ARTHROPLASTY (HIP AND KNEE). Definition : An operation to regain or maintain motion in a chronically painful joint (degenerative joint disease) by means of replacing one or both joint surfaces. Replacement arthroplasty :
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An operation to regain or maintain motion in a chronically painful joint (degenerative joint disease) by means of replacing one or both joint surfaces.
Replacement of one (hemiarthroplasty) or both joint surfaces (total joint arthroplasty) or prosthetic joint replacement.
when a single joint is severely damaged and painful, or completely unstable and disabling, and when loss of its motion would not interfere significantly with the patient's function, it can be fused by producing bony union across it's surfaces in the optimum position of function.
Indications of replacement:
These may include coughing and breathing exercises, ankle range of motion exercises, bed mobility exercises and lower limb strengthening and range of motion activities. Proper positioning of the joint should be stressed.
A general plan of postoperative treatment progression for a patient who has received a total hip replacement follows:
Upon return to home, the patient should be instructed to avoid specific activities and positions "These include:
Total knee replacement (TKR) or Total knee Arthroplasty (TKA).
The rehabilitation of patients who have undergone TKA surgery takes place in three phases:
Early motion, moderate protection, and return to activity. The goal of these phases is :
This phase begins immediately after surgery and emphasizes:
6) Ambulation: for cemented knee prosthesis, weight bearing is allowed to the level of patient's tolerance.
7) For cementless knee prosthesis, ambulation gradually progresses from non weight bearing to toe touch and then one quarter of body-weight bearing across the duration of rehabilitation phase.
8) For both prostheses, assistive device, such as crutches, canes, or walkers, are used during ambulation.
9) The early motion phase ends at the sixth week after TKA surgery.
This phase, which encompasses postsurgical weeks 7to 12, continues the processes of muscle conditioning and joint mobilization and also emphasizes progressive ambulatory activities based on the stages of tissue healing.
(The rehabilitation program must parallel the time frame of fracture healing)
This phase which begins in the 13th week after TKA and lasts until patient's knee function has been normalized or optimized, emphasizes maximizing full activity for the rehabilitating patient.