,
  • classes and procedures for improving the functional state of the muscle group of the operated leg and tonic (antigravitational) muscles of the body,
  • administration and administration of antibiotics, preparations from the spectrum of anticoagulants, anti-inflammatory and painkillers, vitamin-mineral complexes,
  • antiseptic treatment, dressing, wound drainage,
  • applying cold bags with ice to the knee area to reduce pain and reduce swelling.

It is very good when the whole healing process is controlled by the specialist who performed the operation.

When is it allowed to walk and sit? Usually after 24-48 hours, sometimes on day 3, depending on the state of health. Walking is shown using the elbow crutches or walkers. Fully rely and carry the weight on the leg while under the ban, you can only slightly touch it on the floor. The allowable percentage of weight gain on the operated side after a week is 10-15% of the physiologically possible load, after 3 weeks - 50%.

The first steps, attempts to take a sitting position are controlled by the instructor. Movement and sitting are strictly limited by the minutes in the initial phase of recovery, the time limit is increased gradually. By the end of 2-3 weeks you can already walk for 25-30 minutes three times a day, and sit, without changing the position of the body, no more than 20 minutes.

Therapeutic exercise of the early period

What exercises after knee arthroplasty are shown to perform on this period of time.

The artromot is used from the first day after surgery, its task is in passive development of the knee joint.

As you recover, the exercises will be more diverse and more intense, and after 6 weeks you will be able to train on a stationary bike, go to the pool, etc.

  1. Initial rehabilitation begins with the strain of the quadriceps muscle of the thigh with simultaneous activation of the limb. To do this, you need to strain the corresponding segment, lift your leg up in an even position about 30 cm from the surface on which you are lying. It is not necessary to immediately lower the limb; hold it at the achieved level for 5-8 seconds, carefully return it to its original position. Take a two-minute rest interval between repetitions. The number of repetitions - about 10 times.

    The exercise is aimed at the front of the thigh. At the end point, you can fix the position for a couple of seconds.

    Perform very carefully, without discomfort.

    This exercise can be performed without restrictions on the number of repetitions.

    Toe foot should be directed strictly upwards.

    Start with a small amplitude and gradually increase it.

    Hands should be along the body.

    But on the 5th day they begin to master walking in the uneven bars, along a step trainer, a treadmill in suspension. From the hospital is discharged after 14 days, if the patient feels. In some cases, may release home after 3 weeks. Stitches are removed after 10-14 days.

    Features of the late stage (after 3 weeks)

    The listed exercises after knee joint arthroplasty at home continue to be performed using the same procedure as outlined in the previous paragraphs. But they cannot be limited when so much time has passed since the day of the procedure. Exercise therapy after 3 weeks becomes more complicated and expanding, since it is impossible to develop the knee joint after the surgery in full only by practicing a passive-active nature.

    With the right approach, pain and discomfort cease to bother after a month and a half after arthroplasty. Therefore, it is now sensible to add to the complex of exercises after the knee joint endoprosthetics a number of more complex tasks that do not harm the artificial structure, but the static-dynamic indicators will be fruitful day after day.

    In addition, you already need to do walks more often and longer, on average 40-60 minutes. 4 times a day. Step on the leg, if the rehabilitation of the knee joint after the replacement operation is excellent, with 50% load, and only after 8 weeks with a 100% support. Toward the middle of the recovery program, a referral is issued for manual massage of the extremities and certain sections of the spinal column; classes are prescribed on a stationary exercise bike of a moderately gentle nature.

    And now let us dwell on the most important thing: how is the development of the knee after endoprosthetics at the remote dates, and what set of exercises exercise therapy will bring the greatest benefit.

    LFK from 3 to 13 week

    1. Lying on the abdomen, bend the knee with tightening the heel to the buttock. Another technique is based on a similar principle, but it is performed standing up: you need to take hold of the handrails, or alternatively, lean your hands on the table top or take the back of the chair for the back and, standing on a healthy limb, do the same thing.

    Try to get the heel of the buttocks. This is unlikely, but the goal should be this.

