Postoperative Period And Recovery
Remember that below is a guide to recovery and that everyone heals at different rates and some people do take longer. Use this information to help you understand your condition, possible treatment and recovery. The timeframes given below are a minimum, it is important that you appreciate this when considering surgery as your healing and recovery may take longer.
After your operation, a routine enhanced programme of recovery will commence. The main parallel work streams of this programme are as follows:
Mobilisation is commenced on Day One. Gradually there is an increase in the frequency of transfers in and out of bed. This then progresses onto stairs and mobilisation to the toilet/shower and back. Before discharge, the patient is well rehearsed in the exercise routine and the knee should bend to at least ninety degrees. It is extremely important to remain well motivated and perform your exercises after discharge to fully optimise the range of motion of the newly replaced knee.
Will focus more on activities of daily living, functional transfers and adaptation of the home environment.
During the operation, spinal anaesthesia with local infiltration of anaesthetic around the hip is used. After the operation regular oral medication is then used. Ask for extra if required. Before discharge required prescriptions are provided.
Normal diet is introduced as soon as possible. The urine catheter is removed once mobile. Bowel habit should also return to normal before discharge.
Considering Hip And Knee Replacement Here’s What You Should Know
Luna recently had the privilege and opportunity to sit down with Dr. Christopher Boone of Proliance Orthopaedics and Sports Medicine in Seattle to talk about what patients need to know when considering hip or knee replacement.
Here are Dr. Boones answers to commonly asked questions by patients considering surgery to manage their hip and knee pain:
Why do patients need hip or knee replacements?
Dr. Boone: “I get this one all the time: “Why do I need my hip/knee replaced?” Very simply, because your is worn out. People think of arthritis as something you “catch,” but you don’t “catch” arthritis. Rather, arthritis represents the loss of the smooth gliding surface within a joint. Hips, knees, and other joints have a special surface that degenerates and wears out over time that’s arthritis. With the loss of that surface, you end up rubbing two pieces of bone together, which feels very painful a lot like rubbing two pieces of sandpaper together, that’s how I describe it. When that pain sets in, that’s when it is time to consider a hip/knee replacement.”
As a patient in pain, when should I consider having hip or knee replacement surgery?
What should I expect after knee or hip replacement surgery? When can I get back to my normal life? Or to sports?
What activities should I avoid in the first 6 weeks after knee replacement surgery?
How do I find a great joint replacement surgeon? What is the main question a patient should ask?
This entry was posted in Luna Blog.
When Is Total Hip Replacement Considered
Total hip replacements are most often done to provide relief for severe arthritic conditions. The surgery is also performed for other problems like hip fractures. Most total hip replacement patients are over 55 years of age, however the surgery is sometimes performed on younger patients. Patients who are candidates for total hip replacement surgery generally have:
- Severe pain that impedes work and everyday activities
- Pain that can not be managed by anti-inflammatory medications, canes or walkers
- Significant stiffness of the hip
- Advanced arthritis or other problem
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Hip Pain After Knee Replacement
wendy05642
I am 42 and had a total knee replacement 4 weeks ago.I am now having such hip pain it hurts worse than my knee during therapy. Has this happened to anyone else. Also what did you do for it. I am icing both and putting heat in hip also. I’m on blood thinners for two more days , wondering if cortisone shot would help.
5 likes, 19 replies
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Posted 5 years ago
Hey Wendy! Congrats on getting your knee done. Had mine done in July and couldn’t be happier. Had my hip done 4 years ago when I was 46. My hip pain was so bad. Lifting my leg to get out of the car and standing and walking became unbearable. Assuming you have already had an x-ray and osteoarthritis is ruled out then I would go for an MRI. I know when I began to have knee troubles I was walking squed which affected my back and hips. Is it possible that you’ve strained your hip because of your knee issue, do to walking or favoring your knee? As said earlier an x-ray or MRI would help determine the nature of your problem. Good luck with your knee and hip. Wish you a speedy recovery. Just remember your knee can take a long time to heal do to the soft tissue damage and such. So take it easy, do your PT regliously and try to stay patient. Take care!
What Is Partial Knee Replacement
A partial knee replacement is an alternative to total knee replacement for some people with osteoarthritis of the knee. This surgery can be done when the damage is confined to a particular compartment of the knee. In a partial knee replacement, only the damaged part of the knee cartilage is replaced with a prosthesis.
Once partial knee replacement was reserved for older patients who were involved in few activities. Now partial knee replacement is often done in younger people as their recovery is quicker and usually less painful. About 5% to 6% of people with arthritic knees are estimated to be eligible for partial knee replacement.
