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According to the CDC, there were just over 1 million combined total hip/total knee replacement surgeries performed in 2010 in the United States alone. Many people are very anxious about deciding if they “need” a joint replacement; please stop listening to the horror stories! Infection and DVT (deep vein thrombosis, or blood clot) are very rare following surgery and for every unfortunate situation I can show you many positive outcomes. If the surgeon and you have decided a joint replacement is your best option, let’s get you back to living with as little stress as possible!

There are a lot of misconceptions about total hip and knee replacements. To better help you understand what you can expect with these surgeries, I’m doing a two-part series this week. Today’s post will talk about realistic expectations. In the next post, I’ll answer FAQs about these surgeries.

If you’re planning on having a total hip or knee replacement, here are some things you may expect.

• You will most likely receive therapy in the hospital and will probably even walk on the day of your surgery.
• Your recovery is an active process and you will need to be responsible for your ultimate outcome.
• In outpatient rehab, we will initially focus on regaining your range of motion (ROM) and then strengthening you through your available ROM. Especially after a total knee replacement, you will want to gain full extension. Do not stay in bed all day, and more importantly do not lay with a pillow under your knees!
• You will have swelling, which can last up to several months. You’ll be instructed to wear TED hose and these will help decrease swelling. Also, ice is your friend and get that leg elevated.
• Your physical therapist (PT) will give you home exercises. Do them! These will now serve as your part-time job. You will have a better recovery if you can stay motivated through this process. Set goals for yourself!

Initially, maybe you want to work on getting rid of the walker/cane. Then the focus will shift to going up and down a flight of stairs like a “normal person.” When you’ve accomplished that, progress to walking through a super market again and then return to your normal daily routine/work activities.

• You should expect some pain following these surgeries. This will feel different from arthritis pain. Muscle soreness is not a bad thing; rather this is to be expected. As my Grandma “O” used to say, “Suck It Up Buttercup!” Contrary to Grandma’s opinion, it is not necessary to over work yourself. (I’ve had some patients who do their exercises 4-5x per day – this is overkill.)
• More about pain. If you are experiencing high pain levels, it is likely your surgeon provided a script for pain medication. These medications serve a purpose and are likely needed for several weeks after surgery. Now, if you continue to take the medication and your pain is 0 out of 10, then we may have to have a talk!
• As you can expect, there will be some limitations of what you can do after your surgeries. After a total hip replacement, do not bend the hip past 90 degrees of flexion, avoid crossing your legs, and don’t twist or pivot on your operated leg. This is especially important for the first 6 weeks. After this, I recommend to avoid extremes of any the above movements forever, as it is the only way to prevent dislocating your new hip. Once you’ve reached 12 weeks following surgery, however, the chance of dislocation is very low.

After a total knee replacement, you shouldn’t kneel on your operated knee and should also avoid twisting or hopping activities.

-- Bryon Renwand

 

 

 

 

 

 

 

Related: Recovering After Hip/Knee Surgery: Your Questions Answered

First Published September 28, 2015, 4:00 a.m.