    Imitation of walking on the step should be performed with two legs alternately.

    Stretch Achilles tendon.

    When working on a balance, all small muscle fibers are included in the movement.

    When crouching hold the support.

    Similarly, have a foothold for the hands.

    You can perform both sitting and lying on your back or stomach.

    Aqua-gymnastics, balneotherapy and mud therapy

    The patient at the intermediate and final stages of rehabilitation after knee surgery is selected a special complex of kinesitherapy in the aquatic environment, which has an incredibly beneficial effect on the correction of the musculoskeletal system. Plus to this, hydrokinesis helps:

    • dynamic improvement of the ligaments and contractile functions of all the major muscles involved in the biomechanics of the relevant department,
    • regulation of blood flow, metabolic processes, nutrition of tissues around the prosthesis, due to which its strong and reliable fixation with the bone is achieved, correct mechanics,
    • safe and productive adjustment of the range of motion, without burdening the leg and protecting it from overload.

    Water procedures make an incommensurate contribution to the harmonization of the activity of the central nervous system, produce an excellent psychotherapeutic effect, charge with optimism and faith in full recovery.

    When the seam is fully healed, exercise in the pool is a great way to recover.

    After 2-3 months from the day the knee joint prosthesis was performed, it is recommended to undergo a course of balneotherapy and / or mud therapy. Balneotherapy and mud therapy is the use of warm radon and hydrosulphuric baths, therapeutic mud. These physiotherapy tactics are widely practiced in sanatorium-resort health resorts located in areas rich in rare natural resources that have an unrealistic range of therapeutic opportunities. Czech resorts are especially popular all over the world.

    Czech Republic - the leader in the field of orthopedics!

    In the Czech Republic, rehabilitation in a sanatorium after knee arthroplasty is first-class therapeutic and preventive measures for orthopedic disorders, including a variety of therapies for treating natural natural sources with complex compositions. And, of course, in such hospitals, in addition to the unique in its kind effective sessions of physiatrics, a system of restorative physical education was organized.

    Immersion in healing mineral springs and application of mud applications have a powerful analgesic effect, positively affect blood circulation in the structures of the organs of movement, improve metabolism and trophism of musculoskeletal tissues, level up neuromuscular transmission, soothe and tone up the nervous system, increase immunity. Thus, there is a noticeable positive progress in the work of the locomotor support apparatus.

    Life after recovery

    Comprehensive rehabilitation after knee arthroplasty - exercise therapy, the development of articulation in water, training on simulators, massage, various physiotherapy procedures - the key to your successful recovery. You already know that regular sports training should become an integral part of your lifestyle, because they are responsible for the harmonious, long, uninterrupted performance of the new joint. Usually, with properly planned physical activity, knee endoprostheses last for an average of 20–25 years.

    X-ray after surgery. The prosthesis is correct.

    But you also need to understand that a device replacing a natural organ is a kinematic structure made of metal or ceramic with polymer inserts. Like any mechanism, such a prosthetic device requires proper use so that its materials do not prematurely wear out, and the moving parts do not fail due to irrational loads. Therefore, the patient needs to take care of that the endoprosthesis will serve properly for as long as possible. To do this, you must strictly follow the following recommendations:

    • do not lift weights over 15 kg, especially not to carry heavy objects and not to squat with them,
    • don't squat and kneel, eliminate crossing of legs, follow the posture, move slowly, smoothly, evenly,
    • in all sorts of ways avoid injury situations - falls, blows, sprains, bruises and so forth (they can provoke a shift and violation of the integrity of parts of the joint-analogue),
    • during any illness go to the right doctor right away, because, for example, infectious pathogenesis, even the affected oral cavity, can be transferred to the periarticular tissues and cause severe paraprosthetic infection,
    • walking in comfortable shoes, which has a low sole with good cushioning properties,
    • physical activity must be reasonable and without fanaticism, it is important to observe moderation and do nothing through force, to rest when we feel tired,
    • keep track of your own body weight, overweight reduces the life of the implant,
    • you can not make sharp and shock-force movements - jerks, flies, jumps, strikes the ball, intense knee spins, etc.,
    • It is forbidden to play football, volleyball, hockey, basketball and in all sorts of team games, including banned fast running, jumping, skiing, roller skating, skating,
    • Sports such as tennis, golf, boating, cycling, swimming, Nordic walking, hiking.