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Types Of Arthritis That Affect The Knee
Inflammatory arthritis
This broad category includes a wide variety of diagnoses including rheumatoid arthritis, lupus, gout and many others. It is important that patients with these conditions be followed by a qualified rheumatologist as there are a number of exciting new treatments that may decrease the symptoms and perhaps even slow the progression of knee joint damage.
Patients with inflammatory arthritis of the knee usually have joint damage in all three compartments and therefore are not good candidates for partial knee replacement. However, inflammatory arthritis patients who decide to have total knee replacement have an extremely high likelihood of success. These patients often experience total, or near-total, pain relief following a well-performed joint replacement.
Osteoarthritis
Osteoarthritis is also called OA or degenerative joint disease. OA patients represent the large majority of arthritis sufferers. OA may affect multiple joints or it may be localized to the involved knee. Activity limitations due to pain are the hallmarks of this disease.
OA patients who have symptoms limited to one compartment of the knee sometimes are good candidates for minimally-invasive partial knee replacement .
It Doesn’t Always Work
If patients have a knee replacement done for the right reasons, at the right time by the right knee surgeon and have the right rehabilitation afterwards, then a predictably good result is the norm. What is true is that whilst a well done hip replacement tends to work well in most people and requires relatively little rehabilitation, knee replacements are more difficult to get right.
A specialist knee surgeon should take the time to talk to you in detail about your pain and its effect on your life, examine you and look at appropriate xrays. This will allow an accurate diagnosis of your condition and what treatment is required. Knee replacement may sometimes be delayed because pain is not yet bad enough and it is important that your surgeon replaces your knee when it needs replacing and not before. Otherwise there will be a danger that, at best, the relief of pain won’t be as expected, and at worst, should you suffer a complication, you will regret having the procedure done. Where replacement surgery isn’t required because things aren’t bad enough yet, other treatments should be offered to help with ant pain that exists.
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What Happens If You Dont Get A Knee Replacement
Delaying Knee Replacement Surgery May Diminish Health The longer patients wait and allow their knee issues to affect them, the more it impacts overall health. For instance, an inability to walk without pain may lead to avoidance of exercise and weight gain which will put even more pressure on the painful knee.
What You Cannot Do After Knee Replacement
Contact sports such as soccer, running, football, tennis and skiing are often not recommended after a total knee replacement. Though theres many patients who say they have no issues with the former, it may decrease the shelf life of the replacement.
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The Best Healing Strategies
Most people used to need weeks in a hospital after a total joint replacement, Kraay says. Now those who have hospital-based surgery are increasingly likely to be discharged after a few days and to go straight home instead of to a rehab facility. Thats better, experts say, because at home your risk of infection is lower and youre usually more comfortable.
Because the hip is a much simpler joint than the knee, and the surgery much more straightforward, its generally easier to recover from hip replacement and may not even require formal physical therapy, says Daniel Riddle, a professor of physical therapy at Virginia Commonwealth University. Normal activities such as bathing, cooking and climbing stairs often provide enough hip movement to keep your recovery on track. Most people will be about 90 percent recovered within six to eight weeks after surgery, with more small improvements over the next year.
With knee surgery, you can expect to do physical therapy two or three times a week for about a month and exercises at home daily. Riddle says the average person will need eight weeks to recover by about 80 percent. Full recovery may take up to 18 months.
In either case, to help your hip or knee implant last as long as possible, you should walk or exercise every day because it will help you heal and stay mobile long-term, but avoid high-impact activities such as running, jogging and heavy lifting. Instead, opt for biking, swimming or using an elliptical machine.
What Is Total Joint Replacement
When someone talks about getting a hip or knee replacement, theyre probably referring to total joint replacement surgery.
Surgeons perform total joint replacements on many joints, but hips and knees are the most common. During total joint replacement, an orthopedic surgeon removes the damaged cartilage. Then, they replace the damaged sections of the joint with specialized metal, plastic or ceramic parts.
This surgery relieves symptoms of osteoarthritis , which is the most common type of arthritis. OA happens when the cartilage inside a joint breaks down. Cartilage is the smooth material that cushions your joints. When it wears down over time, it causes pain, swelling and stiffness.
The new joint allows you to move without the pain and stiffness of OA.
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Can I Do Martial Arts After Hip Replacement Surgery
Q) Im 57, not overweight and dont smoke. I need a total hip replacement and have been told its my choice when to have it.
Can I ask what your opinion is on people having a replacement hip then continuing to do martial arts, specifically karate? Any kicks I do are to a maximum of waist height. I’ve put off the surgery for the last three years as I have been advised not to train ever again afterwards. Although, apparently its OK to play tennis and badminton, which I would have thought involve significantly greater impact than karate. I’d be interested in your opinion.
Ruth – 2018
A) The main risk of doing karate or other martial arts that involve kicking after a hip replacement would be dislocation of the joint, rather than the impact. Its the twisting movements involved in martial arts kicks that are different from racquet sports.
