Abstract | Zglob kuka spada među najveće zglobove u čovjeka. Zglob zbog svoje anatomske građe i biomehanike, omogućuje podnošenje velikih opterećenja te normalan ravnotežni položaj tijela u prostoru. Zglob kuka, uz sve zglobove ljudskog tijela, podložan je patološkim i degenerativnim promjenama, što ima za posljedicu nastanak i razvoj bolesti lokomotornog sustava. Daljnjim razvojem bolesti zgloba kuka, dolazi do povećanja ograničenosti pokreta i smanjenja funkcije prigodom obavljanja svakodnevnih aktivnosti. Ukoliko se simptomi bolesti ne smiruju putem konzervativne terapije, bolesnik se podvrgava kirurškom liječenju, odnosno artroplastici zgloba kuka. Artroplastika kuka označava kirurški zahvat kod kojeg dolazi do zamjene patološki-oštećenog zgloba s umjetnim zglobom, tj. endoprotezom. Endoproteze danas dijelimo na više vrsta. Prema broju sastavnih dijelova dijelimo ih na parcijalne i totalne, dok prema načinu fiksacije ih dijelimo na cementne, bescementne te hibridne. Postoji niz operativnih pristupa kojima se može ugraditi endoproteza. Najčešće se primjenjuju izravni prednji, izravni bočni i stražnji pristup. Nakon ugradnje endoproteze zgloba kuka, započinje se s fizioterapijskom procjenom i intervencijom. Fizioterapijska procjena čini prvi korak k rehabilitaciji. Procjena bolesnikovog stanja dobiva se putem subjektivnog i objektivnog pregleda te pomoću različitih testova i mjerenja. Cilj procjene je prikupiti što više informacija o samom bolesniku te njegovom stanju, kako bi se napravio kvalitetan plan i program fizioterapijske intervencije. Fizioterapijska intervencija uključuje primjenu fizioterapijskih vježbi te fizikalnih čimbenika u svrhu liječenja prije i poslije operativnog zahvata. Predoperativna intervencija ima za svrhu educirati bolesnika o bolesti i tijeku rehabilitacije te ga pripremiti fizički i psihički za operativni zahvat. Nakon operativnog zahvata odmah započinje postoperativna rehabilitacija, koja se dijeli u četiri faze. Kroz te četiri faze, primjenjuju se različiti terapijski postupci poput elektroterapije, hidroterapije, fizioterapijskih vježbi i drugo. Cilj same fizioterapijske intervencije je vratiti, poboljšati i održavati tjelesnu funkcionalnost zgloba kuka kao i opće zdravlje bolesnika. |
Abstract (english) | The hip joint is one of the largest joints in man. Due to its anatomical structure and biomechanics, the joint allows for high loads and a normal equilibrium position of the body in space. The hip joint, along with all the joints of the human body, is susceptible to pathological and degenerative changes, resulting in the emergence and development of locomotor disease. Further development of hip joint disease, increased mobility constraints and reduced function when carrying out daily activities. If the symptoms of the disease are not calmed through conservative treatment, the patient is subjected to surgical treatment, i.e. the arthroplasty of the hip joint. Hip arthroplasty means a surgical operation involving the replacement of a pathologically damaged joint with an artificial joint, i.e. endoprosthesis. Today we divide endoprosthesis into several species. In terms of the number of components, we divide them into partial and total parts, while, by way of fixation, we divide them into cement, non-cement and hybrid ones. There are a number of operational approaches that can incorporate endoprosthesis. The most commonly used direct front, direct lateral, and back approaches are. After incorporation of the hip joint endoprosthesis, start with physiotherapy evaluation and intervention. The Physiotherapy Assessment is the first step toward rehabilitation. The assessment of the patient’s condition is obtained through subjective and objective examination and various tests and measurements. The objective of the assessment is to gather as much information as possible on the patient’s own condition and condition in order to establish a sound physiotherapy intervention plan and program. Physiotherapy intervention involves the use of physiotherapy exercises and physical factors for treatment purposes. We use a physiotherapy intervention before and after the operation. The purpose of the pre-operational intervention is to educate the patient about the disease and the course of rehabilitation and to prepare him/her physically and mentally for operational intervention. After the operation, post-operative rehabilitation begins immediately, which is part of four phases. Through these four stages, different therapeutic treatments are applied, such as electrotherapy, hydrotherapy, physiotherapy and others. The physiotherapy intervention itself aims to restore, improve and maintain the physical functionality of the hip joint as well as the general health of patients. |