When joint pain is too much,
A Hip and Knee Replacement or other surgeries can be a lifesaver…..Working closely with an orthopedic surgeon who is exceptional in performing knee and hip surgeries, I came up with a quick guide that can prove helpful to persons who are facing the possibility of a knee or hip replacement.
More than 7 million Americans are living with an artificial knee or hip, according to the American Academy of Orthopaedic Surgeons, and those figures are likely to keep growing. Total knee replacements more than doubled between 2000 and 2009, and total hip replacements increased almost as much.
Severe Osteoarthritis is the common reason why a knee replacement or a hip replacement is indicated. Arthritis causes degeneration and erosion within the joint that erodes the soft tissues including the meniscus.
This causes both the bone of the thigh and the lower leg to rub against each other, resulting in a bone-to-bone contact between these two structures that can be very painful. This can also cause severe inflammation, stiffness, and pain. The result can be very debilitating making standing, walking difficult, so with the inability to tolerate simple tasks of daily living.
Hip and knee replacements can provide a new lease on life for patients who experience severe arthritis pain that doesn’t respond to conventional treatments, medication, or lifestyle adjustments. Surgery often restores joint function and makes many daily activities possible once again.
However, what you do before and after surgery will play a big role in the outcomes you experience.Read this guide before you decide on joint surgery.
Steps to Take Before Your Joint Surgery:
1. Explore other alternatives. While surgery can be very beneficial, it’s a major undertaking. Try less intensive treatments first, including drugs, physical modalities such as heat or cold packs, and exercise. You may also want to ask your doctor about cortisone injections.
Cortisone injections work by treating the inflammation that can cause knee pain, swelling, stiffness, and warmth. The effects of a cortisone injection can last from three weeks to three months. I have had patients who report relief for up to a year. Arthritis sufferers who want quick, temporary relief from knee arthritis pain may choose to have a cortisone shot. Ask your primary physician or orthopedic surgeon.
2. Understand your options. If surgery is indicated, your doctor may recommend total or partial joint replacement or other types of operations. That may include arthroscopy, which often takes as little as one hour, or joint fusion surgery, which can be used when joint replacement isn’t feasible.
3. Consider your timing. Deciding when to act can be tricky. You want to have joint surgery as soon as necessary but as late as possible to minimize additional damage and the need for replacement procedures.
4. Lose weight. Your doctor may suggest you take off excess weight to make surgery safer and put less strain on your knees and hips. Maintaining your new figure will also be important.
5. Work out. Exercise plays a big role before and after you’re in the hospital.
6. Review your medications. Let your doctor know about any drugs or supplements you use. Substances like glucosamine can interfere with anticoagulants that reduce the risk of blood clots.
7. Plan your finances. While insurance will probably cover your surgery, it may not extend to other expenses like home health care and medical supplies. Ensure you budget for the total cost.
Steps to Take After Your Joint Surgery:
1. Prevent infection. You can reduce your risk of infection by keeping wounds clean and taking antibiotics as recommended. Contact your doctor if you see warning signs like fever, redness, or drainage from a wound.
It is common to experience swelling days after surgery. Cryotherapy, or using cold packs regularly throughout the day can help ease discomfort and pain. It also keeps the swelling or edema, under control. If left alone, the leg can swell up all the way to the ankles as gravity tends to pull fluids down when we are up on our feet.
Patients always ask how long do they have to apply ice packs each time. Orthopedic surgeons have their specific protocols regarding icing schedules. I recommend for the first 3 days to hourly as feasible, then every two hours once swelling and pain are more controlled. About 20 to 30 minutes should do it, but always check your skin to make sure you don’t freeze your knee or hip! No frostbites!
Most hospitals will send you home with special ice packs, and some even send you with an ice device such as Game Ready, Aircast Cryocooler, Don Joy iceman, or Polar active ice device. There are many available in the market. Basically, it is a device for an ice circulation system. These products are available on the market, even Amazon that can cost anywhere from $75 to $2,700 plus on the high end.
For home use, if one does not have access to these fancy ice devices, here’s a real homemade ice pack you can use that is very effective, just as cold as expensive ice packs and you can make it yourself!
CORN SYRUP COLD PACK: Buy the KARO brand LIGHT (not the dark) corn syrup at your grocery.
2. Do physical therapy. Of course, I am impartial to this, being one. Your surgeon will surely refer you for Physical therapy that will start at your home for a few weeks. You will then be referred to outpatient Physical Therapy soon after, where you can work on an advanced therapeutic activities program.
Expect to work a little harder with your outpatient PT who will help with you regaining more knee flexion and strengthening the hip or knee. This will allow you to progress towards being able to walk again on your own, or with the least restrictive walking device like a cane. Plan to start physical therapy before you leave the hospital. Some orthopedic clinics provide a pre-op consult or even therapy itself for a few visits to prepare you for surgery.
A Physical Therapist can teach you the appropriate Pre-Op exercises or Anti-embolic exercises (Simple exercises that are aimed at preventing blood clots common after any surgical procedure) right after surgery. A home exercise program can be prescribed by your physical therapist which you can probably perform safely on your own at home once you receive proper instructions.
3. Prepare your home. Be ready for departure day. Clear away clutter and area rugs that could lead to falls. Install grab bars in the bathroom and move your sleeping arrangements to the ground floor if necessary. Stairs can be tough to manage early on after your surgery.
4. Dress comfortably. Select loose garments. When doing physical therapy, it is easier for your therapist to access your knee or hip for manual therapy if the therapist so prefers. Elastic waist pants and pull-on tops will save time. Wear slip-on shoes until you can bend your legs.
5. Bathe carefully. Keep your incision dry until the stitches, sutures, or staples are removed. Some surgeons use Aquacel dressings for knee and hip replacements. This is a sterile dressing with an inner non-woven pad made of Hydrofiber technology and ionic silver.
Take sponge baths or use a stool and shower hose. Keep the surgical site dry. If Tegaderm, a transparent dressing is used, you can take a shower without having to cover the area as it is waterproof. Tegaderm is a sterile, breathable, waterproof, germ-proof barrier dressing commonly used in surgical procedures due to its stated qualities.
6. Buy assistive devices. Your physical therapist, medical supply stores, and online catalogs can help you find various items to aid in your recovery. Crutches and walkers can be delivered to the hospital or your home. The use of a walker may be temporary as many of my patient s can pretty much walk on their own once outpatient therapy has started.
TIP: Check your local thrift shops including Goodwill and Salvation Army. I seem to always find barely used walkers in these places for about $8 to $15. Ask your physical therapist to adjust and check it for you for your ideal fit.
Ideally, the walker height should be about the level of your wrist joint when your hand hangs on your side. A good fit can save your back from having to slouch so much forward while walking. Practice the heel/toe walking pattern even before your surgery. This allows better gait patterns and avoids excessive loading on just the surgery side. Ask your physical therapist.
7. Arrange for help. Ask a family member or close friend to bring you home from the hospital and stay with you for the first few days. It is safer for you when there is someone else who can help you while you are recovering and unable to move around well just yet. That knee or hip will feel heavy, stiff, and uncomfortable making walking difficult. If no one is available locally, see if your church has a homebound ministry.
Joint replacement or other surgeries can be the start of an active and fulfilling new life. Being prepared will help you work with your health team to find the appropriate options for your condition.
Feel free to ask me more about joint surgeries and exercises you can do to help feel better and recover faster.
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