PHYSICAL REHABILITATION OF PATIENTS AFTER HIP ARTHROPLASTY

Abstract

Physical rehabilitation of patients after total hip arthroplasty (THA) is a complex, structured, and scientifically grounded process aimed at restoring motor activity, preventing complications, and ensuring the long-term functional success of the surgical intervention. This process plays a decisive role in improving the patient’s quality of life, social adaptation, and ability to return to daily activities. Rehabilitation after THA is generally divided into three main stages: the early postoperative, subacute, and long-term phases. Each stage has its own goals, methods, and physiological rationale. During the early postoperative stage (2–6 weeks after surgery), the primary objectives include pain and edema reduction, prevention of thrombosis, contractures, and dislocations, and training patients in safe movement techniques using assistive devices. At this stage, isometric exercises for the quadriceps and gluteal muscles, passive joint mobilization, and respiratory gymnastics are commonly used to maintain general physical tone and support circulation.

The subacute stage (6–12 weeks) marks the transition from static to dynamic and functional movements. According to contemporary research, including studies by Kovalova and Tsyba (2025) and Madara et al. (2019), an effective rehabilitation program at this phase should combine resistance exercises with elastic bands, training on cycling and balance machines, and post-isometric relaxation techniques to enhance muscle strength, flexibility, and neuromuscular coordination. The use of controlled progressive loading under the supervision of a physiotherapist helps reduce the risk of postoperative limping and compensatory movement patterns.

In the long-term rehabilitation phase (beyond 12 weeks), the main focus is on balance training, gait correction, and restoration of symmetrical movement patterns. As demonstrated by Park and Kim (2023), exercises performed on unstable surfaces, treadmill walking (including backward walking), and training on elliptical machines significantly improve balance, coordination, and confidence in movement, thereby reducing the risk of falls. Long-term rehabilitation also contributes to psychological recovery, fostering patient motivation and independence.

A synthesis of international studies confirms that systematic, individualized, and progressively intensified physical therapy programs yield the best outcomes. According to Minns Lowe et al. (2009) and Dipl-Vw et al. (2021), patients who regularly engage in guided rehabilitation sessions at least three times a week for several months demonstrate significant improvements in muscle strength, gait speed, and overall functional independence. Thus, physical rehabilitation after total hip arthroplasty is not limited to physical exercise alone but represents an integrated process that combines biomechanical correction, education on safe load management, and continuous professional supervision. Such an approach ensures optimal recovery, reduces postoperative complications, and enhances patients’ long-term quality of life.