People are living longer than ever, and many of us are needing our worn-out hips, knees, shoulders or ankles replaced as a result. If you are heading to hospital for a joint replacement, it’s important to know what to expect from the procedure and how you can give yourself the best chance of a smooth recovery.
We spoke to sportsmed Orthopaedic Surgeon Dr Rob Wallace, to find out more about joint replacement surgery and how he recommends preparing for it ahead of time.
Joint replacements involve invasive surgery, which means spending at least a couple of nights in hospital. Depending on your individual situation, you can expect to be going home about four or five days after the procedure, but some patients are discharged even earlier if they’re progressing well.
“Most people are surprised by how comfortable and mobile they are in that early period after surgery,” says Dr Wallace. “We’re often encouraging patients to stand on the day of surgery if it was early enough in the day. Certainly, you’ll be standing the next day and then starting to walk again – on a walking frame at first and getting down to a walking stick by the time you leave hospital.”
If you’re having a hip or knee replacement, these procedures are now often done under spinal anaesthesia rather than a general anaesthetic. It involves an injection into the spinal canal that numbs your body from the waist down coupled with sedatives administered via a drip throughout the surgery to put you to sleep. The difference with using spinal anaesthesia is that you’re still able to breathe for yourself through surgery, and you’re less likely to suffer the post-surgery nausea often associated with a general anaesthetic. Spinal anaesthesia also reduces the risk of complications arising.
Be sure to check which type of anaesthetic you’ll be administered, so you can do some research and know exactly what to expect. Check with your specialist if you are unsure.
1. Speak to your doctor
“Joint replacement surgery is elective, so it should be well planned to reduce the possibility of anything unexpected turning up,” advises Dr Wallace.
The best starting point is to talk to your doctor about getting assessed by an anaesthetist, as well as having your heart and lung function assessed prior to surgery. Make sure you ask your doctor any other questions you might have – writing a list prior to your appointment is always a good idea.
2. Get into some ‘pre-hab’
Recovery from a joint replacement actually starts well before the surgery itself. Ask your doctor about seeing a physiotherapist or exercise physiologist for some ‘pre-habilitation’.
“Muscles can waste a bit around arthritic joints, and then the surgery can make for some further temporary weakness on top of that,” says Dr Wallace. “Pre-hab is about trying to restore some of the strength to the de-conditioned muscles around your joint, to help make the rehabilitation process a bit easier. You might also strengthen some other important muscles – like your core and upper body – which can make it easier to get around on a walking stick after the procedure.”
3. Maintain a healthy weight
It’s never a bad idea to lose some weight if you’re carrying a few extra kilos, but especially when you’re preparing for joint replacement surgery. Even losing five or ten percent of your bodyweight can reduce the risk of complications arising during the procedure. Going forward, the less weight you’re carrying, the less pressure will be on your new joint and the longer it will last.
4. Prepare your home
Don’t wait until after surgery to make sure your house is in a suitable condition for a period of rest and recovery. To prevent falls, tidy up any loose rugs, cords and other tripping hazards both inside and outside the house.
Dr Wallace suggests that, “you’ll also want to minimise the number of stairs you have to climb, and it might be a good idea to rent some equipment. A toilet seat raiser and a rail in the bathroom or shower can help.”
“And to some degree with knees, but definitely with hips, you want to avoid sitting in very low positions where your hip is flexed below 90 degrees. If you have a low-slung lounge suite you might consider renting an adjustable chair with some arm rests just to be safe.”
5. Ask your loved ones for support
For that initial period after surgery, you’re not going to be mobile enough to do much more than move around the house. This is a great time for a loved one or relative to step in where possible – ask them if they’d be willing to assist with things like cleaning, shopping and other errands for the first fortnight or so.