Length of sick leave after knee replacement

Endoprosthetics of the hip and knee joints is one of the most complex joint surgeries, after which a fairly long recovery is required. Having undergone joint replacement with an endoprosthesis, the patient, of course, due to temporary loss of ability to work (TLD), is issued a sick leave certificate (SL). Such a document is necessary not only for receiving compensation payments on the occasion of forced “leave”. The time provided for sick leave will be used productively for:

high-quality engraftment of the joint implant;
adequate adaptation to life with a new joint;
systematic development of the limb and restoration of muscle strength;
preventing possible complications or competently eliminating adverse reactions that have developed after surgery.

The length of a person’s stay at home due to postoperative disability depends primarily on the type and volume of the intervention performed and the period of full rehabilitation established by the health care system according to this criterion. The duration of sick leave will, of course, be influenced by the dynamics of the patient’s recovery. The opening and extension of the worksheet is mandatory regulated by the Labor Code of the Russian Federation and various regulations.

Sick leave after hip and knee replacement

Video (click to play).

high-quality engraftment of the joint implant;
adequate adaptation to life with a new joint;
systematic development of the limb and restoration of muscle strength;
preventing possible complications or competently eliminating adverse reactions that have developed after surgery.

From the first day of admission to the hospital, a certificate of incapacity for work is issued. Upon discharge from an inpatient hospital, the bulletin is closed. As you can understand, the initial period of sick leave is set by the medical structure where you underwent endoprosthetics. And the total volume of days spent in a particular clinic is the period of primary BL.

Naturally, not all patients will have the same number of days of hospitalization: some after surgery need inpatient observation for 5 days, while others may stay there for up to 2 weeks due to unsatisfactory health. As practice shows, on average, patients are kept in a surgical hospital for 5 to 10 days after such high-tech care, after which they are discharged.

Of course, this is not the final term of sick leave. It is clear that for a person who will have to move around with the help of special support devices for at least another 6 weeks, going to work is out of the question. Therefore, the patient is then taken under the control of a polyclinic-type institution at the place of residence, or rather, the attending physician from a local clinic.

So, after discharge, you promptly came to see your attending doctor, who dealt with your medical problem even before the operation. Now you will receive basic recommendations regarding further recovery from him. And, accordingly, from the very first day of your application, you will be given a new sick leave certificate, officially confirming the need for further temporary release from work duties.

The VUT document is issued by an outpatient medical institution for a period of 15 days. That is, the frequency of updating the BL will now be every 15 days. You need to focus on the date of the control visit, entered by the specialist in the appropriate column of the document. The person being rehabilitated is obliged to appear at the specified time to the doctor for the next examination, after which the sick leave will be extended again.

Any non-compliance on the part of the patient with regard to appearances at the clinic is a severe violation of the rules, associated with a lot of problems, including misunderstandings at work, failure to include days in the BC from the day of no-show, difficulties in receiving payments under the VUT.

Ideally, postoperative recovery in connection with the implantation of any joint lasts 3-4 months. This is the period of time during which, with positive dynamics of recovery, the functional, social, everyday and professional potential of opportunities is fully achieved.

Naturally, not all people are twins in terms of the physiological capabilities of the musculoskeletal system for recovery, and in general in terms of the health status of the body. It is also impossible not to say that some people, due to incorrectly performed intervention or insufficiently well-organized rehabilitation, experience complications (contractures, muscle atrophy, periprosthetic infection, dislocation of the endoprosthesis, etc.).

Based on the above, we will indicate that a certain percentage of patients do not fit into generally established rehabilitation standards. At the end of 90-120 days after endoprosthetics, if the clinical picture is unsatisfactory, the issues of granting the patient VUT status will be dealt with by the ITU expert commission.

To do this, the medical and preventive institution (MPI), where the patient was treated and examined during the entire rehabilitation period, sends a package of documents to the local bureau. The delivery package must include all extracts and conclusions on the main diagnosis, diagnostic and therapeutic measures carried out in outpatient and inpatient settings.

Experts of the medical and social commission carefully study the information about the patient received from the health care facility and render a verdict on the degree of limitation of his work capacity. ITU, as one of the common options, can agree that the clinic opens a new one from the date the sick leave is closed until the patient’s quality of life is restored as completely as possible.

The deadlines for the BL are set for health care facilities by the ITU, as well as the admissibility of its extension without their participation, and the cyclic nature of the update. Another option, less likely, is that the expert commission assigns the patient a disability group (usually 3 degrees) with further re-examination at the time specified by the MS authority.

We emphasize that MSEC reserves the right to refuse to extend the BL and assign a group if pathological deviations are confirmed to be insignificant.