    To avoid such consequences, the load must be increased very smoothly, from month to month.

    And finally, act prudently: immediately notify the doctor if local edemas, hematomas, pains are found, have noticed a decrease in support ability, the appearance of stiffness.

    Restrictions: what not to do during rehabilitation?

    The processes of flexion and extension of the leg with the operated joint should be carried out very carefully. The same applies to rotational movements and crossing legs. This restriction is especially important in the first postoperative months.

    High-quality training will help to recover in a couple of months, but usually it takes at least six months or a year to return to the usual life, during which the process of physical activity will fully recover. When this happens, almost all restrictions on lifestyle disappear. Many patients return to active sports, but heavy, traumatic sports (running, figure skating, tennis, basketball, etc.) are now banned for you forever. Training should take place at an easy or quiet pace.

    Exercises after knee replacement

    The most common methods of rehabilitation:

      medications. This is not only a group of medicines to reduce the risk of complications, but also special medicines to strengthen the immune system, speedy tissue repair,

    Homework training. Bubnovsky exercises

    After discharge from the rehabilitation center, we should not forget about the need to continue training. Give them about 20-30 minutes several times a day or as often as recommended by the doctor.

    Daily walks, classes on the exercise bike show very good results. Start with five minutes of fresh air, gradually bring them up to 20-30 minutes several times a day. To facilitate the task, increase the safety of the walk, use a cane.

    Among the many techniques that help recover after endoprosthetics, the program of the Russian doctor Sergey Bubnovsky shows good results. In the first postoperative days, the doctor advises to engage in therapeutic exercises, gradually adding movements for the ankle to it. Loads are coming minimum, but regular: they will avoid thrombosis, swelling, blood stagnation.

    Gymnastics video from Dr. Bubnovsky:

    For the maximum benefit of the exercises and guaranteeing the correctness of their performance, the first few sessions are preferably carried out in a specialized center or an exercise therapy room under the supervision of a specialist.

    Possible complications

    The human body is a unique mechanism, for each of us it has its own distinctive features. After the procedure, endoprosthetics possible complications. In some cases, it may even require additional surgical intervention. For example, this happens in the case of infection.

    The first 1.5 months after the operation may cause swelling, blood clots, redness around the seam. Physical therapy and physiotherapy will help reduce their risk.

    Pain after replacement is removed with the help of cold compresses, psychological trainings, limited use of painkillers.

    30–40 minutes before a workout, it is allowed to take a slight painkiller - Aspirin or Ibuprofen.

    Return to the usual life

    Already after 8 weeks you will be able to obtain permission from the attending physician to drive the vehicle. A prerequisite is the free movement of the legs - which is why your daily activities are so important.

    The next step is to return to work and work. The speed of its occurrence depends on your diligence, nature and requirements of the work. True, those whose activities are associated with heavy physical labor, weight lifting, most likely, will have to retrain and discover new horizons.

    Patient Reviews after Knee Replacement

    People who have undergone arthroplasty, talk about getting rid of pain after surgery, but not all were able to restore motor activity to the level accessible to them in their youth. Although it takes only a little to do this - stop feeling sorry for yourself, do not leave training for a day.

    On the network you can find a lot of video reviews from patients for whom this task has become quite feasible. We suggest to take note of their experience, do not give up and go on the path to the dream of a new joint.

    Regardless of whether you are doing rehabilitation yourself or under the supervision of an experienced rehabilitologist, stay active every day, as much as possible for your health. Do not forget what tests have already been passed, take care of your new joint, keep yourself in shape!

