There are more than 1 million hip and knee replacement surgeries performed in the United States each year, primarily for patients experiencing debilitating arthritis pain in those joints. That number is expected to grow considerably as the population ages and looks to maintain an active lifestyle. However, despite being one of the most common elective orthopedic procedures performed today, many patients whose quality of life could benefit from such a surgery are often hesitant because they know friends or family members who have had a total joint replacement with a poor outcome. That is why helping patients understand what to expect during and after surgery, and how to optimize their health prior to the surgery, is crucial to any successful joint replacement procedure.
Before undergoing total joint replacement surgery, it is vital for a patient to be as medically optimized and strong as possible. This means working on range of motion exercises for the affected joint and doing light strengthening exercises on a consistent basis in order to increase joint and muscle movement, reduce stiffness and pain, and maintain flexibility. In addition, encouraging patients to practice good diabetic control, stop the use of nicotine products and optimize their weight by making healthy lifestyle choices also helps to reduce the risk of infection after surgery and improve patient satisfaction and recovery. These are incredibly important factors for patients to discuss with their surgeon when considering joint replacement surgery in order to increase the likelihood of having a complication-free surgery.
Prior to surgery, patients should be able to meet with their surgeon and care team to discuss the procedure in detail and have all their questions answered regarding post-operative complications, mobility, pain management and the impact on their lifestyle and daily activities. Finding a surgeon who prioritizes sitting with patients and taking the time to answer their questions ahead of surgery is imperative. Further, meeting with the anesthesia care team and participating in instructional classes related to hip and knee replacement helps patients feel at ease with undergoing the surgery and managing the recovery process.
Patients are often concerned about the hospital stay, including what will happen the day of surgery and after the surgery. Thanks to advancements in surgical techniques, many hip and knee replacement surgeries can now be performed as outpatient procedures. This allows patients to go home on the same day as their surgery, often with the support of home health and physical therapy services. For those who have more complex medical problems, an overnight stay is typically recommended.
Pain control techniques have vastly improved in recent years, and surgeons and anesthesiologists now work together to use a variety of methods to treat patients’ pain. These include nerve blocks, medications infiltrated around the actual hip or knee joint and medications administered after surgery that target multiple pain receptors and help keep pain manageable. At Wellstar Orthopedics & Sports Medicine, we ensure that patients are up and walking within a couple of hours of surgery with an assistive device. Most patients no longer require a blood transfusion due to better anesthesia techniques as well as medications that now slow blood loss during surgery, which also contributes to a faster recovery.
After surgery, patients can expect to need a walker for anywhere from a few days to several weeks. Most patients don’t need an assistive device by three to four weeks after surgery, but this does vary. Patients often return to driving around three to four weeks after surgery. In my practice, we typically close the incision with sutures underneath the skin, eliminating the need for patients to return to the office for suture or staple removal. In addition, the bandages we use are waterproof, making it easy for patients to shower after surgery. The total recovery time following joint replacement surgery is usually two to three months. Most patients benefit from attending weekly physical therapy sessions during this time to assist with regaining full joint range of motion, increasing strength throughout the lower extremity and regaining independence with functional activities such as ascending and descending stairs and getting up from a couch.
For those who are interested in doing their homework prior to surgery, there are excellent resources available to patients on both the American Academy of Orthopedic Surgery and American Association of Hip and Knee Surgeons websites. But the most important step for patients as they prepare for joint replacement surgery is to consider choosing a surgeon who has additional fellowship training in hip and knee replacement, is willing to answer their questions and proactively share what to expect, and who they ultimately trust to perform the surgery. Taking the time to find a surgical team that is committed to enhancing patients’ well-being and helping them achieve the best possible outcome will increase the odds of a successful joint replacement.