Primary period of sick leave: hospital period

Of course, this is not the final period of sick leave. It is clear that for a person who will have to move around with the help of special support devices for at least another 6 weeks, going to work is out of the question. Therefore, the patient is then taken under the control of a polyclinic-type institution at the place of residence, or rather, the attending physician from a local clinic. A new certificate of incapacity for work will be opened for them. To avoid misunderstandings, which is not uncommon, it is important to come to the clinic strictly on the same day as your discharge from the surgical hospital.

How long does it take to recover after knee replacement?

Modern surgery at a high level performs knee replacement surgery, which was previously considered impossible. According to statistics, after surgical intervention, patients after such an operation return to their previous, healthy life. In addition to the main treatment, rehabilitation after knee replacement is necessary, otherwise the therapeutic outcome will not be achieved. You can find out about the methodology for conducting the rehabilitation period in our article.

Endoprosthetics is a surgical intervention that results in the replacement of a damaged joint with a prosthesis (implant). Joint replacement is performed when conservative treatment methods do not produce results, and the destroyed joint loses its functioning ability.

A common case of prosthetics is injury to the knee joint, arthrosis. In this case, the cartilage layer between the articular bones wears out over time. Other causes of pathology may be chronic infection, rheumatism, metabolic disorders.

The purpose of the procedure is to remove the worn joint and install a new special element. Such an event will eliminate the deformity of the limb, restore motor function and save the damaged bone.

During the operation, the doctor removes cartilage from the tibia and adjusts the position of the knee joint. After this, the articular joint is replaced and the endoprosthesis is secured. Tissue from the patient or donor is used to fill bone defects.

At the final stage, the surgeon checks the stability and strength of the installed component. Makes versatile movements in the knee at an angle, gives an assessment of smoothness. Knee surgery helps to restore mobility, full function of the leg, and eliminate pain.

Basically, the endoprosthetics operation is positive, without complications and gives an excellent result. But it is worth noting that it depends on the qualifications of the surgeon, the quality of the medical action performed, and the characteristics of the knee joint. It also requires a long postoperative recovery period.

Endoprosthetics is a planned operation that includes examining the patient and conducting a study of the patient’s condition. It is almost impossible to insure yourself against complications that arise after surgery. After all, they are primarily caused by signs of the structure of the knee joint, and only then by ignoring recommendations for strengthening the knee.

In such situations, the following complications may occur:

inflammatory process of the limb;
infection of the knee;
bone fracture near the fixed implant;
displacement of the kneecap;
destruction of a vascular or nerve bundle;
implant deformation;
elevated temperature;
thrombosis;
swelling and fluid accumulation;
failure of the respiratory system;
allergy;
crunching sound while moving;
displacement of the element itself (implant);
limited mobility;
formation of scar tissue.

After surgery, there is a risk of swelling and thrombosis, so you need to take medications that thin the blood, use a special stocking or bandage. In order to avoid complications, you must follow the doctor’s recommendations, avoid unnecessary stress, injuries, and undergo testing to detect allergies to the drug.

Prosthetics provide an opportunity for the victim to get rid of pain and enjoy an active lifestyle. Rehabilitation is, of course, a long period of recovery, but it will help the body avoid the risk of negative complications.

After the operation, rehabilitation of the knee cartilage begins immediately. It is allowed to get out of bed after the first day, but very slowly and smoothly leaning on your elbows. On the second day, you are allowed to put your feet down from the hospital bed. Next you need to learn how to sit correctly. To do this, you need to clasp your endoprosthetic leg with your hands and gradually lower it to the floor. To avoid the risk of deviations, you should apply an elastic bandage to the damaged area.

After 4-6 days, the patient can fully stand on his feet, but he should not lean heavily on a weak limb. The first movement is carried out first on the healthy leg, the sore leg is in a straightened position. It is advisable to touch the floor with it and use an orthopedic device. The patient stays in the hospital for up to 7-10 days, after which he is discharged and continues therapeutic exercises at home. The joint will take about 24 weeks to heal and fully recover.

For the first three months, the patient slowly moves around the house with the help of another person or an additional device. Next, flexion, extension of the leg at an angle of 90 degrees, and balance on the leg are practiced. The effectiveness of strengthening the knee joint is accompanied by the following activities:

Raising the straightened leg, keeping it in good shape (2-3 seconds).
Knee flexion, extension no higher than an angle of 90 degrees.
Perform extension movements in the ankle joint, increasing repetitions gradually.
Extending the straightened and raised leg back at an angle of 45 degrees.
The straightened leg is moved to the side and fixed in an elevated position for 3-5 seconds.

