After careful consideration, you or a loved one have decided to book a joint replacement surgery. So what do we recommend you need to do before the actual procedure?
We want to make sure you have the smoothest experience possible, so have put together a checklist to make sure you are prepared. This will help you have the most efficient and least stressful experience!
If you are unsure about whether a joint replacement is the right decision for you, visit our last blog which works through this very question.
Prepare your body as best you can
Hopefully you have already trialled physiotherapy management before considering a joint replacement surgery. There is plenty that can be done to help your pain and function prior to the joint replacement procedure. If you haven’t visited the physiotherapist yet- no need to worry! Seeing them for pre-operative rehabilitation (sometimes called pre-habilitation) program will ensure you are in good condition before going under the knife.
A physiotherapist will likely check the quality of your movements, strength, flexibility and capacity. By assessing your body and lifestyle, they will give you advice on potentially modifying activities and help you reduce irritation to the joint and pain whilst you await surgery. Their assessment will also identify any areas of restriction and help you restore any movements that you will need (e.g. Knee bend or straighten)- often surgeon's prefer a certain range of movement prior to the operation.
From there they will assess the muscle activation and strength- making sure you can switch on the relevant muscles through a gradually progressed exercise program. They will also help you strengthen the surrounding muscles from the core and hips down to the feet. Balance exercises are also important in this stage and following surgery. There may also be other treatments they can offer to help you in the short term to help relieve pain or accelerate the strengthening process. These options may involve massage, manual therapy, dry needling/ acupuncture, taping or specific braces dependent on the issues you present with.
Start the Weight loss process
When considering osteoarthritis, overall body weight is an extremely important factor. A 3kg loss in weight will reduce the weight put through the knee by up to 12kg in certain situations. That’s 4 a four fold decrease in activites such as stairs! This weight loss will also help when you do eventually have your joint replacement- as it will take load and wear off the new replacement and help it's longevity. Of the 57,000+ knee replacements in a year, about 5,000 of those are revision surgeries! This highlights how important it is to keep the joint replacement healthy post operation.
When considering weight loss, Diet has been shown to be more important than exercise (read one of the studies which demonstrates this here), so it’s a great time to start with good habits that will help you in the long term. I appreciate this can be a hard area to change, so visiting a dietitian will help you identify and change the right areas of your diet. Exercise is also very important and although it can be hard in severe osteoarthritis- there are plenty of options that a physiotherapist or exercise physiologist can help you with. This might include pool based exercises, cycling, upper body exercises or boxing to name a few!
Understand the surgery
It’s extremely important that you understand the actual procedure that you will be undergoing. Whilst you don’t need to know all the finer details, having an accurate understanding of the operation will allow you feel more comfortable with what’s happening. It will also help you to appreciate why you may be in pain afterwards and why the surgeon places certain restrictions on that joint initially and even later down the track. Here’s an animation which shows a simplified surgery. (Whilst animated the 3D video still shows the process- so be warned!)
Know the process before and after the surgery
Prior to the surgery, you will be required to attend certain appointments to prepare. You will work closely with the surgeon to gain all the relevant information about the process. It’s a good idea to write down any questions or problems you are having so that you remember to bring them up when you meet. It’s also important that you bring a close friend or family member to these appointments and future appointments. This will ensure that you ask the right questions and will help you remember what has been said, as there is often a lot of information to take in! The hospital may have a pre-admission clinic where you go in to perform a baseline assessment and get all the information that you will need for your surgery and stay.
Following the surgery, you will most likely stay in hospital for a number of days. This will be to monitor your overall health following the operation and to make sure you are mobile enough and safe to leave After this, you may be required to attend a rehabilitation facility where they can monitor your condition and help you start the recovery process. Everyone’s progress following surgery is different, so it’s best to make sure you have all the steps worked out as best you can prior to surgery. You may then attend as an outpatient physio or be referred to somewhere to continue with the rest of the recovery process.
Keeping all these things in mind will prepare you well for your joint replacement. This will put you in an ideal position to have a smooth recovery afterwards- the better you go into the surgery, the better you will come out! Please get in touch if you are interested in learning more about managing your osteoarthritis or preparing for an upcoming joint replacement surgery.
The next blog in this series will focus more on the recovery, stay tuned if you want more detail about exercises, movement and more!