Total Hip Replacement (cont.)
What is involved in the rehabilitation
process after total hip joint replacement?
After total hip joint replacement
surgery, patients often start physical therapy immediately! On
the first day after surgery, it is common to begin some minor
physical therapy while sitting in a chair. Eventually, rehabilitation
incorporates stepping, walking, and climbing. Initially, supportive
devices such as walker or crutches are used. Pain is monitored
while exercise takes place. Some degree of discomfort is normal.
It is often very gratifying for the patient to notice, even early
on, substantial relief from the preoperative pain for which the
total hip replacement was performed.
Physical therapy is extremely important in the overall outcome
of any joint replacement surgery. The goals of physical therapy
are to prevent contractures, improve patient education, and strengthen
muscles around the hip joint through controlled exercises.
Contractures result from scarring of the tissues around the joint. Contractures
do not permit full range of motion and therefore impede mobility
of the replaced joint. Patients are instructed not to strain the
hip joint with heavy lifting or other unusual activities at home.
Specific techniques of body posturing, sitting, and using an elevated
toilet seat can be extremely helpful. Patients are instructed
not to cross the operated lower extremity across the midline of
the body (not crossing the leg over the other leg) because of
the risk of dislocating the replaced joint. They are discouraged
from bending at the waist and are instructed to use a pillow between
the legs when lying on the nonoperated side in order to prevent
the operated lower extremity from crossing over the midline. Patients
are given home exercise programs to strengthen the muscles around
the buttock and thigh. Most patients attend outpatient physical
therapy for a period of time while incorporating home exercises
regularly into their daily living.
Occupational therapists are also part of the rehabilitation
process. These therapists review precautions with the patients related to everyday
activities. They also educate the patients about the adaptive equipment that is available and the proper ways to do their "ADL's" or activities of daily living.
Next: What other postoperative instructions are given to patients with total hip joint replacements? »
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