髋关节置换术后康复及注意事项（Rehabilitation after hip replacement and the points for attention）

髋关节置换术后康复及注意事项（Rehabilitation after hip replacement and the points for attention） 髋关节置换术后康复及注意事项(Rehabilitation after hip replacement and the points for attention) Rehabilitation after hip replacement and the points for attention Artificial joint surgery has reached a safe and reliable level after nearly fifty years of development. More than 90% of artificial joints have been reported to have been successful for 20 years. The modern artificial joint has reached abrasion resistance and durability, and the entrance has no rejection. The patient, who was lame and lame, was able to move freely after the operation, and even forgot about it. But the polyethylene in artificial joints still wear problems, so surgery should not be too active, when moving, wear low heeled shoes, the appropriate nature walks, hiking and indoor work, rather than going up and down stairs, climbing, running, best use will not increase the joint load sports such as swimming, Taijiquan and gymnastics. Postoperative rehabilitation points On the day of surgery: should maintain the special position of the limb: supine knees, knees and toes between bolster up, to prevent hip adduction internal rotation. When the patient's vital signs are stable, the half seat should be adopted as early as possible. The patient should start the femoral four biceps, triceps and tibialis anterior muscle contraction, and accelerate the venous return to prevent deep vein thrombosis. Give the ice pack a cold compress for 24 hours to relieve the pain, keep the airway clear, encourage the patient to breathe deeply, cough, and prevent lung infection. The first day after surgery: the plasma drainage tube and ureter were removed in the morning, and the walker was guided by the walker. In the afternoon, the patient was told to get out of bed again. The patient was taught to get out of bed, go to bed and walk. Strengthen the exercise of lower limbs muscle strength. At the same time, patients should be given psychological support, and the higher the patient's enthusiasm for investment, the faster the recovery. 1) ankle dorsiflexion: active maximum flexion and extension ankle joint and resistance training. Keep each movement for 5 seconds, repeat 20 times / group, 2~3 sets per day. 2) unit four biceps training: femoral head four static muscle contraction, hold for 5 seconds, every 20 / 2 ~ 3 group, group / day; at the same time the patient on the bed do straight leg raising exercise, do not require the lift height, but there should be about 5 seconds of time slowly; knees hip flexor limb heel to toe to keep the hips slide, prevent hip adduction internal rotation. 3) resistance strength training: resistance, adduction and resistance to abduction, isometric muscle strength training, each action to maintain 5 seconds, repeat 20 times / group, 2~3 groups / day. Second to 3 days after operation: the patient should be more active, while strengthening the ankle dorsiflexion, plantar flexion and thigh four muscle training. From fourth to 14 days after operation, the patient stopped the infusion, with emphasis on muscle exercise and increased joint activities. The flexion of the hip joint was 70 to 90 degrees at the time of discharge. The abduction was 15 degrees and the external rotation was 10 degrees. The church with crutches to walk, rehabilitation training plan after discharge. During this period, the supine position, straight leg elevation and knee flexion hip training should also be performed. And strengthen postural transfer training and joint activity training. From second to 3 weeks after operation, the hip flexion, abduction and external rotation should be strengthened, and the training method must be correct to prevent dislocation of the joint. Train patients to walk with one arm. 3 ~ fourth weeks after operation: should be carried out daily life function training, teach patients how to wear socks, toilet, car, stairs, no bigger rotor bone cutting patients should walk in about 6 weeks. At the same time, the patient should be ordered to review regularly to prepare for the return of the patient to the society. In patients undergoing artificial hip replacement after hospital rehabilitation, the following problems should be paid attention to in daily life: 1) seat to sit within the first month after the operation time should not be too long, so as not to cause hip edema, also can be used cold and raise the limb to improve and maintain the knee joint is less than or equal to the hips, not sitting low chair, sofa, do not cross leg and ankle, before to do not exceed 90 degrees, sitting body back legs forward. 2): toilet toilet with heightening homemade toilet, or body in assisted retroversion of the affected leg forward into the toilet, to keep the knee above the hip. 3) take: do not bend over 2 weeks after the collection of things on the ground, do not suddenly turn around or reach for the items behind, eat the time to put the rice bowl in front of you. 4) ride: sit your hips forward, lean back, and stretch your legs as far as possible. 5) shower: wound healing, auxiliary reliably to shower, because standing there is a certain danger shower, so it can sit on a high stool, head for the mobile hand-held applicator, and prepare a with a long handle bath sponge so as to be able to touch the lower limb and foot. 6) wearing shoes and socks: ask for help or use when choose not to lace, elastic shoes, baggy pants, posterolateral incision can be provided inside the shoe, anterior medial incision can be outside the shoes. 7) can be fully recovered after sports activities: walking, gardening, cycling, bowling, table tennis, swimming, dancing, and maintain a healthy weight. Avoid excessive pressure on the new hip joint, causing wear and tear, such as jumping, running, skiing, water skiing, tennis, etc.. Six months after the operation review: check the overall situation of patients, according to different circumstances, formulate every six months, one year or two years for a review, timely understanding of the patient, reduce patient pain, reduce joint revision rate. Matters needing attention: 1. new joints have limited range of motion. Patients need special attention to avoid joint displacement, including: 1) avoid cross legs and knees while sitting, standing and lying. 2.) keep your feet 6 inches apart when seated. 3) keep your knees below your hips when you sit. Avoid sitting chair is too short. You can sit with a pillow to keep your knees below your hips. 4) when standing up, slide to the edge of the chair, then stand up with a walker or a crutch. 5) avoid bending. Patients may consider the purchase of long handle shoes dial or soft shoes, so without bending can wear shoes and socks off. 6) when lying down, put a pillow between the legs, so that the joints remain in place. Rehabilitation in postoperative patients, should follow the three principles of individual, progressive and comprehensive, in addition to limb exercise, while focusing on healthy limbs, upper limb active, respiratory training and psychological counseling, so that patients eliminate worries, enhance confidence in life. Through rehabilitation, patients can be restored to physical strength, increase muscle strength, increase joint mobility, reduce postoperative complications, and make the patient's movement and daily living ability maximum recovery.