Medical-and-social examination and rehabilitation of patients and disabled persons after the hip total arthroplasty
Purpose. To study the details of medical-and-social rehabilitation of patients and disabled persons after the hip total arthroplasty (HTA), as well as to reveal the possible ways of reducing the primary disability and restoring the optimal working ability in the patients and disabled persons with this pathology. Materials and Methods. We analyzed the materials of 499 patients after the hip arthroplasty, studied the data of the labor character, the degree of physical stress, professional moving, education in the persons, recognized as disabled, and also the problems of social-and-labor rehabilitation of patients. In addition, we developed the predictors of clinical-and-functional outcomes after HTA. Results. As a result of examination, 384 patients were recognized as disabled, among them the disability was determined during the initial examination in 52 patients, and during reexamination - in 332 patients. The vast majority of patients worked in conditions with harmful factors and physical exertions before disability determination (83.3 %), and more than a half of them were engaged in hard kinds of work. As it has been demonstrated, the functional potential formed six months after surgery in case of adequate rehabilitation in majority of the examined patients with unilateral involvement of the hip in the absence of the operated joint complications will be able to meet the requirements of the technological process of a wide range of professions if the contraindicated factors of labor are excluded. Conclusions. The main factors of evaluating the working ability of patients with the implanted joint include etiology, the character of disease process, the stage of pathological process, the degree of statodynamical function disorder, clinical and employment prediction, patient’s social adaptation. The problems of working ability examination should be solved differentially taking the mentioned factors into account.