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A HOLISTIC PERSPECTIVE ON HIP REPLACEMENT HEALTH
Turkey Medicals Co-ordinator, “Total hip replacement; It is an operation to replace the damaged joint with an artificial joint in patients whose hip joint has been severely destroyed.”
Hip replacement is usually performed for 3 reasons;
1- Calcification of the hip
2- Hip fractures
3-After the vascular structure feeding the head part of the joint loses the function of a part of the structure and the living part of the head dies and collapses here (avascular necrosis)
During the operation, both surfaces of the joint are replaced with plastic and metal parts. The prosthesis can be attached to the bone in two ways.
1- In elderly patients whose bone quality is not very good, the prosthesis is fixed to the bone with a filler called bone cement.
2- In younger patients with good bone quality, on the other hand, the prostheses coated with a porous substance are placed very tightly inside the bone, and then the bone of the body moves into the pores on the prosthesis, allowing it to be fixed. This type of prosthesis is called cement-free prosthesis.
Rehabilitation; Hip rehabilitation, like all rehabilitation programs, includes practices aimed at improving the patient’s quality of life. After hip surgeries, the patient is taught information such as how to adapt to his new hip, how to use this hip from now on, what to pay attention to.
In hip replacements, it is divided into 2 periods, preoperative and postoperative.
During the preoperative period, the physiotherapist gives the patient information about how he should behave during the operation and after. Warns the patient about the risk of dislocation of the prosthesis. Teaches the patient how to sit, get up and go to bed. He introduces the device that the patient will use for walking before the operation and tells how he should walk with this device. It makes the patient do strengthening exercises for the abdominal, waist and leg muscles. Especially since the leg muscles may weaken after surgery, it is of great importance to strengthen them before. Again, in order to prevent lung complications that may occur after surgery (side effects of surgery) and to ensure that sputum secretion that will accumulate in the lung is easily excreted, breathing and coughing exercises are taught to the patient before surgery. In this way, the patient is prepared for both the operation and the postoperative period.
The most important thing to be considered after the operation is the risk of dislocation of the prosthesis. To prevent this, the patient’s operated leg is positioned appropriately. Other risks are that the surgical site gets infected with germs and throws clots from the leg to the lung or brain. Again, during this period, it is tried to reduce complications that may occur in the lungs and heart.
The rehabilitation program is determined by the physiotherapist according to the place of cutting and the type of prosthesis. In short, when the patient’s condition stabilizes after surgery and all the findings return to normal, the rehabilitation program begins as soon as possible with the recommendation of the physician.
After the operation, the patient starts to be carried out with an auxiliary device 2 times a day. The auxiliary device to be used and the weight to be given to the operated leg are determined by the type of prosthesis. Strengthening exercises are started for the muscles around the hips and leg muscles. During this period, breathing and coughing exercises aimed at emptying the sputum secretion in the lungs and exercises that prevent the release of clots to the lungs or brain that allow blood to return from the veins to the heart are important. Stretching exercises that prevent shortening of the side muscles are shown to the patient.
The exercise program is continued by adding exercise every day. The patient is discharged by the doctor after receiving sitting – getting up, walking, going up and down stairs trainings at the hospital.
Situations that need to be taken into account in daily life activities;
1- When sitting, the legs should be bent from the knees rather than from the hips.
2- It is not allowed to lie on the operated side without the definite permission of the physician.
3- When Decking on the firm side, a thick pillow should definitely be placed between the two knees and the knees should be slightly bent.
4- It should not be sat on short chairs and toilet bowls. A riser part can be used for toilet bowls. The chairs should be high enough not to bend the leg. If it is necessary to sit in a short chair, this time the torso should be moved back away from the leg. Upgraded apparatuses are used after discharge from the hospital until the doctor says there is no need (about 6-10 weeks).
5- The feet should not be kept crossed when walking and especially when turning.
6- Touching the feet, wearing trousers, bending the torso forward excessively, such as pulling the yoga up by the foot while lying down, is strictly prohibited.
7- When sitting, the trunk should be slightly tilted back. When sitting or standing up, the shoulders should not come in front of the hips.
8- When sitting in a chair, the knees should not be higher than the hips.
9- It should not be entered without placing a stool in the bathtub to take a bath.
10- When climbing the stairs, first the firm side and then the sick side go up to the upper step, then the two sides of the crutches are taken to the upper step together. When descending the stairs, first both crutches are placed on the bottom step, then the operated side is lowered down, and finally the solid side is lowered down.
11- Crutches / walkers are continued to be used until the doctor says otherwise.
12- One should not sit for more than 1 hour before standing up or stretching.
13- It is possible to return to driving 6 weeks after the operation, but for this, the control of the operated leg should be very good and little effort should be spent when moving the foot from the accelerator pedal to the brake.
14- The trunk should not be turned to the side of the operated leg, and the operated leg should not be turned inward.
15.-In order to prevent the shortening of the muscle groups in the front of the hip, it should be tried to lie flat in bed for about 15-30 minutes every day.
16- If it is noticed that a swelling has formed on the operated leg after leaving the hospital, the foot is lifted up by supporting it from the bottom during supine lying, if the swelling does not go away, the doctor is contacted. In addition, if tenderness develops in the calf, it is also necessary to consult a doctor. If it is necessary not to put full weight on the operated leg, in these people, the leg muscles cannot perform an adequate blood pumping function due to insufficient use, and swelling occurs This swelling lasts until the foot is fully loaded and usually disappears at night.
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Turkey's world-renowned organ transplant specialist. Dr. Demirbaş has 104 international publications and 102 national publications.
Physician's Resume:
Born on August 7, 1963 in Çorum, Prof. Dr. Alper Demirbaş has been continuing his work as the President of MedicalPark Antalya Hospital Organ Transplantation Center since 2008.
Prof. who performed the first tissue incompatible kidney transplant in Turkey, the first blood type incompatible kidney transplant, the first kidney-pancreas transplant program and the first cadaveric donor and live donor liver transplant in Antalya. Dr. As of August 2016, Alper Demirbaş has performed 4900 kidney transplants, 500 liver transplants and 95 pancreas transplants.
In addition to being the chairman of 6 national congresses, he has also been an invited speaker at 12 international and 65 national scientific congresses. Dr. Alper Demirbaş was married and the father of 1 girl and 1 boy.
Awards:
Eczacibasi Medical Award of 2002, Akdeniz University Service Award of 2005, Izder Medical Man of the Year Award of 2006, BÖHAK Medical Man of the Year Award of 2007, Sabah Mediterranean Newspaper Scientist of the Year Award of 2007, ANTIKAD Scientist of the Year Award of 2009, Social Ethics Association Award of 2010, Işık University Medical Man of the Year Award of 2015, VTV Antalya's Brand Value Award of 2015.
Certificates:
Doctor of Medicine Degree Hacettepe University Faculty of Medicine Ankara, General Surgeon Ministry of Health Turkey EKFMG (0-477-343-8), University of Miami School of Medicine Member of Multiple Organ Transplant, ASTS Multiorgan Transplant Scholarship. Lecturer at Kyoto University. Lecturer at University of Essen, Research assistant at the University of Cambridge .
Professional Members:
American Society of Transplant Surgeons, American Transplantation Society Nominated, Middle East and Southern Africa Council Transplantation Society 2007, International Liver Transplantation Association, Turkish Transplantation Association, Turkish Society of Surgery, Turkish Hepatobiliary Surgery Association.
Disclaimer:
Our website contents consist of articles approved by our Web and Medical Editorial Board with the contributions of our physicians. Our contents are prepared only for informational purposes for public benefit. Be sure to consult your doctor for diagnosis and treatment.