Doctor trauma surgeon
Roman Horobets
+38 044 232 81 15
+38 093 902 80 90
+38 044 452 70 70
Kotel'nykova, 95
Kyiv, Ukraine
dr.traumatologist@gmail.com
Українська Русский English
Hip and knee arthroplasty in medical centre "Omega-Kyiv"
Maksimovycha str., 10 
Vasyl`kivska sub. st. Kyiv
Maps tel. +38 (067) 915-00-55





 Joints arthroplasty is an operative intervention consisting in joints’ work surface replacement by artificial implants. It is usually performed in joints diseases and damages, which can’t be treated in any other way. Arthrosis is main pathology in which endoprosthesis is needed. Deforming arthrosis is diseases characterizing with destruction of the joint’s cartilage leading in limitation of movements, significant deformation and pain syndrome. The chief mechanism of arthrosis development is a joint tissue and subchondral zone blood supply violation. Dependently on pathological changes 3 or 4 atrthrosis changes (according to different classifications) are marked. Decision about joint replacement should be put off for as long as the pain syndrome will allow. However, it is not reasonable to wait for movements limitation development as far as it complicates the operation both for patient and needs to use a soft tissue plastics. Arthroplasty is widely performed in hip, knee, shoulder and elbow joints. Implants are made of different materials and alloys. Endoprosthesis’ components may be prepared from titanium, ceramics, polyethylene or stainless steel. Bioinertness and nontoxicity are main conditions. Implants fixation may be of 2 types: cement (special medical cement) and mechanic one – due to growing of bone in to the surface. Mechanic fixation has an advantage in bone mass preservation, however, not always allows early loads, which are extremely important for aged patients. In wear or instability the change of a component or entire implant is possible. Such intervention is called revision arthroplasty.

Hip arthroplasty Horobets









  

Recommendations to patient after arthroplasty of the joints

(This is general information and may be not objective enough in each individual case and therefore should be obligatory agreed with doctor)

Basic principles:
Gradualeness of loads. Implants stability is provided by not only axes of loads but also tendons, muscles and joint's capsule. Stitched during operation tissues and scars around implants need to grow together and strengthen. These processes take approximately 3 - 4 weeks. Remember: absence of loads leads in atrophy, however, harsh overloads may cause affection of tissues; gradual load promotes strengthening of soft tissues and bones.

Thromboembolism prevention. After the operation there is risk of vessels occlusion with blood clots caused by sedentary regimen and vascular pathology. Therefore it is necessary to intake anticoagulants (blood diluting drugs) during 1 - 3 weeks up to complete restoration of motile regimen. The course of these drugs and their dosages should be prescribed by doctor individually. It is of great importance to provide thorough self control of fulfillment of all prescriptions both in the hospital and at home. It is also recommended to use elastic bandages and compression stockings to prevent thromboembolism. Avoid blood pressure rise and palpitations while doing exercises and/or walking. 

Maitenance. Getting up from the bed first time should be done with a help of either relatives or social workers in order they could support you or soften your falling down in case if you lose the balance. It is recommended to sit during 3 - 5 minutes in the bed before standing up on the legs. Don't forget to roll your legs with elastic bandage or put on compression stockings.  

Body weight control. Gaining the weight decreases capacity of implants' working components and harms the organism by overloading the heart and violating blood supply. Thus it is stricktly recommended to move regularly and correct dietary habits by taking healthy quantitatively and qualitatively balanced diet. Before starting the diet it is preferable to consult your family physician or dietologist.  

Infections prophylaxis. There is a risk of implant contamination after endoprosthetic operation. Infection may permeate from outside or develop inside the organism. When visiting doctors, dentists, physiotheraputists always inform them about you have implants. Any bacterial infection of any localization in the organism should be obligatory treated as far as it is diagnosed. 

It is impossible to underevaluate importance of adhering to healthy lifestyle: it is known that smoking and alcohol abuse poison one's organism, worsen its immunological responce and blood circulation. 

Connection with doctor. Never be shy to call your doctor in case if you have some doubts or if you forgot to ask something. It may resque your life and prevent complications. Pay special attention on worsening of pain, increasing of edema, soaking of bandage, postoperative wound reddening, local or general body temperature increase, shortening or deformation of the extremity, acute reduction of movements volume, sensitivity loss, retrosternal aches, dyspnoea, complicated defecation or/and urination, etc. 

After hip joint repacement it is necessary to prevent luxation of its components. First few weeks after the intervention growing and strengthening of soft tissues and muscles are going on, therefore flexions in hip joint for more than 90°, tighs crossing and marked inner or external rotation of hip especially when it is flexed should be avoided. Bed, chairs and toilet should be high enough - not lower than patella's upper edge.   

Excess flexion and external rotation should be better limited for the rest of life if life conditions allow it. In this regimen luxation risk is reduced and working capacity of implant's components is remarkably increased. 

After knee joint replacement it is necessary to remember that knee joint is easily cooled which may cause development of tissues inflammation. In case of using bandages and tutors follow them not to compress soft tissues as far as it may lead in ischemia and venous congestion in the extremities leading in thrombs formation. Compression stockings and elastic bandages should compress minimally and evenly. UHF-therapy, ultrasound and shockwave therapy, electroprocedures, magnetic and harsh heat procedures are condtraindicated to patients after knee joint replacement.


Ендопротез кульшового суглобуЕндопротезування колінного суглобу