Joint Replacement: What You Should Know
What do I need to know about getting a joint replacement?
If you are about to undergo hip or knee joint replacement, here are some things you should know to best prepare for the surgery and recovery. Joint replacement surgery is a big undertaking and the decision to do it should not be taken lightly. While significant improvements in function can occur in the first six months after surgery, it often takes upwards of a year to fully return to prior levels of function. Setting yourself up for the most success is imperative to the process. A recent study looked at the role of weight loss as an intervention to certain musculoskeletal disorders. They found that individuals with osteoarthritis that participated in a weight loss program had improved levels of pain and disability. Thus, participating in a program prior to surgery may allow an individual to delay the surgery and/or improve out comes after surgery. While participating in a weight loss program with a very painful and arthritic joint may be challenging, finding exercises that minimize joint stress may be the best option. This may include riding a bike or swimming which decreases weight bearing and impact forces on the joints of the lower extremities. Don’t forget that diet is also an integral part of any weight loss program, so consulting with a nutritional expert can also help to achieve this goal.
Hip Replacement Depicted
Knee Replacement Depicted
What is “Pre-hab”?
Further, participating in physical therapy or rehabilitation prior to surgery can also improve long-term outcomes. We call this rehab prior to surgery “pre-hab” and can greatly improve post-operative pain and dysfunction. Many studies have looked at strength levels pre and post-surgical and found that individuals who completed lower extremity strengthening programs prior to surgery had greater functional capacity at six and twelve months post-operatively. Other studies have looked at the functional outcomes of joint replacement individuals compared to “healthy” individuals and found that even after six months significant dysfunction was still exhibited similar to that of pre-surgery. Again stresses the importance of diligence. Both in the time prior to the surgery and after the surgery to effectively rehabilitate the replaced joint.
How long is the recovery?
Lastly, let’s take a look at what to expect during those first six months after surgery. You will hopefully be discharged within the first three days after surgery with the expectation that you can walk with the use of an assistive device, get in/out of a chair and bed, and ascend/descend stairs independently. At this time, you will likely be set up with home-health physical therapy for the first week or two until you feel capable of making it to an outpatient physical therapy clinic. Initially, physical therapy will consist of managing symptoms such as swelling and pain through various manual therapies and modalities. You will be instructed on lower extremity strengthening exercises and balance exercises that will also be prescribed as a home exercise routine. It should be expected that during the first twelve weeks post-operatively that the recovery may not be easy, but that if you work hard and attend physical therapy regularly that by 4-6 months you should begin to feel some sense of normalcy. Just remember, many individuals take up to 12 months to fully recover to prior levels of function.
Going through the joint replacement process is unfortunately challenging, but will be well worth it in the end. It should allow you to get back to many more activities with decreased levels of pain, but requires hard work and dedication to do so. Don’t hesitate to reach out to discuss this process, so you know what to expect both before and after surgery!