Rééducation de la hanche opérée

Hip disorders usually cause walking perturbation due to pain, stiffness and muscular deficiency at variable degrees, depending on the disease history. Palliative surgery is proposed for slightly arthrosic dysplasia; the rehabilitation includes first maintenance while waiting for consolidation, then a rehabilitation aimed at muscular reinforcement and walking. In case of advanced-stage arthrosis or destructive rheumatic disease, arthroplasty is mandatory. Rehabilitation is guided by the disease history, the pre-operative clinical status, the selected surgical technique and the surgeon's instructions. A program is elaborated from accurate clinical check-up and analysis of observations, and then adapted according to the evolution of preliminary objectives. Such rehabilitation is essentially manual and individual, with periodical reassessments and a particular attention for complications. Rehabilitating an operated hip is based on some rules and on an individual procedure specifically adapted to the patient's hip rather than on a systematic protocol. It is not useful in case of first-line arthroplasty in primitive hip arthrosis, but the rehabilitation of patients with de-arthrodesis or complicated surgery require initiation in a specialized centre prior to external physiotherapy.