As the realm of orthopedic medicine has continued to expand over the years, surgeries have become more and more commonplace. Among those surgeries, some of the most frequently performed operations are joint replacements. Joint replacement is a surgical procedure in which either some or all parts of a joint are removed and replaced with a prosthesis, an artificial body part. Many joints in the body can be replaced, including the hip, knee, ankle, shoulder, elbow, wrist, and thumb. The most commonly performed joint replacements are hips, known as a Total Hip Arthroplasty (THA), and knees, known as a Total Knee Arthroplasty (TKA). Typically, these surgeries are performed on older patients with severe arthritis but are also performed after severe trauma in elderly patients, such as a fall. Joint replacements are designed to replicate movements of a normal joint so that people can return to normal, healthy lifestyles.
Physical Therapy (PT) is often an integral part of the recovery process for patients that have undergone a joint replacement. PT often starts very early in the patient’s recovery, and can even begin on the day of the surgery, in the case of a TKA or THA. Patients often spend a couple of days in the hospital, where they undergo PT before they are sent home. Once the patient returns home, they are usually treated by a Home Health PT until they are strong enough and mobile enough to leave their home. When a patient is no longer homebound, they are typically referred to an outpatient PT clinic by their surgeon. In outpatient PT, the patient should expect to perform a number of exercises to help strengthen the muscles around the replaced joint and throughout the affected extremity. As the patient progresses, the exercises will increase in intensity accordingly. The PT will also be stretching the patient to help the patient attain full range of motion in their replaced joint. The goal of outpatient PT is to help a patient return to their desired level of functional and recreational activity.
Before surgery, patients should not discontinue exercise. In fact, patients tend to recover more quickly following a joint replacement if they are active with exercise leading up to their surgery. Some strategies for pre-surgery exercise for knee and hip arthritis include low-impact cardiovascular activities, such as biking and swimming, and low load, high repetition exercises focused on strengthening the quadriceps and hip musculature. These surgeries regularly require at least a few months to a full year for a full recovery. Joint replacements have evolved to the point where they are now routine surgeries for many orthopedic surgeons. Currently, the outcomes after these surgeries are quite good, but there remain risks as with any surgery. If a patient is looking for any further guidance, they should not hesitate to consult with their surgeon or their physical therapist.
Jayson DeLeaumount, DPT