Ensure the Best Outcome After Joint Replacement Surgery
More than half a million Americans undergo surgery for knee or hip joint replacement every year in the U.S. While the majority of patients who have joint replacement surgery have positive outcomes and no complications, as with any surgery, there are risks involved. As with any procedure, if you are having joint replacement surgery, you need to prepare beforehand to reduce your risk of complications and maximize the benefits of the procedure.
Minimize your risks
According to Francis Cyran, MD, an orthopaedic surgeon at UCLA Health System, the two most important steps patients can take to minimize their risks are to be at a healthy weight and to not smoke. “Generally, the more overweight you are, the more complications can arise,” says Dr. Cyran. “For the surgeon, it is much harder to see what you’re doing in a morbidly obese person than in a person of normal weight. The surgery takes longer and the incision is larger. Post-surgery, the components used to replace the joint are more likely to fail or wear out more rapidly.”
Smokers have a much higher infection rate and more frequently have wound healing problems than non-smokers. Research suggests that smokers have a higher risk of infections, pneumonia, stroke, and death post-surgery compared to non-smokers. Additionally, preoperative alcohol “misuse” (defined as drinking more than four times a week, having more than nine standard drinks in a typical day, or routinely having more than six drinks a day) tends to result in postoperative complications.
“It’s really not much of a surprise that people who consumed this much alcohol had more problems following surgery,” says Dr. Cyran. “The recommended alcohol intake for older adults of no more than one alcoholic drink per day is not associated with a higher incidence of postoperative problems.”
What to expect
Before and after joint replacement surgery, appropriate exercises can help extend your range of motion and speed healing.
Knee: Before knee surgery, exercise to get the muscles around the knee as strong as pos-sible. Straight leg lifts and stationary cycling are good choices. After surgery, expect to be in the hospital for three to five days. You will be encouraged to walk as much as possible during this time and participate in physical therapy. After returning home, you’ll mainly be walking and doing additional physical therapy for six to eight weeks.
Hip: For hip replacement, as for knee replacement, the more motion you go into surgery with, the more you come out with. Do similar exercises for the hip as you do for the knees, only make sure you’re on a high seat when cycling to avoid placing the hips in deep flexion, which may compromise the repair of the soft tissues during the healing phase. Expect to go home within a couple of days after an uneventful surgery. Avoid deep-seated chairs—for example, a low sofa with deep cushions. Recovery generally takes six to eight weeks.
Shoulder: There’s not much you can do to strengthen the shoulder area prior to surgery; however, because of the nature of the shoulder joint, you can still expect to have greater range of motion after surgery than before. Expect to go home within a couple of days after surgery. You can start doing simple activities, such as working at a desk, almost immediately. But avoid raising your arm above shoulder level, as you might when hailing a cab, for example, or doing any type of overhead exercise. For the first couple of weeks, you won’t lift anything heavier than a coffee cup. However, you can extend your range of motion by sitting at a table with your hands on a placemat, then walking your hands straight out along the table as far as possible.
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