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Joint Replacement: What To Expect and How To Prepare

Written by Jen Ryskamp
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Joint Replacement 0014I think it is safe to say that many of us know of at least one or more people who have been affected by osteoarthritis resulting
 in joint replacement. Surgeons are able to replace many joints from the shoulder to the hip, knee, fingers and even joints within the toes. Technology has come a long way over the years and made joint replacements simpler and less invasive, resulting in shorter recovery period over all. However, during my short career as a clinician so far I have seen a common theme among many joint replacement patients: recovery is much harder and takes longer than anticipated.

I have heard on more than one occasion “I thought this would be a 6 week recovery,” or “I didn’t’ realize how painful this would be.”  I have even had one patient allude to the fact that their surgeon told them the recovery would be only a few weeks. The reality is that joint replacement, especially knee, hip and shoulder, are very involved surgeries and can take up to one year for full recovery.

Maybe you are reading this knowing that you are facing one of these joint replacements in the near future. My intent is not to give you doubt or make this a negative experience, but to help you enter this challenge with eyes wide open. Your surgeon may have a very good reputation and while they may perform the surgery perfectly, the body will always react to trauma the same… With swelling, inflammation and pain. But don’t worry! There are things that can be done to help! And physical therapy is an important part.

First, you will want to educate yourself before arriving for your surgery date. Often there are classes that are offered through your surgeon or the hospital that help to prepare you. I think it is important to do your own research as well. The internet is a great tool to use to understand the process of surgery itself. You may even want to find a video on Youtube (if you can stomach it) to watch whatever surgery you are about to go through. It will also be important to know what is expected of you in the 1-2 days following your procedure. For the lower extremity, many surgeons have requirements such as the ability to walk a certain distance or going up or down stairs before they will sign discharge documents.

Second, be prepared when you get home. It would be beneficial to request help from a friend or family member to get around your home for the first 1-2 weeks or longer once you are out of the hospital. If there is no one available to help, you may consider staying at a skilled nursing facility. Activities of daily living (ADL’s) such as using a restroom, cooking, cleaning, walking longer distances, or even moving around in bed could be very taxing after a major replacement surgery. Not to mention you may feel out of sorts depending on what type of pain meds your doctor prescribes and how your body responds to those will often times make you “foggy” and fatigued.

Third, ice, elevate (when possible), and control the pain with medications. These methods are the best way to keep the pain under control. Icing and elevating helps to reduce swelling and inflammation. A good rule to follow when elevating is to keep the affected limb above heart level. This is how excess fluids will flow toward the lymphatic system and be reabsorbed by the body. Make sure you are icing and elevating on a regular basis, before things get swollen and painful as well as taking your pain medications on a schedule. Your medications will help to decrease the pain by blocking the pain message from getting to your brain, as well as reduce the body’s reaction to pain.

Fourth, keep moving and stay as loose as possible. Maybe you have already been to a physical therapist for this particular problem. Often time’s surgeons will prescribe therapy before surgery in order to try to prolong the need for replacement. The stronger and more flexible you are before surgery, the easier recovery is in most cases. After surgery, regaining motion, flexibility and strength is your greatest priority so that you can get back to a normal life. Your physical therapist, working together with your surgeon, will help to come up with a program that you should follow in the weeks and months after surgery. 

Fifth, make sure you are taking in the right nutrients, enough liquids and getting plenty of rest. It is important to work with your body to help it to heal especially in the first 6-12 weeks. This means eating adequate amounts of fruits and vegetables and foods that contain essential vitamins and minerals so that your body has plenty of the right tools to put things back together. Within the first 12 weeks is when your body is doing the most significant amount of dissolving and rebuilding tissues, cartilage and bone. And believe it or not this tearing down and rebuilding requires a great deal of energy. Getting enough rest is essential. 

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