More than 1.25 million Americans will undergo knee or hip replacement surgery every year. And while most will report a dramatic improvement in their quality of life following recovery, some will experience a rougher road to recovery than others.
If you or someone you care about is thinking about joint replacement surgery, experts say that there are steps you can take to make your recovery smoother and your procedure even more successful.
“The best thing for a good outcome after elective joint replacement surgery is to be informed and prepared,” says Dr. Elizabeth Desmond, orthopedic surgeon at Dignity Health Sierra Nevada Memorial Hospital. “It is important to have a good understanding and reasonable expectations of your operative and post-operative course.”
Dr. Desmond says the key is to ask questions early on in the process.
“You should ask how long you will be in the hospital (some joint replacements are done as an outpatient, others with a very short hospital stay),” she explains. “You should also have a discussion about pain management and you should have your home set up ahead of time for your needs, including having any needed assistive devices available.”
Dr. Desmond says patients should approach the pain management conversation with the goal of minimizing their use of opiate medications as much as possible. And regarding the home set up, she recommends minimizing stair use and planning ahead to ensure needed items are within each.
Recommended assistive devices may include a walker, a shower chair, a raised toilet seat, a bedside commode, or anything else your physician believes may be useful during your recovery.
Once your joint replacement surgery is complete and you’re back home, it’s important to remember that the work has only just begun. How you rehabilitate your joint will help to determine how your recovery goes and how successful your procedure ultimately is.
“The repeated goal at all stages is rehabilitation,” Dr. Desmond says. “The reason patients choose to have joint replacement is due to pain and a loss of function. The best way to ensure a good outcome is to participate in therapy/rehab and follow the specific activity restrictions and recommendations you have been given.”
While it may seem counterintuitive, Dr. Desmond says it is important to begin moving and walking as soon as possible after joint and hip replacement surgery.
“There will be some pain and discomfort, but delaying your rehab only makes recovery longer and more difficult,” she explains.
For the first couple days after surgery, Dr. Desmond says patients should focus on adequately controlling their pain (ideally a combination of non-narcotic and narcotic pain medications) and working with their physical therapist.
Then, one to two weeks following surgery, the focus should be on progressing with physical therapy rehabilitation.
“Do your assigned exercises as prescribed and wean off of narcotic pain medications,” Dr. Desmond says. “Ideally at this point you should stop taking narcotic pain medication if possible.”
One to two months out from surgery, the focus should continue to be strengthening the joint through rehabilitation with physical therapy.
“If you were given any specific activity or motion restrictions, these should be coming to an end at 6-8 weeks, which will make your rehab progress even better,” Dr. Desmond explains.
Throughout your recovery, you should keep an eye on your incision and the joint itself. Infections can happen and should be treated quickly.
The most common signs of infection are fevers, chills, night sweats, redness, increasing swelling, discharge or a foul smell around the wound.
Another complication that is infrequent but would need to be addressed quickly is a blood clot or pulmonary embolism, which may cause leg swelling, calf pain/cramping/soreness, shortness of breath, chest pain that worsens when you take a deep breath or cough, rapid breathing, or rapid pulse. Immediately contact your doctor if those symptoms are present.
In general, Dr. Desmond says patients should expect to be gradually improving following joint replacement surgery.
“There will be days that are worse than others, but the trajectory should be that of improvement,” she says. “Any changes that worsen and do not improve with rest or elevation should be reported and evaluated.”
If you are fortunate enough to have a spouse, family member of friend around to help you recover following joint surgery, they can help to increase the success of your procedure too.
“Having someone present is very important,” Dr. Desmond says. “The patient will need help with many basic tasks, from transportation, prescription pick up, changing dressings, food preparation, etc. The partner can help to ensure that the patient is taking all of the prescribed medications at the appropriate intervals and is aware of any signs of common complications.”
Finally, Dr. Desmond wants people to know that in general, joint replacement surgery is very successful in addressing issues of joint pain and decreased mobility.
“The important thing to remember is that the improvement will not happen all at once,” she says. “Most patients will take at least three months to return to their basic, daily, non-strenuous activities. Full recovery and strength can take up to six to 12 months. In the end, the vast majority of patients have a significant improvement in their quality of life.”