Artificial Hip Joint (hip TEP) and Rehab

Artificial hip joint (hip TEP): surgery and rehab

The hip TEP (total hip endoprosthesis) is an artificial hip joint. It is primarily used when the hip joints are worn and is made of metal, plastic or ceramic. Find out everything here about surgical procedures, the subsequent rehabilitation (“hip rehab”) and life with an artificial hip joint.

Hip TEP: General

Endoprostheses are used to replace diseased joints. A total endoprosthesis (short: TEP) replaces a complete joint, a hemiprosthesis only parts of a joint. The hip prosthesis (hip TEP) is used when the joints of the hip are badly worn or painful, and a non-surgical treatment does not improve. In USA, over 200,000 people get a hip TEP every year (1).

There are various diseases that make an artificial hip joint necessary. These include pronounced forms of osteoporosis, broken fragments or decomposition of the femoral head (necrosis) due to diabetes or after accidents. By far the most common disease that leads to hip surgery is wear and tear of the hip joint (coxarthrosis). The articular cartilage wears out, which increases the friction in the joint. The cartilage splinters and tears. The result is pain and increasing mobility restrictions. Osteoarthritis can also affect younger people, for example if the joint wears out prematurely due to malposition of the joint, broken bones or lack of movement (possibly associated with being overweight).

You can read more about diagnosis, therapy and rehabilitation of coxarthrosis in the article: Hip arthrosis.

Hip TEP: surgery

A hip TEP is supposed to functionally replace the natural hip joint. The structure of the endoprosthesis therefore corresponds to the body’s own joint and consists of an articular socket and an articular head that can move in the socket. In order for the artificial joint to function permanently, materials are used that do not decompose in the body and do not trigger any intolerance reactions. At the same time, the prostheses are extremely stable, withstand high loads and do not wear out due to the movement in the joint. The high-tech materials used include titanium, ceramics and special plastics.

Anchoring to the bone

The hip TEP must be firmly attached to the bone so that it can perform its function. The surgeon can choose between three methods. Cemented hip prostheses are fixed with joint cement. In the cementless version, the prosthesis is screwed to the bone or clamped to it. In the hybrid prosthesis, part is screwed and part is cemented. Later the bone grows firmly with the endoprosthesis. However, the first fixation is already so stable that you can put strain on the joint shortly after the operation.

Procedure and follow-up care

The operation is performed under general anesthesia, sometimes with spinal cord anesthesia. You usually have to stay in the hospital for a week or two after the operation. During this time, the first mobilization begins. The joint is moved under the guidance of a physiotherapist and is subjected to increasing stress. Shortly after the operation, patients can usually walk short distances when accompanied by the therapist. Regular stretching and bending exercises promote the mobility of the new joint. You must continue these and other exercises after your hospital stay at home or in rehab.

Hip TEP: rehabilitation

For an artificial hip joint, the steps to mobilize and build muscle are especially important after the operation so that the new joint can function optimally. Experts therefore recommend rehab after the operation. This can take place on an outpatient basis at private physiotherapists or clinics. With inpatient rehab in a health clinic, even more comprehensive care is possible.

Stabilization through muscle building

The most important goal of “hip rehab” is to build muscles. Often the joint was previously spared to avoid pain, which leads to the loss of muscle mass. But muscles are important to support and stabilize the new joint. In rehabilitation, specially trained physiotherapists or physiotherapists show you which exercises and sports are particularly suitable for this. It is important to pay attention to hip-gentle movements and the right amount of sport.

Individual therapy

Depending on your age and the course of the operation, doctors and specialists in the rehabilitation clinic determine the appropriate combination of measures for you. In addition to physiotherapy, this also includes physical therapies such as B. massages and treatments with heat, light or water. This promotes the mobility of the joint so that you can be active again as quickly as possible and do everyday things yourself.

Life with the hip TEP

Rehabilitation prepares you optimally for a return to everyday life. Experts will show you how to avoid protective postures, how to walk properly (gait training) and how much stress and relief makes sense. You will learn how to deal with falls and the best postures when showering or bathing. You will also receive tips on what to consider when driving, cycling, walking or carrying loads. In detailed consultations, you will also receive information on returning to work or retraining, if required.

Chances of recovery and benefits of rehab

It usually takes at least a year for an artificial hip joint to fully stabilize and the body to adjust to it. Experts recommend a customized exercise and exercise program to support and accelerate this process. Physiotherapy and exercise therapy in rehab are part of the standard of care in order to maintain or restore performance in everyday and working life (2). Rehabilitation measures not only make the new joint more stable and flexible, it also avoids late effects and complications such as pain or loosening of the prosthesis (3). Rehabilitation also reduces pain and requires less medication.

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