8 Must-Know Facts About Joint Replacements
Posted 2/3/2017 by UHBlog
People who are in severe pain will do almost anything to try to improve their quality of life. Or will they?
According to joint replacement specialist Matthew Kraay, MD, undergoing joint replacement surgery to alleviate pain and improve quality of life requires a pre-operative and post-operative commitment. Some people aren't willing or able to do what's needed to have this elective surgery.
“Patients and their families or friends really need to be involved through what we call the episode of care, which is the period of time before, during and after joint replacement surgery,” Dr. Kraay says.
If you or a loved one is thinking about undergoing joint replacement surgery, here are eight must-know facts:
- Lose weight if you are overweight. “Since our society tends to be overweight, we're going to encourage many of our patients to lose weight before surgery since it makes the surgery safer for the patient,” he says.
People with a body mass index (BMI) of 40 are at increased risk of complications, and people with BMIs above 40 may not be able to have the surgery.
- Address your other health concerns. Because this is an elective surgery, you need to make sure you're as healthy as can be. For instance, if you have high blood pressure or diabetes, these will need to be under control. If you smoke, that's a risk factor that can impact the surgery or outcomes.
If you have skin problems or dental (periodontal) disease, these also need attention since problems stemming from open wounds or problem teeth can cause an infection to develop in or around a total hip or knee replacement.
If you have rheumatoid arthritis, you may need to stop some of your arthritis medications up to a month before your surgery since many of these have a long-lasting effect and can affect your wound healing. This will require coordination with your rheumatologist.
“The key is to get in the best possible shape you can be in so you can make it through your surgery safely and successfully,” Dr. Kraay says.
- Exercise. “We know patients are in pain, but some of them may need to do some physical conditioning and strengthening in preparation for their surgery,” he says.
In most cases, low-impact fitness activities, such as riding a bike or swimming, as well as some weight-bearing exercises, can help you prepare. People who are really physically inactive may need physical therapy to get them “in shape” for surgery.
- Take a preoperative teaching class. At University Hospitals, all patients and a loved one or support person – known as a “care partner´– will be expected to take an informational class before their joint replacement surgery. The class will cover how to prepare for whatever joint replacement surgery is being done, as well as what can be expected during and after the procedure.
“People learn best by repetition,” Dr. Kraay says. “The more patients and their care partners learn about the surgery and what to expect along the way, the more comfortable everyone will be with the entire process of joint replacement surgery. Patients are more satisfied with their care and have a better surgical experience if they have a good understanding about the journey they are undertaking.”
- Prepare your home. Depending on the type of surgery and your mobility, you may need to make modifications at home before the procedure. For instance, some people need an elevated toilet at home or handrails on their stairs.
- Expect to move. According to Dr. Kraay, most hip and knee joint replacement surgeries last somewhere between one-and-one-half to three hours, depending on the type of surgery and the person's health and severity of arthritis.
“Right after your surgery, you're usually up and moving,” he says. “Within 48 hours, you can expect to go home.”
- Enlist help. “Joint replacement surgery today is totally different than what you may have heard from family or neighbors who may have had surgery years ago," Dr. Kraay says. “Nearly everyone will go home, and not to rehab or a nursing facility. You need to line up friends or family (care partners) to help you for the first few days after coming home until you can get around on your own.”
- Do the exercises. With knee replacements, there is a fair amount of physical therapy required to help recover and restore your range of motion and strengthen the muscles around the knee. You'll also have exercises to do with a hip replacement once your body heals.
“The No. 1 thing is you should be involved in your outcome and do the things we recommend,” he says.
Matthew Kraay, MD is an adult reconstructive orthopedic surgeon, director, Joint Reconstruction and Arthritis Surgery, and director, Center for Joint Replacement and Preservation, at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Kraay or any other doctor online.