    What determines the success of rehabilitation

    Half of success depends on the skill and skill of the surgeon, and the second half only on the patient:

    • Will he be able to complete the entire rehabilitation program?
    • Do not relax after a few weeks and even years
    • Will do as it should, not only in a rehabilitation center, but also at home

    When performing the rehabilitation program, the patient is not alone:

    • The patient should not guess:
      • will not be dangerous or undesirable exercises that hurt him
      • Will there be any side effects?
    • He does not need to make his own choice of exercises.
    • There is no need to purchase mechanical simulators (they must be in a rehabilitation center)

    All these issues are decided by the attending physician and rehabilitologist.

    Surgeons are aware of the main dangers of the early postoperative period:

    Risk of blood clots:

    You can suspect signs of thrombosis by pain, swelling and redness below or above the knee

    The risk of developing infectious inflammation:

    Elevated temperature, blood cell levels going up in blood can be alarming symptoms.

    To prevent postoperative complications, coagulants (blood thinners) and antibiotics are prescribed.

    A rehabilitologist visits the patient within a few hours after the operation and shows the first necessary exercises that he will need to perform.

    After discharge, the question of a rehabilitation center is usually raised, but classes there are not cheap, and therefore many patients decide to do the restoration themselves.

    But if a person does not intend to undergo rehabilitation at all (nowhere - either in the center or at home), then it is better to refuse the operation itself altogether.

    Is self-rehabilitation possible at home?

    Probably, yes, because the impossible is really nothing.

    But in practice, it is difficult to restore the joint independently and for a long time after prosthetics.:

    • There is a lack of purely specific knowledge owned by orthopedic traumatologists.
    • Because of the fear of pain, there is a barrier that reduces the volume and amplitude of movements.
    • Self-pity, disorganization of class schedule, etc. interfere.

    Mechanotherapy is practiced in orthopedics - a method of passive rehabilitation, when the movements of a patient limb are carried out by mechanical simulators, which are always in the rehabilitation center.

    The first two days after surgery

    Hand exercises

    • Squeeze and unclench fists
    • Bend and unbend arms in elbows
    • Rotation fists in both directions
    • Similar elbow rotation
    • "Boxing" with the separation of the blades from the bed
    • Straight and cross "scissors"
    • Pull up

    Exercises for a healthy leg

    • Ankle Circular Motion
    • Squeezing and unclenching
    • Knee bend
    • Raised straight leg
    • Leaning on the heel and elbows, lift the buttocks
    • We begin to sit down with the help of a handrail, first without lowering the legs to the floor, and on the second day, we lower them

    Exercises for a sore leg

    • Squeeze and unclench fingers
    • We pull foot on ourselves and from ourselves
    • Alternately, bend and unbend the legs while lying and sitting
    • In the sitting position, we put our feet on the bench, raise and lower them without lifting the heels

    The gymnastics of the first two days is performed at a slow pace.:

    • Three to five minute breaks are taken between several exercises.
    • Some exercises combine with a breathing rhythm.

    After it turned out to sit on the bed with your legs down, you need to learn to stand on crutches or walkers

    Walking on walkers or crutches

    Walking with aids is done on the second day.. Walking on crutches is somewhat more difficult, since more physical strength is required. For older people, walking on walkers is preferable not on crutches.

    It is easier, of course, to see or experiment with crutches before the operation, but the general technique is simple:

    It is necessary to get up, holding the handrail with one hand, the other with the handle of a crutch or walker, supported by a healthy leg

    Walking on crutches and on walkers is built on the same principle:

    • They serve as additional support for the body:
      We rely on crutches in the armpits, and on the walkers with our hands
    • Initially, we are moving forward, at a small step, both crutches or walkers
    • With a healthy foot, we take a step and tighten the operated leg with a sliding movement on the floor.
    • Sore foot should first touch the floor with the heel, and then you can lower the entire foot.

    The first walk with additional support should be short and be performed with the help of an instructor

    Two to seven days after surgery

    The patient by this time independently sits in a bed, having lowered legs to a floor, and itself goes on crutches.

    We repeat all previous exercises in the prone position and sitting, but more actively and in large amplitudes.

