Specifics of rehabilitation of patients with the consequences of hip joint injuries after total hip arthroplasty
Keywords:hip joint, endoprosthesis, rehabilitation, functional state
Postoperative rehabilitation is an integral part of the complex treatment of patients who underwent hip joint replacement. Time and methods of conducting it today are a subject of discussion among specialists.
Objective: to improve the methodology for postoperative rehabilitation of patients after hip joint replacement and to evaluate its effectiveness.
Methods: a prospective comparative study of the effectiveness of the developed rehabilitation technique in 25 patients (12 men and 13 women, age 22 to 79 years) with the consequences of hip joint traumatic injuries who underwent joint replacement was carried out. The control group included 25 patients (9 men, 16 women, age from 40 to 74 years) after joint replacement due to coxarthrosis caused by the transitory reactive arthritis. Selection criteria were: limb shortening more than1.5 cm, flexion contracture in hip joint, pelvic incline, pain in the area of sacroiliac joint. Rehabilitation exercises started the next day after arthroplasty by different methods and continued to be performed after discharge from the hospital. Results were evaluated after 3 months. after the surgery using the Harris and Oxford Hip Score scores.
Results: in 3 months after joint replacement in the main group, the functional state of hip joint was better than in the control group: according to the Harris score — 77.2 and 72.3 points (p < 0.05), Oxford Hip Score — 36.1 and 34.4 points respectively (p < 0.05). This was achieved through the introduction of exercises for preactivation of m. erector spinae; symmetrical exercises for the balanced recovery of the frontal spine-pelvic balance and the correct stereotype of walking; active control of lumbar lordosis.Conclusions: the developed technique of rehabilitation of patients after hip joint replacement is acceptable and more effective in comparison with the currently used.
Hansen T. Fast track in hip arthroplasty. EFORT Open Reviews. 2017;2(5):179–188. doi: 10.1302/2058-5241.2.160060.
Irvin RE. Why and how to optimize posture. In: Lumbopelvic pain integration of research and therapy. Eds. A. Vleeming, V. Mooney, R. Stoeckart. Chyrchill Livingstone, Edinburg, 2007. pp. 239–251.
Korzh M, Staude V, Kondratyev A, Karpinsky M. Stress-strain state of the system «lumbar spine – sacrum – pelvis» in the conditions of front pelvis. Orthopaedics, Traumatology and Prosthetics. 2016;1(602):54–62. doi: 10.15674/0030-59872016154-61.
Hammer N, Steinke H, Lingslebe U, Bechmann I, Josten C, Slowik V, Böhme J. Ligamentous influence in pelvic load distribution. The Spine Journal. 2013;13(10):1321–1330. doi: 10.1016/ j.spinee.2013.03.050.
Ravin T. Visualization of pelvic biomechanical dysfunction. In: Movement, stability and lumbopelvic pain: integration of research and therapy. Eds. A. Vleeming, V. Mooney, R. Stoeckart. Churchill Livingstone, Edinburg, 2007. pp. 327–339.
Mc Gill SM, Grenier S, Kacic N, Cholewicki J. Coordination of muscle activity to assure stability of the lumbar spine. J Electromyography Kinesiology. 2003;13(4):353–359.
Vleeming A, Albert HB, Ostgaard HC, Sturesson B, Stuge B. European guidelines for the diagnosis and treatment of pelvic girdle pain. Eur Spine J. 2008;17(6):794–819. doi: 10.1007/s00586-008-0602-4.
Vleeming A. The role of the pelvic girdle in coupling the spine and the legs: a clinical-anatomical perspective on pelvic stability. In: Movement, stability and lumbopelvic pain: integration of research and therapy. Eds. A. Vleeming, V. Mooney, R. Stoeckart. Churchill Livingstone, Edinburg, 2007. pp. 113–137.
