REHABILITATION OF PATIENTS AFTER ENDOPROSTHESIS OF LARGE JOINTS OF THE LOWER EXTREMITIES

Nasirli G. A., Ahmedzade A. Ya.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Purpose of research. To evaluate the results of combined use of invasive and non-invasive methods of local and General therapeutic effects on the patient’s body before and after surgery, taking into account the etiology of the musculoskeletal system lesion. Methods. In the hi-tech clinic of the Azerbaijan Medical University, high-tech medical care operations have been carried out since the beginning of 2014 these are hip and knee replacements. In 2014-2019, a total of 218 patients were operated on. Operations were performed in patients with nosological forms such as coxarthrosis and gonarthrosis of various etiologies of stage III-IV (71.1%), aseptic necrosis of the femoral head (22.4%), rheumatoid arthritis (3.2%), false joints of the femoral neck (1.81%). We used prostheses imported by leading European and American companies with cement and cement-free fixation, total and single-band. Of the operated patients, women had 143 (66.1%), the average age was 60.8 years; men – 75 (33.8%), the average age was 500.4 years. 154 (70.6%) patients with hip joint pathology were operated on, 64 (29.3%) patients with knee joint pathology were operated on. Results. Knee replacement was performed in 64 patients (29.3%). Of these, 7 patients received total knee replacement with an AGG (Biometrics) implant. 57 patients had total arthroplasty with an AGS implant from Implanteast (Germany), the tibial component of which has a floating platform. 154 patients underwent hip replacement (70.6%), 52 (33.7%) with a cement implant. Of these, 4 patients had a subcapital fracture of the femoral neck, and 3 patients had a false joint of the femoral neck. 102 (66.2%) patients were operated with a cementless implant. All patients in the Department of gravity blood surgery had blood taken 5-6 days before the operation (on an outpatient basis) for autohemotransfusion to compensate for blood loss during the operation. In the pre- and post-operative period, prevention of thromboembolic complications was performed. 1 day, for 12 h before the operation the patient was subcutaneously injected solution Fraxiparine 0.3 ml or a solution Clexane 0.4 ml. In the same doses, continued to introduce these drugs until the patient’s discharge, which averaged 12 days. The average duration of hip replacement surgery is 1 hour. 30 minutes for cementless implantation and 2 hours for cementless implantation. After the operation, patients are observed in the intensive care unit until the next day. Restorative conservative treatment was performed in patients who underwent reconstructive and bone-plastic surgery for diseases and lesions of the musculoskeletal system: 3 weeks after knee replacement surgery, 1.5 months – after hip replacement, and was aimed at optimizing and accelerating the recovery of lost limb function. Correctly performed restorative conservative treatment after surgery is an important component of the success of surgical treatment and medical rehabilitation of patients with diseases and injuries of the musculoskeletal system.

coxarthrosis, gonarthrosis, endoprosthesis treatment, rehabilitation

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«Bulletin of problems biology and medicine» Issue 1 (155), 2020 year, 170-175 pages, index UDK 616.728.2:616.71

10.29254/2077-4214-2020-1-155-170-175