    The number of repetitions increases

    • keeping the foot extended
    • keeping the straight leg raised to 20-30
    • extension of the limb with a roller under the heel
    • isometric exercises with tension of the gluteus and quadriceps
    • bends and turns of the trunk with outstretched hand
    • imitation of walking
    • exercises in the supine position (on a healthy leg) with a roller between the legs
  1. Starting from the second day, the development of the knee joint with the help of mechanotherapy begins - passive flexion-extension of the knee joint on a mechanical simulator with a gradual increase in speed, angle and duration
  2. Day nine after surgery

    The dynamics of exercise for the operated leg increases:

    • Lying on the side bend and unbend the leg in the ankle
    • Pull the sock up and lift the leg by 10 cm (specialist help is allowed)
    • We make small moves with a sore foot.
    • Added exercises with a focus on the handrail standing:
      Swing forward and lift your feet to a small angle

    Late recovery period

    It begins 1.5 months after surgery.

    The objectives of the late recovery period - the restoration of the functions of the diseased limb

    Exercises are added with support and load on the sore leg.:

    • Mahi standing on a sore leg
    • Walking on bent legs holding onto handrails
    • Exercises "scissors" and "bike", etc.

    Late rehabilitation period

    This period is usually considered a period of more than two months after surgery. However, for all their time.

    The tasks of this period are mainly adaptation:

    • Sick learn to walk with a cane
    • Performs exercises with weighting
    • Begins on a stationary bike

    In the photo below - exercises with a knee joint to develop:

    How long should I recover

    In fact, concern for the joint will last a lifetime. It is impossible at the end of rehabilitation immediately forget about the prosthesis.

    • Six months after the operation, it is necessary to carry out a control examination of the knee at the surgeon.
    • Then visit the doctor annually.
    • For several years, you need to do active therapeutic exercises every day.
    • Then you can simply perform daily gymnastics, maintaining your normal weight.
    • 10 years after the operation, it is necessary to conduct an especially thorough examination, since the prosthesis resource could come to an end.

    Video: Rehabilitation after knee arthroplasty

    In the area of ​​the knees of a person have heavy loads. This site is often a place that is traumatized. Therefore, diseases arise that can be cured only by surgical intervention. If other methods of treatment have been tried in case of a disease of the knee joint that did not bring healing and improvement, the joint is replaced with an artificial one.

    Following the difficult operation, special attention is paid to the recovery period. Let's talk about how the rehabilitation period after the operation of knee joint endoprosthesis replacement should be carried out, what should be done to return to normal life.

    Indications for surgery

    Implanting the prosthesis into the knee area involves replacing the articular bones with artificial ones. The operation is completed - the pain should go away, the mobility of the limb should recover.

    The operation is recommended in the following cases:

    • arthrosis with bone deformation,
    • osteoarthritis,
    • the presence of tumors,
    • frequent injuries
    • dystrophic changes in the articular tissue.

    There are also contraindications to surgical intervention. This is an infectious inflammation of the operated site, heart disease, damage to the articular vessels. It is impossible to do the operation to patients who are unable to move and those who do not have a bone marrow area of ​​the femur.

    Before operating procedures, a survey is required. Any inflammatory processes and chronic diseases should be excluded.

    During the operation, it is possible to use two types of anesthesia - general or spinal. The approximate intervention time is from one and a half to two hours. Then comes the crucial moment - the operative period after knee joint endoprosthesis replacement, which should be taken very seriously.

    Before the start of surgery, many patients are interested in the time spent on the hospital after knee replacement, as much as the maximum period can last. You can count on for three months, then whether the medical board decides whether or not to extend the sick leave. The decision depends on the state of health of the patient and how quickly the restoration of the operated area passes.

    Features of the recovery stages

    Rehabilitation after knee arthroplasty takes place from the first hours of the end of the operation. Install drainage through which blood is pumped out. Although the limb is already mobile, you can not get out of bed. If you feel well, you are allowed to get up with crutches, but for a short time. You can sit, hanging the limbs from the bed.

