Total hip arthrplasty (THA) is a surgical procedure performed mainly to increase joint stability, mobility, quality of life, and improve walking.
The results of studies conducted 3–6 months after TKA surgery show pain reduction and joint It shows that the patient, the orthopedist and the physiotherapist are very satisfied in terms of mobility. However, after THA, various levels of functional losses may occur in patients, regardless of the success of the surgery, the selection of the appropriate prosthesis, or orthopedic-related problems such as loosening of the prosthesis or malalignment of the extremities. interest. According to studies conducted on this subject, after hip replacement surgery, patients generally experience difficulty in daily living activities and multi-level muscle weakness, weakness in the hip abductor muscles, weakness in the hip extensor and flexor muscles, and a long-term decrease in the maximal muscle strength of the hip adductors (6). -48 months) Functional disorders or disabilities that range from moderate to severe occur. Disorders in walking or functional losses and asymmetries are observed both preoperatively,
and postoperatively. In general, musculoskeletal system problems and function problems that can be seen in the postoperative period, including the preoperative period
in patients with THA. Losses can be summarized as follows:
• Muscle weaknesses (mainly hip abductors,
extensors, flexors, adductors,
gluteus minimus, tensor fascia lata muscles).
• Decrease in joint range of motion. and loss of flexibility (especially the hip joint, knee and ankle joints).
• Muscle stiffness and contractures (shortness or contracture in the iliopsoas, rectus femoris, tensor fascia lata, gastrosoleus and lumbar extensors).
• Extremity. alignment disorders (disorders in the same side knee, same side standing, opposite side knee),
• Balance problems and problems in transferring weight to the operated leg.
• Asymmetry in walking and Trendelenburg gait, decrease in walking speed, abnormalities in walking parameters .
• Loss or inadequacy in daily living activities.
All these dysfunctions and inadequacies can persist in patients even years after surgery. en
causes loss of movement. Muscle weaknesses, difficulties in walking and loss of movement in the operated lower extremity increase the risk of falling in patients.
The risk of falling increases even more on uneven floors, steps or stairs; It causes fractures or other musculoskeletal system problems with high morbidity and mortality rates. Dysfunction or loss of function reduces mobility, as well as physical activity level and independent living capacity. The patient requires assistance or becomes completely dependent on activities of daily living and other activities. Muscle weakness and muscle stiffness increase alternately; There is a loss of flexibility in the joints and the range of motion of the joint decreases. This situation further increases the loss of activity and dependence in patients.
For optimal recovery of patients after THA, loss of functions must be eliminated or lost functions must be regained. For this reason, the place of physiotherapy rehabilitation and the role of the physiotherapist in the treatment after hip arthrplasty is very important.
The physiotherapy and rehabilitation program of THA generally includes the following:
1. Pre-surgical rehabilitation and information,
2. Post-surgery rehabilitation and
preventing complications,
3. Gait training and functional rehabilitation,
4. Home exercises and recommendations
Physiotherapy and rehabilitation after TKA are effective in reducing patients' pain, increasing joint mobility, improving functional It has very beneficial effects in preventing or reducing post-surgical complications as well as improving the level of surgery. It is also very effective in improving health-related quality of life and reducing the duration of hospital stay. The protective effect of rehabilitation in the late period is also important for situations such as falls after THA, muscle weakness and prosthesis loosening problems due to weaknesses.
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