Hsu CY. Outcomes following the intervention of the hip joint approach for a patient with non-specific low back pain in Taiwan: a case report: materials of the 9th Interdisciplinary World Congress on Low Back & Pelvic Pain, 2016, рр. 357–358.
Okuda T, Kawahara N, Kagetika K, et al. The effects of hip-joint range of motion limitation on the lumbar spine: an analysis of pelvic motion conducted using gait analysis: materials of the 9th Interdisciplinary World Congress on Low Back & Pelvic Pain, 2016. p. 318.
Bondarenko S. Total hip arthroplasty with consequences of reactive arthritis. Kharkiv, 2009. p. 168
Filipenko V, Zlatnyk R, Bondarenko S, Akonjom M. Features of radiological and anatomical changes in bone of the hip joint due to injuries. Orthopaedics, Traumatology and Prosthetics. 2015;3(600):55–60. doi: 10.15674/0030-59872015355-60.
Filipenko V, et al. Rehabilitation of patients with endoprosthetics of the hip joint: method. recommendations [Editor Bondarenko N.]; Sytenko Institute of Spine and Joint Pathology, National Academy of Medical Sciences, Kharkiv, 2011. 31 p.
Harris WH. Traumatic artritis of the hip after dislocation and acetabular fractures: treatment by mold arthroplasty. J Bone Joint Surg. 1969;51-A(4):737–755.
Dawson J, Fitzpatrick R, Carr A, Murray D. Questionnaire on the perceptions of patients about total hip replacement. J Bone Joint Surg. Br. 1996;78-B:185–190.
Richardson CA, Snijders CJ, Hides JA, Damen L, Pas MS, Storm J. The relation between the transversus abdominis muscles, sacroiliac joint mechanics, and low back pain. Spine. 2002;27(4):399–405.
Schouppe S, Danneels L, Ridder ED, et al. Applying an active lumbopelvic control strategy during lumbar extension exercises: Effect on muscle recruitment patterns of the lumbopelvic region: materials of the 9th Interdisciplinary World Congress on Low Back & Pelvic Pain 2016, рр. 356–357.
Tsang S, Lam HM, Ng HL, et al. Effects of core muscle pre-activation on the recruitment of Hip muscles during Hip exercises: materials of the 9th Interdisciplinary World Congress on Low Back & Pelvic Pain 2016. р. 247
Ogura H, Kihara T, Gamada K. Effect of standing exercises using pelvis and thorax realignment devise on the symptoms of care workers with low back pain: materials of the 9th Interdisciplinary World Congress on Low Back & Pelvic Pain 2016. р.368
Don Tigny RL. A detailed and critical biomechanical analysis of the sacroiliac joints and relevant kinesiology. In: Movement, stability and lumbopelvic pain: integration of research and therapy. Eds. A. Vleeming, V. Mooney, R. Stoeckart. Churchill Livingstone, Edinburg, 2007. pp. 290–293.
Copyright (c) 2017 Volodymyr Filipenko, Stanislav Bondarenko, Volodymyr Staude, Artur Moisei, Ahmed Badnaoui
This work is licensed under a Creative Commons Attribution 4.0 International License.
The authors retain the right of authorship of their manuscript and pass the journal the right of the first publication of this article, which automatically become available after 6 months from the date of publication under the terms of Creative Commons Attribution License, which allows others to freely distribute the published manuscript with mandatory linking to authors of the original research and the first publication of this one in this journal.
Authors have the right to enter into a separate supplemental agreement on the additional non-exclusive distribution of manuscript in the form in which it was published by the journal (i.e. to put work in electronic storage of an institution or publish as a part of the book) while maintaining the reference to the first publication of the manuscript in this journal.
The editorial policy of the journal allows authors and encourages manuscript accommodation online (i.e. in storage of an institution or on the personal websites) as before submission of the manuscript to the editorial office, and during its editorial processing because it contributes to productive scientific discussion and positively affects the efficiency and dynamics of the published manuscript citation (see The Effect of Open Access).