    Depending on the patient's state of health, in the first days of rehabilitation after prosthetics of the knee joint, painkillers and sleeping pills are prescribed. Do not be afraid if edema appears on the operated area or the temperature rises - these are normal postoperative consequences.

    A separate program is drawn up for each patient, aimed at recovering from the knee joint arthroplasty. Strong loads are prohibited, but feasible physical activity will benefit.

    It is important to understand that in the first days after knee arthroplasty and rehabilitation there will be painful sensations when walking. To do this, there are several restorative techniques, which will be discussed later.

    Recovery Techniques

    After total knee arthroplasty (the operation takes a little longer), it is possible to get up with the help of aids only after three days. Several techniques are used for full rehabilitation:

    1. therapeutic exercises after the replacement of the knee joint, aimed at the restoration of muscle tissue (raise and lower legs, hold in a tense position),
    2. straighten the knee
    3. lying on the bed bend the limb (you can with support),
    4. lymphatic drainage is used for the outflow of fluid generated during the rehabilitation period,
    5. cold treatment
    6. walking, including climbing and descending the stairs.

    Rehabilitation includes exercise therapy after knee arthroplasty. Gymnastic exercises help to get rid of pain, strengthen the muscles of the limbs. When you study the exercises under the guidance of a specialist, you can do them at home on your own.

    Any movements should be carried out evenly with a gradual increase in load. If during the performance of therapeutic exercises the temperature rises or any discharge from the operated area appears, it is necessary to immediately seek medical help.

    Sports and wellness training

    • You will need to get to the operation in the best fit possible. To do this, a doctor who knows all the features of your state of health will have to make a training plan. You will need to do special exercises to strengthen the muscles of the whole body. This will help you prepare the body for use with postoperative walkers and crutches. In addition to the exercises of the physical-fitness complex, swimming, water gymnastics, exercises on a stationary bike, Nordic Nordic walking are suitable for you. It is important to take these trainings with all seriousness, because their result depends on how quickly you can rehabilitate after surgery.
    • Ask friends or rent crutches to try to master this auxiliary element of postoperative rehabilitation. Oddly enough, learning to use crutches is better on healthy legs.
    • You will need to pay attention to your weight. If it is excessive, try to lose some weight, because the pressure on the prosthetic joint depends on body weight.
    • Before surgery, it would be good to give up bad habits: alcohol should be eliminated, and smoking reduced to a minimum (and ideally quit). This will allow you to avoid postoperative problems with the lungs, increase the body's resistance to new loads, speed up the healing process.

    Preparation of a comfortable postoperative environment

    • For some time after knee arthroplasty, you will have to move around with crutches. In order to make it more convenient for you in your own home, you should rearrange all the items of regular use so that they are at the level of hands.
    • If there is a ladder in your private house, take care to minimize the need to use it regularly. To do this, transfer all the things you need to the first floor.
    • Prepare a reliable chair for the postoperative period. It must be high enough so that when you sit your legs can stand straight. Also worth taking care of good armrests, which you can rely on when lifting.
    • Equip your bathroom with handrails and a seat so that you can take a shower as safely as possible.

    The general program of therapeutic postoperative gymnastics

    Rehabilitation in the first period after the endoprosthetic replacement of the knee includes regular exercises.First, they are carried out with the help and under the supervision of doctors, after a while you will be able to do these exercises yourself. Usually, complex charging is done three times a day.