That said, it seems like quite a sweeping statement to be advised to never train again. You’re clearly someone who will demand a high level of function from any joint replacement, so it might help to see an orthopaedic surgeon with expertise in surgical management of hip osteoarthritis in sportspeople. They’d be able to advise you on the specifics of treatment and rehabilitation, and on what the full range of options are available to you, not just a total hip replacement.
Its worth doing some research online about your local surgeons and their areas of expertise. Your GP should then be able to refer you.
What Is The Best Time To Resume My Regular Activities Following A Hip Replacement Surgery
Physical therapys goal is to help you get back to your daily life. The amount of physical activity required to complete a task will determine the time it takes to accomplish that task.
Driving: It may take up to one month for you to be able again to drive safely after having surgery on your right hip. You might be able to drive again in a matter of weeks if it was your left hip. You can start in a parking lot, then move slowly to rural roads and eventually to the highway. You might not be able to drive again if you are taking medications that can impair coordination.
Work: You can return to work in two weeks if you have a desk job that requires little activity. It is recommended that you take off six weeks for any job that requires heavy lifting, or is otherwise difficult on your hips.
Sports: You can return to sports that require little activity like golf when you feel at ease. You should wait six weeks for contact sports that have high-impact. You should wait six weeks for the incision to heal completely before you can get into a pool.
Sex: You can go back to sexual activity at any time you feel like it, as long as you can do so comfortably.
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Radiofrequency Ablation For Knee Pain
If all of these methods fail to control your knee pain from osteoarthritis, there are still options. Radiofrequency ablation controls pain in the knees by destroying the sensory nerves that carry the pain signal from the knee to the brain.
RFA is likely a temporary fix, as nerves will grow back in six months to two years, and the pain may return.
Hip And Knee Replacement Surgerythe Evidence
There has been much media coverage about whether hip or, especially, knee replacement surgery is better for patients or not. There is no doubt that replacing an arthritic hip or knee joint at an appropriate time leads to a significant improvement in the patients quality of life. Function is restored and pain relief achieved. Hundreds of studies have shown the clinical outcome improvements provided surgery is done at the correct time.
Patients should always try non-operative therapies first but a time will be reached when these treatments no longer control pain and their function deteriorates. Pain at rest and at night or severe mobility restrictions is an indicator of end stage disease. Osteoarthritis of the hip and knee is not reversible and, at some point, surgery may need serious consideration.
There are many misconceptions about joint replacement.
Hip and knee replacement surgery is well-established, and we can now look back over 50 years and evaluate what works best. Remember, not every new product is better .
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Shoulder Replacement Failure In Younger Patients
This isnt the first time a study has found disturbing results in younger shoulder replacement patients. A few years ago, I shared one that found even higher numbers4 in 10of shoulder replacement failure in the under-55 age group. In this case, revisions were necessary in these patients within the first 10 years after surgery. Imagine undergoing a second shoulder replacement before you reach 65, which would still be considered young even for the first replacement. Even without failure of the device, artificial joints are designed for older people and, as such, they arent designed to last forever, so the younger you get a joint replaced, the more likely you are to get it replaced again.
In addition, younger patients are simply more active than older patients. In other words a 55-year-old shoulder replacement patient will expect a lot more from his or her artificial joint than an 85-year-old patient. This means the more stress that is placed on the prosthetic shoulder, the faster it will break down. Ive covered this issue before as it relates to knee replacements in younger patients.
The upshot? The authors of the above study suggested that maybe its time to give up the practice of replacing shoulders in some patients. Why would the orthopedic surgeons who authored the study recommend this? It seems like they were blown away at the complication and surgical revision rates in this procedure.
Chris Centeno, MD
Understanding A Shoulder Replacement
Artemida-psy/Shutterstock
The shoulder joint is an intricate ball-and-socket structure. Its complexity in structure allows for a range of motion that is greater than any other joint in the human body. It can roll, rotate, and lift. It can move the arm straight up and down and forward and backward, and so on. No other joint is so versatile. In fact, we probably dont realize how important the shoulder is until it becomes damaged in some way and suddenly we cant reach up into a cabinet without pain. Because of the millimeter precision of every structure in the joint , its impossible to replace it and have an artificial joint function exactly like the original.
A shoulder replacement surgery involves amputating the shoulder joint. This consists of cutting through muscles and other tissues to access the joint and then removing the proximal end, or head, of the humerus bone, also known as the ball. The glenoid process, or socket, of the shoulder blade is then shaved out and resurfaced. A plastic prosthetic socket is cemented into the glenoid process. The upper part of the humerus bone is hollowed out, a metal stem is inserted into the bone, and a metal head is attached to the end.
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