Post traumatic conditions of upper and lower limbs

Highly developed degenerative disorder of the hip and knee as well as traumas are most common causes of surgical treatment, i.e. implantation of endoprosthesis.

Hip and knee endoprosthesis imitate the shape of the joint.

Arthroplasty is a method in orthopedic surgery used to replace or remodel common surface of a joint by using implants made of artificial materials aiming to establish painless movability of the joint.  High percentage of surgical interventions in Serbian orthopedics belongs to implantation of great joint endoprosthesis. An orthopedic surgeon decides on type of endoprosthesis to be implanted, based on pathological substrate and age of a patient.  Lifecycle of the implanted endoprosthesis depends on numerous factors, but the most important one is body weight.

Early post surgery rehabilitation begins at an orthopedics department, and it is carried out in order to prevent development of post surgery complications and to assist a patient to get into a vertical position. This is followed by referring patients to some specialized institution for extended rehabilitation for 28 days. In our institution, patients may have rehabilitation with a referral from the national health insurance fund or at their own costs. 

In Specialized Rehabilitation Hospital Banja Koviljaca, extended post surgery rehabilitation is carried out successfully in patients after implantation of hip and knee endoprosthesis, aiming to pain relief, faster mobilization, reaching optimum functional recovery and improving ability for independent execution of everyday activities. Caution measures and limitation of load onto the operated leg are defined as per an operator's order and with follow-ups at an orthopedist in our Hospital.  Depending on a type of implanted knee endoprosthesis, rehabilitation takes 4 to 6 weeks, and after this period, patients may usually walk with full support or without aids.

After implantation of the hip endoprosthesis until full establishment of independent walk, it takes 4 weeks to 3 months, depending on a type of implanted prosthesis and a general condition of a patient.  Rehabilitation in our Hospital is individual for each patient depending on her/his general health condition and functional abilities at admission.

Rehabilitation of patients after implantation of hip and knee endoprosthesis in Specialized Rehabilitation Hospital Banja Koviljaca includes kinesitherapy, electric therapy, magnetic therapy, phototherapy and hydrokinesitherapy in a pool with sulphuric thermomineral water, and in overweight patients, there is also a diet supervised by our dietitian.   
Application of traditional physical agents results in better healing of post surgery cuts, relief of post surgery pain and swelling, and in better connection of the prosthesis to the adjacent bone. A particular place in rehabilitation is taken by kinesitherapy which is used to strengthen muscles of the operated leg and healthy limbs, improve movability in the operated joint, and patients are trained to walk with adequate aids (walker, cane, crutches) across flat surface and up and downstairs; they are trained to apply protective movements and positions for hip endoprosthesis, as well as for proper execution of everyday activities and corresponding exercise program at home, and all this in order to prevent prosthesis dislocation as possible post surgery complication and to improve quality of life.  Hydrokinesitherapy, i.e. walking and exercising in water, are done in a pool with SULPHURIC thermomineral water which in addition that it makes walking and exercising easier, it also has beneficial effect on muscles and bones.