    • Ankle training. This is one of the first exercises that will be available to you after surgery. While lying down, pull the sock toward you without bending your legs, and then away from you, as if trying to stand on tiptoes. Take 10-15 approaches, repeat every two to three hours.
    • Static muscle tension. Due to the fact that before the operation you did therapeutic exercises, your muscles came to a tone. And now you need to remind them of this. Spend a "roll call" of the muscles of the musculoskeletal system: lying on the bed, alternately strain the buttocks, front and rear thigh muscles. This controlled tension and relaxation of muscles will increase the blood circulation and bring the lower limbs to the necessary tone.
    • Side swings of the foot. Imagine that you are standing on a flat floor at the front attention. Your task: take the operated leg to the side and return to the starting position. Despite the riot of fantasy, you can not stand for now, the poet is doing the exercise lying down. Do not forget to pull the sock on yourself while the legs are moving away and rest between sets.
    • Raise your legs lying. Lying on your back, strain your front thigh muscles, pull the sock toward you and lift the operated leg somewhere 20-30 cm. Hold it in this position for up to 10 seconds - as long as you can without pain. Slowly put your foot back on the couch, rest for a couple of minutes and repeat the exercise. It is necessary to do about a dozen approaches with breaks for rest and muscle relaxation.
    • Lift legs sitting. When the doctor allows you to sit, the same exercise as the previous one can be performed on the chair. To do this, you need to straighten the leg as much as possible, try to slightly raise it above the floor and hold it in this position for 5-10 seconds.
    • Bending the legs lying. Lie down comfortably and slowly begin to pull the operated limb towards you without lifting your heels from the couch. Reaching the bend of the leg at a right angle, in the same way, slowly, return it to its place.
    • Bending the legs while sitting. Sit on the edge of the bed, putting a healthy toe leg under the heel of the operated, try to bend the leg as much as possible. Hold her in that position for a few seconds. Then return the leg to its original position.
    • In order to avoid bedsores, you you will need to do pelvic elevations, legs bent at the knees. Do not forget that you can not load the operated limb yet, so lean on a healthy leg and shoulders. You can also try to bend and raise your back, adding a head as a point of support.
    • Train your hands: their stamina will come in handy when walking on crutches. To do this, it is recommended to spread your arms to the sides, holding the ribbon expander or elastic harness.

    In the first two or three weeks after the endoprosthesis, the main part of physiotherapy exercises is aimed at restoring the motor activity of the lower extremities. It is also important during this period to bring in the tone and all the other muscles of the body, to increase endurance to the loads.

    In addition to exercise therapy, you can be shown such types of activities as water gymnastics in the pool, walking on a stepped trainer, dry underwater massage. The first training you will conduct under the supervision of doctors, and in 2-3 weeks, when you are discharged from the hospital, you can continue them at home, alone. By this time, the pain is usually pass, so classes should not give you discomfort.

    Home rehabilitation training

    When 15-20 days after the surgery you are finally at home, do not hurry to relax. On the contrary: new exercises will have to be added to the exercises mastered in the hospital. Homework is a very important rehabilitation stage. How long does recovery take after surgery? All individually, but on average - about six months, but in fact - all my life. Because the presence of a prosthesis in the knee joint, one way or another, will change the whole of your usual existence.

    Depending on your health and general condition, you can use crutches, special walkers or a cane. Additional support will not hurt you, as long as you can rely on the operated leg with only a 50% load. Full load on the leg is possible only with the permission of the doctor two months after the endoprosthesis.

    You should also continue your classes in the pool: aqua-gymnastics and swimming help keep your entire body in good shape. After eight weeks from the time of the operation, sports such as table tennis, golf, shooting, and slow skiing are usually allowed.

    Simply put, your life in the postoperative period should be moderately active: excessive loads are just as contraindicated as complete rest. Try to find a middle ground and enjoy the new life situation.

    Therapeutic gymnastics in the first four months

    To the exercises conducted by you in the hospital, you should add new ones, gradually increasing the load on the knee joint:

