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Total Joint Replacement, What to Expect After Surgery

6/3/2011 1

Our joints allow us to move, reach, bend, walk, and engage in activities — both that are necessary to everyday life and that we enjoy. Often, we take for granted that joints make these movements possible. As we age, conditions like osteoarthritis and rheumatoid arthritis, or traumatic injury can affect our joints, resulting in the need for joint replacement surgery.

Help During Recovery


Normally, a smooth layer of cartilage, which allows frictionless and pain-free movement, covers a joint’s bone ends. However, when the cartilage is damaged or worn, movements become stiff and painful. When a joint is worn to the point where bone is rubbing on bone, even daily activities — walking, going up and down stairs and bending — become difficult. The pain and lack of mobility associated with joint problems can be debilitating.

When total joint replacement surgery is a viable solution, the goal is to relieve joint pain by replacing the damaged cartilage with metal and/or plastic surfaces. This replacement restores joint movement and function, and in turn, increases mobility. Patients undergoing joint replacement surgery improve their quality of life with greater independence and healthier, pain-free activity.

After surgery, a proactive home health routine, including rehabilitation and physical therapy, is required to ensure the best function of a new joint. Each person will vary in how quickly they recover and regain mobility, however, “All patients returning home from any joint replacement surgery can expect to need the help and support of family, friends, and/or an outside agency for a period of at least a few weeks,” Nan Davidson, clinical nurse specialist in surgery services at Porter Center for Joint Replacement in Denver, explains. If surgery is the best option for you, then knowing what to expect afterwards will help you prepare — and set you up for success!

Knee Replacement — You’re Not Alone


According to the National Association of Orthopedic Nurses, each year, more than 581,000 Americans undergo knee replacement surgery. A successful knee replacement and recovery period can give you not only a new knee, but also a new lease on life!

 

Recovery Basics After Knee Replacement


Most people can stand and move around the day of, or shortly after knee replacement surgery. “It is a wonderful boost in patient confidence to actually stand on the new knee the evening of surgery, or very soon after. It sets the stage for a strong recovery,” explains Davidson. Temporary use of walking devices, such as crutches, a walker or a cane, will most likely be necessary to support full body weight, with the duration depending completely on the surgery and individual home health recovery progress.

Most patients return to home from the hospital and begin a home health regime just a few days after surgery. Once home, physical therapy and rehabilitation will continue for six to eight weeks to restore strength and motion of the new knee and the muscles that support it. Upon completion, patients can return to enjoying most activities.

Many patients return to work soon after surgery, and can resume home duties and low impact activities seven to 12 weeks after surgery. When recovering from knee replacement, it’s important to be realistic and remember that you’ll progress at your own pace, as your body is ready to!

 

Lifestyle Adjustments After Knee Replacement


Although on the road to recovery, patients still need to take care of their new knee. Setting practical goals with your doctor or physical therapist for bending and straightening the affected knee, climbing stairs, and walking certain distances can help you push for recovery without over-doing it.

Upon returning home, keep the space safe and accessible by removing loose rugs, clutter and furniture that’s difficult to move around. An elevated toilet seat or toilet safety rails, a shower bench or chair, grab bars, and other assistive equipment (LINK Dear Daughter), such as long-handled reaching tools and sponges may be helpful.

After full rehabilitation, patients can return to normal household and work routines. Participation in low-impact activities, such as walking, dancing, golfing, hiking, swimming, bowling and gardening are encouraged. It’s important to avoid high-impact activities, such as running and basketball, as these can cause undue stress on the knee.

 

Hip Replacement — You’re Not Alone


According to the National Association of Orthopedic Nurses, each year, more than 193,000 Americans undergo hip replacement surgery. A successful hip replacement and home health recovery period can not only repair the hip and minimize pain, but also creates a path of healthier being!

 

Recovery Basics After Hip Replacement


The first step to recovery from a hip replacement is putting weight on the leg. Depending on the type of replacement you’ve received, this can take anywhere from four to eight weeks. Leading up to this, mobility will require an assistive device, such as a walker or cane, that will enable mobility to build strength and encourage healing.

Physical therapy is essential to a full recovery from hip replacement surgery. Most people are able to return directly to their own home after surgery, and can therefore continue exercises at home or in an outpatient rehabilitation setting. Light housework can be resumed within two weeks post-surgery — however, heavier home duties, like shoveling snow or moving furniture, should wait until seven to 12 weeks, or as suggested by your doctor. Depending on the speed of recovery, as well as the type of work a patient does, it may be six weeks until returning to work is advised.

 

Lifestyle Adjustments After Hip Replacement


During the recovery period, certain precautions should be taken to ensure a new hip heals properly. Although exercise is an important piece to the recovery process, consult a doctor, home health nurse or physical therapist for specific instructions on bending, crossing your legs, and lifting or twisting the affected leg.

It’s also important to make necessary changes to your home to ensure a safe recovery environment. “Just as with knee replacement surgery, patients need to make sure their home environment is clear of anything that they may trip on or fall over,” says Davidson. “Preparing for the return home after hip replacement surgery will entail getting an assistive device for walking, and other equipment to ensure safety, like a shower chair and/or grab bars.” Your doctor and physical therapist will provide specialized suggestions based on your unique situation.

As the rehabilitation process continues, patients will be able to resume most daily activities, work and exercise. However, high-impact activities, such as running, jumping rope and jogging should be avoided. Substitute physical activities like swimming, cycling, walking, dancing and golfing. These are safe for a new hip.

 

Shoulder Replacement — You’re Not Alone


Although far less common than hip and knee replacements, shoulder joint replacement surgery is becoming more prevalent. The American Academy of Orthopedic Surgeons cites that each year, 23,000 Americans have this surgery. Approaching recovery and rehabilitation with information and realistic expectations will ensure that it’s a successful process.

 

Recovery Basics After Shoulder Replacement


After shoulder replacement surgery, most patients are able to complete limited basic personal care tasks in two weeks, with more complex tasks taking up to six weeks to resume. Patients typically have to wear an arm sling to support the shoulder during this time after surgery. “Again, arranging support for the temporary limitation in your arm can limit or avoid frustrations. Prepare your home, plan meals ahead of time — having things in order makes for a smoother rehabilitation period,” notes Davidson. Talk with a doctor, home health nurse or physical therapist to ensure that you’ll have what’s needed upon arrival at home.

 

Lifestyle Adjustments After Shoulder Replacement


Short-term, patients recovering from shoulder replacement cannot use the affected arm to lift their body weight in bed or up from a chair. Patients in recovery should always avoid placing the affected arm in extreme positions, and ask for assistance when needed. It’s important not to overdo it — lifting anything heavier than a glass of water isn’t recommended. However, it is essential that patients engage in exercises during therapy sessions and at home, as advised by a physical therapist.

The only long-term limitations resulting from shoulder joint replacement are that recovered patients refrain from heavy lifting and participation in contact sports.