Dos and Don’ts After Joint Replacement

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Joint replacement or arthroplasty is a replacement of a worn out or damaged joint. The operation is performed by an orthopedic surgeon. A new joint is called prosthesis and can be metal, ceramic or plastic. Knee joint replacement is most often done after rheumatoid arthritis destroys it, whereas hip joint usually needs replacement after femoral (hip bone) neck fracture in elderly people. There are also other joints (shoulder, wrist,) that can be replaced but we will focus on most common knee and hip joint replacements. We will discuss the behavior and lifestyle features after changing a joint.

What to expect immediately after the procedure?

After a knee or hip replacement surgery you will have to stay in hospital for a few days (approximately a week) depending on your general state of health. You will feel pain for a month or less after the operation and will have to take medication such as paracetamol, diclofenac or ibuprofen. Also, most of the patients receive drugs to prevent formation of blood clots (e.g. fraxiparine). Physical therapy begins the day after operation to strengthen the muscles and to help regain motion. Studies say that early mobilization and discharge from the hospital may lead to faster recovery. After hospitalization you may receive some weeks of rehabilitation but the largest part of the recovery process depends on your own efforts. So, what should one do after joint replacement?

Recommendations after arthroplasty

Although advices concerning life after joint replacement for different joints vary, the goals of rehabilitation are similar. Soon after operation you should walk with walkers or crutches so that the joint is not challenged with an inadequate load. The rehabilitation programme includes exercises to strengthen and stretch the muscles as well as training daily activities (e.g. stair climbing, walking and bending). During the period from three to six months people regain their previous activity level and maintain active lifestyle. You should remember that not all kinds of sports can be played after joint replacement. Walking, cycling and swimming are recommended, but high – impact sports (e.g. running, skiing) are not.

First days after the replacement patients do bedside exercises and mobility training from bed to chair. A specialist teaches a patient to perform these exercises, walk with crutches, discuss assessment of the home environment and usually after a couple of days the patient is transferred to a rehabilitation unit. There he begins strengthening and stretching exercises. He is taught to be independent and to get used to the life with an artificial joint. Moreover, you should remember about the care of incision area. It must be kept dry, if you feel a burning sensation avoid using lotions and apply an icepack for 10 – 15 minutes instead. Doctors always perform leg measurement preoperatively and postoperatively (immediately after operation and after a few weeks). Leg length correction is possible if needed.

There are three options to plan your recovery period:
  • A physical therapy specialist will come to your home. This option is the most popular among patients as they prefer to go back home soon after the operation.
  • Rehabilitation hospitals are better for patients who can hardly walk with crutches and cannot perform daily activities.
  • Convalescent homes are for patients whose physical activity is very poor and they need a lot of medical care and regular observation.

What should be avoided?

First of all, it is very important to avoid overworking and straining the joint during the recovery period. There are also some specific precautions to prevent some complications for different joints. One of the most important ones is measures against hip dislocation and continuous passive motion after total knee replacement. Soon after hip joint replacement:

  • you should not cross your legs or turn them inward;
  • when you lie on your side put a pillow between your legs;
  • you should not bend on your hip when you want to reach some objects;
  • you should use assistive tools for reaching objects;
  • You should sit only on elevated chairs or toilet seats.

Continuous passive motion is based on moving replaced knee with a special device in order to improve its flexion degree. If a patient lives alone or in multilevel home he needs better flexion than a patient living in a one level home and with his family. The help of friends, family or home care agencies for the first few weeks after the operation is inevitable.

Every patient is encouraged to start moving the replaced joints the other day after operation and to lead an active life. The earlier you start moving the better. Exercising helps to maintain your health and prevents from gaining weight, which burdens your joints. On the other hand, you should remember that an artificial joint cannot function as good as the natural one and needs more care.