OLDER HIP PROSTHESES
Definition
Wednesday, May 6, 2009
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The total joint replacement of hip or joint replacement surgery is intended to replace the hip joint, which is impaired by various processes pathological.
The hip joint consists of two surfaces that represent segments of a sphere, a hole (called a cup or cup and located in the pelvis bone) and another mass (femoral head), both surfaces almost perfect to pair. The operation of total hip replacement involves replacing the worn femoral head by a metal ball attached to a stem or stem and the socket for a bowl of super-tough plastic (polyethylene). These two components can be attached to bone by a special cement called methylmethacrylate (cemented prosthesis).
The placement of this new joint is designed to get relief pain, decrease stiffness, increase mobility and return the length of the lower limbs. This focused on improving the quality of life for patients, improving the performance of everyday activities and obtaining a higher degree of personal autonomy. Causes
The most common diseases that may intervene in a prosthetic or hip replacement are:
• Osteoarthritis of the hip or hip osteoarthritis: the most common indication for an arthroplasty. The joint surfaces are covered with articular cartilage, the cartilage wears away in case of osteoarthritis, leaving exposed the underlying bone resulting in pain and limitation of mobility. • Phase
aftermath of systemic rheumatic diseases (rheumatoid arthritis, ankylosing spondylitis ...).
• Fractures of the pelvis and the proximal end of femur and avascular necrosis of the femoral head.
• Malignant tumors of the femoral head.
is recommended that surgery for hip arthroplasty performed in advanced age as possible, since the half-life is rarely longer than 20 years and the later parts are more contentious, especially in case of cemented prosthesis. For this reason, prior to the placement of a prosthesis usually made interventions that modify the control points on femoral head (varus and valgus osteotomy) and, thus delaying joint replacement. Symptoms
Usually the patient a candidate for total hip replacement has a significant deterioration of the joint, resulting in severe pain at rest and when walking, marked restriction of mobility, periarticular muscle contractures, lameness, malposition of the lower limb, etc. Physiotherapy
Whenever possible, we recommend that these patients carry out a preoperative treatment, designed to obtain pain relief and strengthening the muscles around the joint, a quick and successful recovery is closely related to muscle condition reached at the time of the intervention. This preoperative treatment should include:
• Strengthening the muscles of the affected leg muscle
• Strengthening of the upper and lower limbs healthy, in order that progress be made more easily.
• Teaching breathing exercises, mainly diaphragmatic, in order to prevent pulmonary complications.
• Learning to use batons and gait to use.
Postoperatively, the trend with these patients is to make a physiotherapy as early as possible, but not to mobilize new joint abusively. Recovery is faster or slower depends on many variables such as age of the patient, if the prosthesis is cemented or no (longer delay in the cementless), the type of prosthesis, bone status, associated diseases , etc.
patient should be explained to those movements or positions that pose a risk of prosthesis dislocation: hip flexion above 90 degrees, making rotations of the lower limb, sleeping on the healthy side, cross your legs, sit on low chairs, etc. .
During the first 48 hours after the operation, is installed on your back, having to move progressively a sitting position in bed by raising the head or using pillows. Should carry out systematic breathing exercises, postural changes, active movements of the ankles and static contractions of the quadriceps and glutes.
From the third day, the therapist begins the progressive mobilization of the operated hip, by flexion, extension and separation by assisted exercises, active and resisted.
After a few days, the patient stands up, initially with the aid of a walker, then with two sticks and, finally, a single rod in the opposite hand. The therapist must teach and correct how to walk, how to sit and rise from a chair, how to climb and descend stairs, how to divide symmetrically body weight, etc.
exercises are needed to strengthen the muscles around the joint, which will allow the execution of daily activities more easily and provide greater stability to the prosthesis and, therefore, decreasing the risk of dislocation of the same.
Lic. Luz Marina Castro
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