The benefits of the Bambach for joint replacement surgery of the hip or knee.

Joint Replacement Surgery

When sitting on the Bambach Saddle Seat

  • The hips are at an angle of 45-degree flexion in external rotation and abduction. This is especially beneficial following hip replacement as excessive hip flexion and adduction increases the risk of dislocation.
  • In this sitting position the hip joint is in its position of maximal joint surface contact (closed pack position) where there is maximum contact of the head of femur with the acetabulum (ball and socket joint of the hip). This is the position of most comfort and stability.
  • This position places the limbs in a mid range position which is beneficial in maintaining muscle length and normal tone. Also as the hip is not flexed past 60, which is when the hamstrings act on the pelvis, there is less tension around the joint.
  • By providing secure pelvic control. The Bambach Saddle Seat can be finely adjusted so the pelvis is stabilised in its upright, neutral position. It then follows, as the spine responds to the correct pelvic angle that it can be active in its natural upright curves.
  • A clear midline assists maintenance of balance and symmetry. This ensures a healthy posture and reduces the risk of further musculoskeletal problems during rehabilitation from surgery.
  • Partial weight bearing can be encouraged through to standing from a half-sitting position, which stimulates lower limb proprioception (sensory feedback), mobilizes the joints and improves muscle tone.
  • Being in a position of half standing also means that the individual does not have to go through the whole range of hip/knee joint movement when standing or sitting down.
  • Facilitation of independence in sitting and other motor activities which can hasten the return to work following surgery.
  • Thoracic, abdominal and pelvic spaces are maximized resulting in improved lung and internal organ function and circulation.
  • Retraction of the shoulder girdle into the neutral position means that upper limb tasks and fine motor activities are facilitated meaning that self care activities, such as meals, washing and dressing, and writing, computer work, hobbies and playing games are more easily performed.

What is joint replacement surgery?

Joint replacement (arthroplasty) is usually considered once other therapies, such as pain medications or physiotherapy, have failed. Most people require total hip or knee arthroplasty as a result of osteoarthritis (about 85% of all cases) however it is also considered in patients who suffer from rheumatoid arthritis and other medical conditions such as a bone tumor or avascular necrosis (bone loss due to insufficient blood supply).

Total joint replacement represents a significant advancement in the treatment of osteoarthritis and is the most effective mode of therapy for osteoarthritis of both the hip and knee. This has lead to more than 80,000 hip or knee replacements being performed each year in the UK. The typical indication for joint replacement surgery of the hip and knee are debilitating pain and major limitation of functions such as walking and daily activities, or impaired ability to sleep or work.

The aims of lower limb joint replacement are:

  • To relieve pain
  • To improve range of movement at the joint
  • To improve the functional ability of the individual
  • To improve quality of life
  • To prevent further deformity
APA - Australian Physiotherapy Association