If you regularly and diligently perform gymnastic exercises, then rehabilitation of the knee joint can be completed after a 12-week recovery period. But you should not suddenly stop gymnastics; it is advisable to continue it with cycling, swimming, and long walking. When your knee hurts during exercise, it is possible to relieve the pain with a cold compress, painkiller, or ointment. But it is better to immediately contact your doctor.

It happens that a patient cannot independently cope with rehabilitation after knee replacement. For this purpose, there are sanatoriums in which procedures will be performed on patients under the supervision of a medical professional. But it is worth considering the condition that treatment is paid in such an institution.

Physiotherapeutic procedure is an integral part of the rehabilitation process after endoprosthetics. Its main task is to prevent displacement of the joint and teach the patient how to properly use the new prosthesis. In addition, it helps to strengthen the muscles near the location of the prosthesis with the help of special exercises.

The physiotherapist will prescribe a set of physical exercises for the patient to perform independently. He will analyze and confirm which poses are beneficial for the knee joint and what load the knee can withstand.

The rehabilitation period after knee arthroplasty is not only about gymnastic exercises with a small load. A prerequisite for healing the wound and preventing inflammation is taking medications. The doctor prescribes antibiotics and non-steroidal anti-inflammatory drugs according to the nature of the disease. They will help relieve muscle spasms and normalize humoral function.

Chondroprotectors are important means for restoring cartilage areas. Angioprotectors provide tissues with nutrients and increase blood circulation.

Massage is an important addition to drug therapy and physiotherapy. He also provides all possible assistance to the operated knee joint. To do this, you need to massage the affected area using the medicine.

The patient should take a comfortable position and relax. The massage therapist performs light movements without pressing on the painful area of the joint. They should gradually become stronger with little pressure. Rubbing is done with the pads of the fingers; massage manipulations should preferably be smooth, slow, and soft. The event will not be superfluous, as it will complement the postoperative recovery period.

For how many days can a certificate of incapacity for work be issued? In case of temporary disability due to a disease of the knee bone tissue, the attending physician issues a sick leave certificate. The duration of the document is initially 15 days. In case of complications, sick leave may be extended by decision of the medical commission.

After the end of this rehabilitation period, a patient with an unfavorable prognosis undergoes a medical and social examination in accordance with the Order of the Ministry of Health “On approval of the Procedure for issuing certificates of incapacity for work.” Accordingly, the document is extended for another 4 months from the date of the original date of incapacity. Otherwise, a refusal is received, the sheet is closed.

Patients who suffer from bone pathology are entitled to disability benefits. It is possible to apply for social assistance if you provide all x-rays and a doctor’s report confirming the diagnosis. That is, to officially confirm that the person cannot fully and independently move.

No exception is rehabilitation after knee replacement to receive disability benefits. This social benefit is provided for a year. In order to extend it after the end of the period, you must undergo a re-examination and present a complete package of documents to the members of the medical commission.

But one factor should be taken into account, if a person can stand in a standing position for about two hours a day, then the disability, unfortunately, is not prolonged. With this level of personality, it is allowed to engage in work activities in a sitting position without causing harm to one’s health.

This video provides a technique for performing knee rehabilitation exercises after prosthetics. It is suitable for the patient to perform exercises at home.

Sources

Mazurov, V. I. Gout / V. I. Mazurov, M. S. Petrova, I. B. Belyaeva. – M.: Phoenix, 2009. – 128 p.
Aleshina, O. Diseases of the legs. Varicose veins, arthritis, gout. Treatment and prevention / O. Aleshina. – M.: Content, 2013. – 208 p.
Preobrazhensky, A. A. Magnetic materials / A. A. Preobrazhensky. – M.: [not specified], 2021. – 748 p.

Author of the article: Inna Drobysh

Let me introduce myself. My name is Inna. I have been working as a nurse in a rheumatology center for more than 7 years. I believe that I am currently a professional in my field and want to teach all site visitors to solve complex and not so complex problems. All materials for the site have been collected and carefully processed in order to convey all the necessary information in a convenient form. However, in order to apply everything described on the site, a MANDATORY consultation with professionals is required.

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How long is sick leave after a hip replacement?

According to the law, after such an operation, rehabilitation lasts 3 months: the person spends 2 weeks in the hospital under the supervision of doctors and then continues to be treated at home. Immediately after discharge, an open sick leave certificate is issued for a period of 3 months.

