Rehabilitation after total hip arthroplasty

Abstract

Zglob kuka važan je zglob u ljudskom tijelu. Sastoji se od acetabuluma i glave bedrene kosti. Služi kao potpora cijelom tijelu prilikom stajanja, hodanja, trčanja i održavanja ravnoteže. Osteoartritis je najčešća bolest zglobova. Često zahvaća velike, noseće zglobove poput koljena i kuka. Od osteoartritisa obolijeva velik broj ljudi, naročito stariji. Bolest je progresivna te je krajnja terapija ortopedski kirurški postupak – artroplastika zgloba kuka. To je kirurški postupak koji se sastoji od zamjene komponenti zgloba endoprotezama. Dijelimo ju na totalnu i djelomičnu. U totalnoj artroplastici zamjenjuju se i acetabularna i femuralna dok se u djelomičnoj najčešće zamjenjuje samo femuralna komponenta. U periodu nakon artroplastike bitno je bolesniku povratiti funkcionalnost, pokretljivost i kvalitetu života, a to se najbolje postiže kvalitetnom rehabilitacijom. U rehabilitaciju spadaju edukacija bolesnika, provođenje vježbi, sprječavanje neželjenih komplikacija i štetnih učinaka te kontrola boli. Provođenje vježbi počinje na dan operacije i provodi se i do godinu dana nakon same artroplastike. Može se provoditi samostalno kod kuće, na grupnoj ili individualiziranoj fizikalnoj terapiji. Kao dodatak uz standardne vježbe može se provoditi i hidroterapija, stimulacija mišića električnom energijom, vožnja sobnog bicikla i upotreba ručnog ergometra. Do sada nije ustanovljen najbolji protokol vježbi za rehabilitaciju bolesnika nakon ugradnje endoproteze kuka.The hip joint is a very important joint in the human body. The main parts of the hip are the acetabulum and the head of the femur. Its main role in the body is to provide support for the whole body while standing, walking, running and maintaining balance. Osteoarthritis is the most common joint disease. It often affects large, weight-bearing joints such as the knee and the hip. Osteoarthritis is a progressive disease that affects a large number of people, especially the elderly and its last step treatment is orthopedic surgery – hip arthroplasty. Hip arthroplasty is a surgical procedure in which the hip joint is replaced by a prosthetic implant. There are two types of arthroplasty: total arthroplasty, in which both joint components are replaced, and hemi arthroplasty, in which only the femural component is replaced. In the time following arthroplasty it is of upmost importance for the patient to regain funcionality, mobility and quality of life, goals which are best achieved throught rehabilitation. The main components of rehabilitation are education, exercise protocols, pain management and prevention of complications. The exercise protocol starts at the day of the surgery, lasts up to one year and it is performed either at home or at the physical training facility. Hidrotherapy, electric stimulation, arm and cycle ergometer can all be added to the standard exercise protocol. So far there has been insufficient evidence to establish the best exercise protocol