A joint replacement - quite commonly a hip or knee replacement - is a surgery performed to replace a dysfunctional, damaged and quite often painful joint in the body. Usually, osteoarthritis is the primary reason for a joint replacement. However, not all osteoarthritis joints need replacing, nor is it necessary to have surgery. A joint replacement is usually scheduled after a consultation with an orthopaedic surgeon, who will ascertain whether a joint replacement is a suitable option for your condition. It is suggested that individuals with difficulty managing the signs and symptoms of osteoarthritis consult with a physiotherapist, particularly because conservative management is often very successful and can delay or negate the need for surgery! Even if surgery is scheduled, if you have not already, it is suggested by your doctor, orthopaedic surgeon and physiotherapist that you engage in physical therapy prior to your surgery to make sure you are prepared.
I'm scheduled to have a joint replacement. What should I expect?
Before your surgery, it is important that you consider that you will most likely be limited in your mobility after your surgery. If you are having your hip or knee replaced, you will be on crutches for some time (usually 2-4 weeks) after the surgery. It is important that you prepare your home to accommodate your limited mobility. This might mean placing a shower chair in your shower, a raised seat over the toilet and clearing passageways to allow for the use of a mobility aid. It may also mean discussing with friends and family alternative transport options if you are restricted in your ability to drive after your surgery because of the medication you are on or your ability to drive a car.
After your surgery, you will be required to get out of bed and get your new joint moving quickly, usually the day after surgery. You will be using crutches or a frame on this day, so familiarity with how to use these devices is helpful, but your physiotherapist will help you if you are unfamiliar. Your physiotherapist will also give you some exercises to perform independently while in the hospital. These exercises serve a specific purpose and should be done as directed. The initial goals of physiotherapy are to teach you to walk with your new joint, restore some strength, encourage pain and swelling to ease and, most importantly, get the joint moving!
When it comes to leaving the hospital, you need to demonstrate the ability to transfer in and out of bed independently, mobilise around environments similar to those you have at home and walk up and down steps. Your physiotherapist will practise these things with you to ensure you are ready. Sometimes, patients will spend a short amount of time in inpatient rehabilitation. This is usually a decision made prior to surgery and is suitable for individuals with significant comorbidities, very limited mobility or individuals who live alone.
Upon your discharge, your physiotherapist will make an appointment at the hospital outpatient clinic or a private physiotherapy clinic of your choice. It is suggested that you see your outpatient or private physiotherapist in the first 5-7 days after discharge.
Post-operative physiotherapy duration is different for everyone and depends largely upon physical fitness prior to surgery, functional goals and the level or function that needs to be restored to reach those goals, the amount of swelling, pain and restriction in your new joint and the level of independence you have in managing these things. Typically, 12 weeks of intensive, self-guided rehabilitation monitored by your physiotherapist is sufficient, but your mobility, strength and function will continue to improve in the 12 months after surgery! Everyone’s rehabilitation plan will be different, which you should discuss with your physiotherapist during your first consultation. Your physiotherapist will guide you towards ambulating without your crutches, progress your exercises and give you strategies to manage the discomfort in your new joint as the area heals after surgery. Once your wound is healed, your physiotherapist might recommend participation in hydrotherapy. Hydrotherapy is very beneficial for swelling and pain management, gait re-education and strengthening of your new joint; however, it is not essential. Your management plan should be tailored to meet your needs and access to facilities and equipment. Regardless, post-operative rehabilitation is very involved and sufficient time needs to be dedicated to getting the most out of your new joint replacement.
Book in with one of our physiotherapists today to discuss the management of osteoarthritis, preparation or recovery from a joint replacement today!
Blog by Brittany Romas – Physiotherapist, PhysioChoice Hampton.
Brittany holds a Bachelor of Applied Science and a Master of Physiotherapy from La Trobe University. She is currently studying for her Masters of Sports and Exercise Physiotherapy at La Trobe University. She is an avid powerlifter and has a strong interest in strength conditioning, acute sports injuries, and occupational-related conditions. Brittany has spent time in South East Asia working with paediatric patients with a large range of neurological disorders; she has developed a keen interest in providing disability support in conjunction with the NDIS. Brittany believes in a holistic approach to her client’s rehabilitation and treatments, including Hydrotherapy, Dry Needling and Clinical Pilates.