Why is this happening:

a person must adhere to an individual schedule of classes under the supervision of exercise therapy specialists, therefore, stay at home;
at first you cannot put heavy loads, because the prosthesis has not yet taken root in the body and there is a danger of dislocation, a person should always have the opportunity to lie down and rest - this is impossible at work;
90% of people after endoprosthetics experience severe pain in a sitting position, so frequent changes of position and taking painkillers are required - if the work is sedentary, the person needs to go through the recovery stage in a calm environment;
If you do not adhere to the regimen for a year after surgery, complications such as dislocations and fractures are possible. The risk increases in older people with concomitant diseases or endocrine disorders; working pensioners after endoprosthetics should be more attentive to their health after surgery.

Even a year after hip replacement, up to 22% of patients complain of pain. These are official statistics, so you need to be prepared to extend your sick leave in case of continuous pain that will not allow you to work normally.

acute stage and the inflammatory reaction ends;
wound healing, which is monitored by doctors;
initial recovery period, also supervised by clinic staff.

At home, there is a late recovery period, during which bone tissue is renewed and the body adapts to the prosthesis.

3 – 4 months is the minimum period that is given to a patient whose health is fine. It is difficult to imagine that when bone tissue is destroyed, the body works like a clock. In most cases, return to work is delayed after a hip replacement.

If after 3 months a person is unable to go to work due to health reasons, the issuance of sick leave is transferred to the responsibility of the attending physician. He can issue sick leave for up to 15 days, based on the patient’s well-being. That is, a person must come to the hospital 2 times a month or more often - as the doctor says.

After 4 months from the date of the onset of temporary disability, sick leave is closed. The following is possible:

A man goes to work.
The doctor submits an application to declare the patient incapacitated. A medical and social examination is appointed and the person is recognized as disabled. The group is determined by members of the commission based on available documents on health status.

If health does not improve or a person wants to spend more time at home and devote it to recovery, temporary disability is an option. Immediately after joint replacement surgery, documents are submitted for disability, the amount of payments is determined, and the patient sits at home. After a year, the documents are submitted again, after which the disability can be lifted and the person starts working. In case of health problems, the disability is extended and he then receives disability benefits.

A temporary disability certificate with slow recovery and adaptation, but with positive dynamics, can be extended to 7–8 months.

If conservative treatment does not help a person, one has to resort to surgery. But it often happens that after surgery a person is unable to fulfill his work obligations. How does a medical and social examination proceed in this case:

Logically, an operation is performed on a person in order to improve his well-being. After the operation, the patient should feel better, but he turns to the authorized bodies to recognize him as disabled.
Disability may not be prescribed and the patient is at a loss as to how to continue to live.

The solution is as follows: sue the medical organization, justifying this by the fact that before the operation the person did not have a disability, but after the surgery he needed it because his condition worsened. In this way, you can appeal the ITU decision.

Controversial situations with sick leave, temporary incapacity and disability arise when a person simultaneously undergoes surgery on both hip joints. The length of sick leave after hip replacement on both sides depends on the patient’s condition and the dynamics of the recovery process, but does not exceed 2–3 months.

Then there is the opportunity to extend sick leave or temporarily apply for disability. Much depends on the position a person occupies: if it is an office sedentary job, then he is theoretically able to perform it. If it is severe physical, associated with lifting heavy objects or constantly being on your feet, then it is better to immediately register a disability and adapt to prostheses. In a year the group may not continue.

A controversial situation in which you will need the help of a lawyer and advice from a doctor is related to the alternate replacement of the hip joint. If the duration of sick leave after hip replacement on one side is 3–4 months, and the next operation is scheduled in 5–6 months, should you go to work or spend time at home taking care of your own health.

There are cases when the ITU decision allows a person to be sent for retraining if the previous place of work is unavailable due to health reasons, and to temporarily receive disability benefits. In any case, the timing of the extension of sick leave is within the competence of the attending physician, who also refers the person to a commission and writes his opinion on the condition of the operated joints. Therefore, you need to turn to him for help.

To submit an application for ITU, documents are collected - x-rays, duration of sick leave after surgery to replace the hip joint or both, a copy of the diploma, work record book. The presence of concomitant diseases and length of stay in hospital treatment are of great importance.

How to extend sick leave after endoprosthetics

If after 3 months a person is unable to go to work due to health reasons, the issuance of sick leave is transferred to the responsibility of the attending physician. He can issue sick leave for up to 15 days, based on the patient’s well-being. That is, a person must come to the hospital 2 times a month or more often - as the doctor says.

After 4 months from the date of the onset of temporary disability, sick leave is closed. The following is possible:

A man goes to work.
The doctor submits an application to declare the patient incapacitated. A medical and social examination is appointed and the person is recognized as disabled. The group is determined by members of the commission based on available documents on health status.

A temporary disability certificate with slow recovery and adaptation, but with positive dynamics, can be extended to 7–8 months.