Issue №2-90, 2019

Protocol of early rehabilitation after еndoprosthesis replacement of major joints (literature review)

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1 Sekirin A.B.

1 «Moscow Regional Scientific Research Clinical Institute named after M.F. Vladimirsky», Moscow, Russia


ABSTRACT

Diseases of the musculoskeletal system occupy the second place in the structure of temporary disability of the adultpopulation and the third place in terms of the frequency of causes of disability and mortality. The most common diseaseof the musculoskeletal system and the most common cause of disability in older people is osteoarthritis. One of the mosteffective methods for restoring the quality of life of patients suffering from osteoarthritis is endoprosthesis replacement ofthe damaged joint. Medical rehabilitation is a recognized area of medical care and its mandatory stage, which is characterizedby a multidisciplinary approach. Protocols currently in use include clinical ways of coordinating the activities of multifunctionalgroups of orthopedic surgeons, physiotherapists, kinesiotherapists, nurses in massage, and others involved inhelping patients after endoprosthetic replacement.In recent years, early postoperative rehabilitation (Enhanced Recoveryafter Surgery – ERAS) – a protocol involving the use of interdisciplinary multicomponent programs for standardization andimprovement of patient management algorithms in the perioperative period, is becoming increasingly widespread in variousfields of medicine. The goal of ERAS is to provide faster and more efficient recovery of patients using methods whoseeffectiveness is justified by using evidence-based medicine. It has been demonstrated that ERAS makes it possible to achievea reduction in the incidence of postoperative complications by 50%, the length of stay in hospital by 30%, and the frequencyof repeated hospitalizations, thereby reducing the cost of healthcare. Restoration of the functional capabilities of patientsafter endoprosthetics of large joints still remains a difficult problem, the solution of which should be aimed at improvingthe quality of life of patients, successful restoration of their social and labor activity. In this regard, it is relevant to conductresearch aimed at improving and increasing the effectiveness of medical rehabilitation methods.


KEYWORDS: early rehabilitation, osteoarthritis, coxarthrosis, gonarthrosis, disability, endoprosthetics, multidisciplinary approach, postoperative period, evidence-based medicine.



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