Role of Physiotherapy Post Surgery

Role of Physiotherapy Post Surgery

Patients suffering from chronic hip joint problems requiring replacement surgery usually have balance and coordination problems as well as lack of joint position sense. As a result, they are not able to walk independently without support.

Physiotherapist assesses the functional ability of patient's hip joint and muscles including the patient's walking pattern prior to planning for rehabilitation; and then charts out a rehabilitation plan for next 6 months of the recovery phase. The plan focuses on joint mobility, muscular strengthening, balance and walking pattern correction.

For first two days post surgery, the physiotherapist might ask the patient to start activities like toe movement, foot movement and deep breathing exercises. This improves the healing process and helps the body to combat the effects of anesthesia.

Pain management in the initial phases of recovery is very important and should be controlled with medication. Initially, the patient might feel -

• loss of appetite
• nausea
• constipation
• congestion in the chest

These symptoms are very normal post surgery and would disappear as the recovery continues. It is important that the patient gets active as soon as possible post surgery and start pedaling feet and pumping ankles regularly. This would help in improving blood circulation.

The post surgery rehabilitation includes the following -

• The hip is covered with a dressing post surgery and a drainage tube is attached at the operation site to drain excess fluid from the wound.
• The legs are kept separated at a distance by the usage of pillows between the legs. This helps avoid excessive rotatory or twisting movement at the level of hip.
• The patient is made to wear elastic stocking or adhesive bandaging to reduce the risk of clot formation and lung complications.

Gradually, the rehabilitation activities progress to teaching non-weight bearing standing using crutch, then to walking with the crutch and finally, to standing in weight bearing position and then walking in weight bearing position.

The success of surgery depends largely on the patient's compliance to the instructions.

Patients should perform exercises focusing on the flexibility and strengthening of muscles supporting the hip and surrounding joints; especially, quadriceps, hamstring and calf strengthening exercises.

Recovery time varies significantly from patient to patient with rehabilitation program, typically extending from 3 - 12 months.

It is important to be aware that the replaced hip will never function in the same manner as the normal hip. Usage of the replaced hip would always involve many precautions and limitations.

It is essential to maintain a healthy weight, as above average weight or obesity might reduce the life span of hip replacement.

References:

1. Georgetown University Hospital Joint Reconstruction Center: Total Hip Replacement: Brief Summary of Care Before and After Surgery
2. Suncoast Seminars: Proposed Rehab Protocol for Total Hip Replacement
3. Dancerhips.com; Surgical Hip Replacement Options; Naomi Rabinowitz, M.D., LAc
4. Chico Orthopaedic Surgery & Sports Medical Associates: Hip
5. McKinley Health Center: Overuse Knee Injuries
6. PT Notes; Iliotibial Band Stretches: IT Band Stretches; D.K. Mangusan Jr., PTRP
7. Iliotibial Band Stretch and a Hip Replacement - (http://www.livestrong.com/article/441430-iliotibial-band-stretch-and-a-hip-replacement/#ixzz1sO8UwWK7)
8. Hip Replacement Recovery: What to Expect, Timelines, Outcomes - (http://willapse.hubpages.com/hub/Hip-Replacement-Recovery-What-to-Expect-Timelines-Outcomes)
9. Recovering from Total Hip Replacement Surgery - (http://bonesmart.org/hip/recovering-from-hip-replacement-surgery/)
10. Hip Replacement: - (http://books.google.co.in/books?id=y91FFiRlRiMC&pg=PA12&dq=hip+replacement+surgery+recovery+time&hl=en&sa=X&ei=MLGOT8raM4vqrQfMmsS0CQ&ved=0CHQQ6AEwCA#v=onepage&q=hip%20replacement%20surgery%20recovery%20time&f=false)