Rehabilitation of Patients with Rheumatoid Arthritis after Hip Replacement

S.I. Herasymenko, M.V. Poluliakh, A.M. Babko, A.S. Herasymenko, V.M. Hromadsky, I.V. Roi, T.V. Zamorskyi


Rheumatoid defeat of the hip joints has a rapid and aggressive course that not only leads to destruction of the bulk of the joints, but also affects the para-articular tissues as a consequence of inflammatory and autoimmune aggression. To restore the function of the hip joints in patients with rheumatoid arthritis in the late stages of the disease is possible only with the help of surgery — total hip replacement. All this increases the influence of the preparatory phase and the early postoperative rehabilitation treatment on the results of orthopedic treatment of this challenging group of patients. Main purpose — to improve the results of orthopedic treatment of patients with rheumatoid arthritis, in whom total hip arthroplasty was performed by improving the approaches to the preoperative preparatory phase and the early postoperative rehabilitation treatment. Materials and methods. In this work, we have performed an analysis of the results of total hip arthroplasty and the effectiveness of rehabilitation in 146 patients with rheumatoid arthritis, in whom 203 surgical interventions were performed. 57 of them underwent arthroplasty of both hip joints. The age of patients ranged from 18 to 77 years and averaged 45.1 ± 1.1 years. There 4 times more women than men. Results. Good results were obtained in 169 (83.3 %) cases, satisfactory — in 34 (16.7 %) cases. The reason for a satisfactory outcome in patients was ankylosis of hip preoperatively or severe contractures with significant muscle wasting, which affected the functional outcome. Conclusions. The program of rehabilitation treatment in rheumatoid arthritis patients with prosthetic hip allows to carry out the preparation of the musculoskeletal system prior to surgery, to improve muscle strength and movement in the joint during the postoperative period, and to get good results in 83.3 % of cases. The proposed rehabilitation scheme makes it possible to restore the lost function of the hip joint and to return the patient to the active way of life.


rheumatoid arthritis; hip joint; endoprosthesis; rehabilitation


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