All information from Dr. Vanni Strigelli related to physical therapy and pain management after hip and knee surgery.
It’s a mistake to either do too little or too much. After discharge two weekly sessions with a physical therapist, combined with exercises performed independently three times a day, will be sufficient.
Upon discharge you will be given a sheet with recommended exercises. It is important to walk frequently, but for only a few minutes during the first few weeks.
CRUTCHES
Two crutches are typically used for the first 2-4 weeks postoperatively, followed by one crutch on the non-operated side for another 2-4 weeks.
THIGH SWELLING AND HEMATOMA
After any arthroplasty surgery swelling of the operated leg is expected, sometimes associated with a hematoma (bruise) around the surgical wound. This is not a complication, but a normal postoperative course, which often worries patients. Sitting for more than 30 minutes can worsen the swelling for the first month after surgery. It is advisable to alternate short walks with periods of rest in bed with the leg elevated (the ankle should be higher than the heart).
HOW TO PREVENT OR REDUCE SWELLING
- Lie in bed with two pillows under the foot of the operated leg. During hospitalization it is possible to tilt the bed without needing to place pillows;
- Do not sit for more than 30 minutes;
- Apply cryotherapy for 20 minutes several times a day;
- Elastic compression stockings may be indicated by medical advice.
INFECTIONS
During acute infections in anatomical areas even distant from the joint some bacteria can enter the bloodstream and reach the prosthesis. Infections must always be treated, but therapy is particularly important for those with a prosthesis. For two years after surgery any dental treatment should be accompanied by preventive antibiotic therapy suggested by your dentist. The recommendation is to use 2 grams of amoxicillin 1 hour before, if not contraindicated.
EXERCISE BIKE, BICYCLE, SPORTS
Pedaling on an exercise bike is a fundamental exercise after hip prosthesis surgery: the goal is to improve joint mobility. Exercising with the bike will also help resolve groin pain that may be present, especially when getting up from a seated position after surgery. It is not advisable to exceed 2-3 minutes of pedaling per session. About 6-10 weeks postoperatively it will be permissible to increase the pedaling time and use a bicycle outdoors in addition to an exercise bike at home. In general patients with a knee or hip prosthesis should be prepared for a reduction in sports performance. The higher the activity level, the greater the risk of prosthesis wear.
Generally, contact sports and high-impact activities should be avoided and are not recommended
SPORTS ALLOWED AFTER HIP SURGERY
- Bicycling
- Golf
- Swimming
- Doubles tennis
- Dancing
- Hiking
- Bowling
- Aerobics
- Rowing
Permitted if experienced: skiing, skating and weightlifting.
High-impact sports are prohibited: soccer, football, basketball, squash.
SPORTS ALLOWED AFTER KNEE SURGERY
- Bicycling
- Exercise bike
- Golf
- Swimming
- Dancing
- Hiking
- Regular walking
- Speed walking
- Bowling
- Canoeing
Permitted if experienced: skiing, cross-country skiing, doubles tennis, horseback riding, rowing, ice skating.
Prohibited sports: running (jogging), soccer, football, basketball, volleyball.
WARNING: when using a bicycle, the main risk is the moment when you stop and have to put your foot on the ground. This phase is at high risk of falling. Therefore you should resume bicycling when you feel confident and pay close attention when stopping and starting.
The resumption of sports activities like long hikes in the mountains, tennis or other sports can occur between the sixth and twelfth month, always considering individual variability.
DRIVING A CAR
Driving is not allowed immediately after being discharged from the hospital. This would pose a risk to yourself and other motorists and pedestrians. Driving is permitted starting from the fourth to the seventh week after surgery, with individual variability and after medical advice. It is recommended to start driving only for short distances and only if absolutely necessary. As the weeks progress, you can gradually increase the duration of driving. You will be able to drive freely by the third to fourth month after surgery.
