Degree of severity of disability after hip prosthesis
The degree of disability (GdB) is a measure of the impairment of a person by a disability and originates from the German law for severely disabled persons. If “only” one hip joint is affected and a hip joint prosthesis is only implanted on one side, a 20% degree of severe disability exists. If both hip joints are affected and a prosthesis was implanted on both sides, even 40%. In general, from a degree of disability of 30%, equal treatment can be obtained from the Employment Agency, from 50% the person in question is considered severely disabled.
Prognosis
For most patients, a hip joint endoprosthesis can provide good to very good long-term results. Pain relief in combination with a significantly improved mobility and thus a considerable increase in quality of life has a positive effect. Surgical intervention in the case of fractures close to the hip joint, which tend to occur very frequently in older people, stabilizes the hip joint and promises rapid mobilization instead of long periods of bed rest without surgery.
The lifespan of prostheses is limited. As a rule, a replacement operation must be performed on average after 12 to 18 years. The word “average” already implies deviations in both directions.
For example, individual prosthesis models may last significantly longer, but the service life of the prosthesis may also be well below average. There are several factors that can have a negative influence on the service life of the prosthesis. For example, the prosthesis may loosen after only a few years due to accidents, overloading, osteoporosis, or “material abrasion”.
A replacement operation then becomes a necessity. However, as one can imagine, such replacement operations cannot be performed permanently. This means that they should be avoided if possible, but in any case they should be postponed for a long time.
All factors that could cause such a loosening of the hip prosthesis should be avoided. In particular, the severe overloading of the artificial hip joint by lifting heavy loads, the performance of joint shaking sports, should be avoided. Research is currently working on the development of so-called “abrasion-free” materials.
Sooner or later one can speak of “best starting conditions” on the part of the material. The patient then only has to help by behaving correctly in order to achieve even better prognoses. Problem: Uncontrolled movements!
There are sports that are suitable, conditionally suitable or unsuitable for prosthesis wearers. The classification depends on the frequency of so-called critical movements. Such critical movements are generally understood to be extreme movements, such as strong twisting movements, compressions, movements of the leg towards the body (= adduction), or crossed leg positions.
These movements in particular can cause luxation (= dislocation) of the hip prosthesis-hip endoprosthesis. Under certain circumstances, this can make a new operation necessary.Consequently, sports whose load is particularly in the speed and endurance range, where there may still be constant changes of direction, are unsuitable. Most ball sports cannot exclude such critical movements, because especially in contact with an opponent (man against man) uncontrolled movements occur again and again.
The ball sports of bouncing and hitting balls are an exception. Other unsuitable sports include martial arts, kickback games (tennis, squash), jumping sports, alpine skiing and many more. Ask your attending physician whether and to what extent he can still endorse “your” previous sport.
He can assess individually what is best for you. Especially with regard to the sport “alpine skiing”, which has just been mentioned, the experts are arguing. There are supporters, but also strict opponents.
However, since it is important to avoid critical movements and falls, it can be stated: experienced skiers who have been practicing the sport for many decades can usually ski with prostheses relatively unharmed, especially if runs on moguls and in deep snow are avoided and the descents are limited to prepared slopes. However, the risk is extremely high in the event of falls. What do I have to consider when choosing a sport?
As already mentioned above, it is extremely important to avoid sports with high impact loads. Sports with abrupt movements should also be avoided. So far, there is no information available as to which sports might cause the prosthesis to loosen.
There are, however, surveys that have examined tennis in particular with regard to prosthesis loosening. In summary, it can be said that a minimally increased loosening rate was found. However, since tennis as such implies an improved musculature in the corresponding hip area, the advantages and disadvantages – statistically speaking – cancelled each other out. The double play proved to be particularly positive in tennis, as it reduced the damaging kicks and stops. Suitable sports: Conditionally suitable sports: Unsuitable sports
- Running/Walking
- Hiking
- Cross-country skiing
- Cycling
- Swimming
- Dancing
- Golf
- Skittles/Bowling
- Sailing
- Tennis
- Table tennis
- Alpine skiing
- Soccer
- Handball
- Volleyball
- Basketball
- Riding