Arthroplasty rehab - specialists and information

What is arthroplasty rehabilitation?

Rehabilitation is the monitored healing and recovery process after the artificial joint has been inserted.

Without rehabilitation, it could become displaced or loose. Wound healing disorders would also be possible.

Fundamentals of arthroplasty

An endoprosthesis is a permanently inserted implant that replaces a damaged joint in our case.

In addition to the most common applications of hip, shoulder and knee TEP, ankle, elbow and finger joints are also replaced.

The need arises in rare cases due to accidents and predominantly due to damage caused by osteoarthritis. The patient group is therefore somewhat older.

However,modern TEPs generally last 20 to 25 years. This means that no more than two endoprosthetic operations are required in the course of a lifetime.

The hip TEP surgically replaces the acetabulum and the femoral head @ SciePro | AdobeStock

Why is arthroplasty rehab necessary?

Arthroplasty rehab has three main objectives:

1. Patients learn the correct movement sequences with the artificial joint.
2. Supervised rehabilitation reduces the risk of complications
3. Arthroplasty rehabilitation promotes targeted muscle development

Point 3 is important because patients have not been moving the damaged joint properly for some time before the operation. In principle, orthopaedic rehabilitation is just as important for the success of the treatment as the operation itself.

Is arthroplasty rehabilitation always part of aftercare?

Basically: yes. There may be younger patients who carry out the rehabilitation program independently at home with outpatient monitoring, but these are exceptions. The health insurance companies cover the costs of rehabilitation.

Procedure for arthroplasty rehabilitation

The procedures differ between rehabilitation after the insertion of a prosthesis for:

• knee
• hip or
• shoulder

Rehabilitation generally takes two to three weeks, or longer depending on the type of prosthesis, age and physical condition.

Rehabilitation after the insertion of a knee TEP

Postoperative rehabilitation after knee arthroplasty has a decisive influence on the service life of the prosthesis.

For this reason, arthroplasty rehabilitation begins on the first day after the operation.

It pursues these primary goals:

• primary wound healing
• decongestion
• pain therapy
• Achieving a good range of motion

The first steps are contractions of the muscles around the knee and early gait training. This is followed by exercises for strength, endurance, mobility and coordination.

At the same time, a medical check is carried out using kinetic surface EMG. This is an electromyography that takes place while the knee is moving.

Doctors also monitor the gait and proper function of the knee. An essential part of arthroplasty rehab is motivating patients to perform movement exercises for life. Younger people can return to sport as a result.

The kneeTEP (total knee arthroplasty) is an artificial knee joint that completely replaces the natural joint @ Henrie /AdobeStock

Rehabilitation after the use of a hip TEP

Rehabilitation after hip replacement surgery can take longer. It should be noted that patients are usually at least 70 or 80+ years old. As a result, wound healing of the upper muscle and skin layers usually takes 14 days, while internal healing takes around three to six months.

Endoprosthesis rehabilitation reduces pain and gives the hip the necessary mobility and resilience. It also allows younger patients to engage in sporting activities.

Rehabilitation l asts at least three weeks, after which the desired final result cannot be expected. However, after this time, patients are usually mobile without pain.

The aims of arthroplasty rehabilitation after hip surgery are

1. Restoring normal walking movements
2. normal use of the toilet
3. Pain reduction when sitting and lying in all positions

This requires special movement exercises under the supervision of an orthopaedic physiotherapist. The patient must not immediately put too much strain on the new hip.

Training in the correct sleeping position is also important: ideally, patients should sleep on their back for three months after the operation, but for at least 14 days. When lying on their side, the operated side should be on top and supported by a pillow.

After hip surgery, patients must learn that they:

• do not sit low
• not to cross their legs
• not turn their upper body with their legs stationary and
• not to use stairs without support from the handrail

Rehabilitation after the use of a shoulder TEP

Physiotherapeutic mobilization of the shoulder joint during shoulder arthroplasty begins immediately after the operation. This involves passive physiotherapy.

The physiotherapist moves the patient's arm. The type of movement is precisely specified. A shoulder motorized splint can also be used. The operated shoulder joint moves on this to the pre-set extent.

Training is provided:

• Muscle development
• coordination
• Mobility

Patients learn to perform the necessary movements themselves. To do this, the physiotherapist trains them with active physiotherapy exercises.

Physiotherapy after a shoulder TEP @ contrastwerkstatt /AdobeStock

What do patients need to pay attention to after arthroplasty rehabilitation?

It is crucial for patients to put appropriate strain on the artificial joint and avoid incorrect movements.

This mainly involves extreme movements. When walking after a knee and hip prosthesis, crutches are still required for some time.

Carrying heavy loads should always be avoided. Heavy loads are loads over 20% of your own body weight. It is also advisable to take antibiotics to protect against infections.

Complications, risks and prognosis

Possible complications are

• Thrombosis
• infections
• Loosening of the endoprosthesis and
• Injuries to muscles, skin or bones

These risks can be minimized with a well-conducted arthroplasty rehabilitation. The prognosis for successful healing naturally varies from case to case, but is good overall .

Conclusion

Proven procedures now exist for arthroplasty. The material used for artificial joints has also improved. Well-performed arthroplasty rehabilitation considerably increases the chances of success.