    • Leg fold. Lay the mat, lie on your stomach and try to bend your knee as much as possible, to reach the fifth point with your heel. Probably, after the operation you will not succeed, but in this matter the process is important, not the result. A similar exercise can be done from a standing position, leaning on a healthy leg and handrails (or a stable horizontal surface, such as a table).
    • We walk on the steps. Find the steps with the railing, because you need additional support. Standing on a healthy leg at the bottom of the stairs, bring the operated limb one step higher. You can also train and descend from the stairs, and side steps.
    • From foot to foot. In order to use all the small muscles of the musculoskeletal system, it is very useful to perform an exercise with the transfer of weight from one limb to another. To do this, you'd better find a support for which you will hold, and put the feet of the entire foot on the floor. First, lean on a healthy leg, and then slowly begin to transfer weight from it to the prosthetic limb and back.
    • Heel spout. An exercise similar to the previous exercise can be performed not only with a side amplitude, but also with weight transfer from toe to heel and from heel to toe. Hold onto the handrails - a prosthetic leg may not be obedient for the first time, and a fall is fraught with implant damage.
    • Move the wall. Imagine that you are an atlas with incredible strength, and you want to push the boundaries of your home. Stand facing the wall at arm's length, press them against the surface. Bend a healthy leg slightly at the knee, and a prosthetic leg - as much as possible, set it back. Both limbs should touch the floor with the entire foot. Now make an effort in the hands, as if trying to move the wall, feel the tension of the muscles in the operated leg. If the first time to do the work of Atlanta failed, do not worry: you have a dozen approaches ahead.
    • Half squats. This exercise is also better to perform in support. Put your legs shoulder-width apart, stand firmly on both feet, straighten your back. Do a shallow squat (up to 45 degrees) and return to the starting position. Be careful not to overdo it: if you sit too low, it can lead to a dislocation of the knee joint, so excessive zeal is unacceptable here.
    • Work with the Expander. An expander is often used to develop the underlying muscles of the musculoskeletal system.One end of it is attached to the ankle, the other to a static support (chair or healthy foot), and then exercises to flex and stretch the legs are performed. Due to the resistance of the expander, an additional load is created on the muscles of the prosthetic leg, and those that were not previously involved start working. Thanks to such training, soon the prosthetic leg will be able to move as smoothly as a healthy one.

    How rehabilitation takes place after the operation, how quickly the body's motor functions can be restored, depends largely on the patient. If your classes are regular and high-quality, undoubtedly, a good result will not take long. In order to properly perform complex gymnastics, you can watch the exercises in the video on our website. Do them together with the instructor and take your first steps on the renewed leg!

    Natural Rehabilitation Assistants

    For the speedy restoration of the musculoskeletal system after implantation of the implant in the patella, patients are often prescribed various physical procedures. What can help in the development of a knee joint?

    • First is therapeutic mud. Mud therapy as a method to cope with many ailments, especially with problems of the joints, has been known for a long time. In modern conditions it is often used in hospitals and sanatoriums for postoperative rehabilitation of patients. The beneficial properties of therapeutic mud are very extensive: it has anti-inflammatory and anti-bacterial action, improves overall muscle tone, and immunity. It also contributes to the acceleration of metabolic processes in the body, which is very important in the postoperative period. Mud treatment can be carried out both in the hospital of your city, and in hospitals in Russia (for example, in Pyatigorsk, in the Volgograd region on Lake Elton, in the Crimea, etc.) and abroad. It all depends on your financial capabilities. If they are not large, then you can arrange treatment at home by buying dirt at the pharmacy.
    • Secondly, they perfectly contribute to rehabilitation after knee arthroplasty. mineral water. Treatment with mineral water baths (balneotherapy) is also a long-known method of restoring and strengthening the body. Such water procedures with a liquid from natural mineral sources have a positive effect on the strengthening of bone and cartilage tissues, respiratory system, and general health. They improve blood flow and energize tired patients. By the way, it is useful in mineral water not only to bathe, but also to drink it to cleanse the body and saturate the cells with oxygen.
    • Third, an important part of rehabilitation is aqua-gymnastics. It has a beneficial effect on the development of the respiratory system, which is very important after surgery. Also, doing exercises in water speeds up blood circulation and improves the tone of blood vessels. It is useful for the whole body and, in particular, for the cardiovascular system. The main advantage of this type of physiotherapy after knee arthroplasty is that the implant load is reduced in water. Thus, you can develop the prosthetic leg as safely and efficiently as possible, without fear of harming yourself with your own weight.

    Watch the video: Total Knee Replacement Part 4: Rehab after Surgery (April 2020).

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