Looking at a Joint Replacement? What to Expect Before and After Surgery

Leaves are changing and the cool weather is starting to set in. This is the season when people contemplate scheduling a joint replacement surgery. The two most common joint replacement surgeries are total hip arthroplasty (THA) aka a hip replacement and total knee arthroplasty (TKA) aka a knee replacement. Arthritis is a common condition that may trigger your healthcare provider to recommend a joint replacement surgery.^1,2 Joint replacements are a treatment option for persisting severe joint pain, stiffness, limited mobility, and swelling after exhausting all non-surgical options including physical therapy.¹ Despite joint replacement surgeries being common among the older adult population, there is still a risk of complications and recovery time that is associated with any surgery. After TKA, it usually takes around a year to return to full function, but most people resume to usual activities within 6 weeks and for a THA most people are doing well 3 months post-op and will continue to improve within the first year.^1,2 Undergoing a joint replacement surgery is a big decision. In this blog, we will be discussing what you should expect before and after surgery.

Pre-hab

According to the Arthritis Foundation, pre-habilitation aka “pre-hab” is an exercise physical therapy that is started 6 or more weeks prior to surgery.³ Pre-hab may include a combination of strength, aerobic, and flexibility exercises to improve your fitness prior to surgery.³ Studies have shown that people who participated in pre-hab for 6 weeks before surgery reduced their odds of requiring inpatient rehab by 73%.³ Patients who complete pre-hab and are in general more fit going into surgery have shorter hospital stays and need fewer outpatient rehab sessions.³ Discuss with your surgeon about your options for pre-hab.

Rehab

In general, you will see physical therapy within 24 hours after your surgery. Getting up from bed and walking is important to reduce the risk of post-surgical complications such as blood clots.⁴ Physical therapists will educate you on any joint precautions and initiate a home exercise program. Once discharged from the hospital, you will see a physical therapist in your home or an outpatient clinic for a frequency and duration that depends on your post-surgical status, post-surgical protocol, and/or functional limitations. At your first visit, your physical therapist will assess your function, range of motion, strength, skin/scar integrity, and mobility, among other things. Then, you will create goals and a plan of care for rehab with your physical therapist.  

Despite the noted benefits of pre-hab, insurance companies may not cover more than 6 weeks of rehabilitation which includes prehab and rehab depending on where you live and the type of insurance you have.³ Prior to surgery, call your insurance to ask about your specific benefits and discuss with your surgeon your options for prehab especially if your insurance does not cover it.³ At Live Your Life MN & FL, we can be an option to provide in-home insurance covered services. We also have a private pay option should your insurance not cover the necessary pre-hab and rehab services you are seeking. Our staff of amazing physical therapists would love to see you for all your rehabilitation needs. Contact us for a free consultation today!

References

¹Total Knee Replacement Surgery Information | Cleveland Clinic: Health Library. Cleveland Clinic. Published 2016. https://my.clevelandclinic.org/health/treatments/8512-knee-replacement

²Mayo Clinic. Hip replacement – Mayo Clinic. Mayoclinic.org. Published 2018. https://www.mayoclinic.org/tests-procedures/hip-replacement/about/pac-20385042

³Pre-hab for Surgery | Arthritis Foundation. www.arthritis.org. https://www.arthritis.org/health-wellness/treatment/joint-surgery/preplanning/pre-hab-for-surgery

⁴Life After Joint Replacement: Why Physical Therapy Is Key. www.henryford.com. Accessed October 1, 2023. https://www.henryford.com/blog/2021/12/physical-therapy-joint-replacement