What to Expect with a Joint Replacement

Once you have tried every conservative treatment for a painful joint, you may be ready to go ahead and just get that joint replaced. Whether it is your shoulder, knee, or hip, there are common treatments and procedures that are followed leading up to this decision. As you will be told in your appointment, this is an elective procedure, so there are important steps to follow that keep you safe and ensure there are no complications with insurance coverage.

The first step includes conservative treatments such as:

• Cortisone injections (knee & shoulder)
• Physical Therapy
• Viscosupplementation (knee)
• Use of an ambulatory aide, such as a walker or cane

Following trying conservative treatments, your physician will have you follow-up and at that point make the decision to go ahead and proceed with a joint replacement. There are multiple factors in the decision to replace a joint, on the patient’s side, as well as the physician’s. Some of the risk factors that will be discussed are obesity, smoking, vascular disease, or other conditions which may impede the body with healing itself. Be prepared, if necessary, to be instructed to lose weight and stop smoking. Also, once the decision is made, there are multiple clearances and tests that much be performed. Some testing includes getting a chest x-ray, EKG, and multiple blood tests. Medical clearance for surgery is another requirement, this may just be with you primary care physician, but depending on your total heath, there may be other required clearances such as cardiac and dental.

Again, this is an elective procedure, and the outcome is based not just on the doctor’s skill, but on your body’s ability to heal and your willingness to participate in your own treatment and well-being.  Many physicians will have you participate in what is known as “prehab”, this is essentially similar to the physical therapy you will be doing after the surgery, and will prepare the muscles by increasing strength and flexibility prior the surgery. All of these requirements will take time and effort, but the end result of a successful joint replacement is the culmination of your efforts not only in getting to various appointments and having testing done, but truly participating in your own journey to improved mobility.

Finally, surgery day! You have already had your preoperative appointment and received all the last minute information such as when to arrive and where to be, as well as any equipment you might need, such as a walker.

Once your surgery is finished, you may be taken for some postoperative x-rays, or  to the recovery room.  You can also expect to be up or walking around that same day once any effects of the anesthesia wear off.  Research has shown that the sooner a patient is up and around the day of surgery, the sooner that healing can begin. In fact, due to this principal, the stay in the hospital (barring any complications) is just one night. You get to go home either to your own home, or if there have been other arrangements made for you, to a facility that can care for you. 

This is when actively participating in your health and wellness will be of great importance. You will have skilled nursing care and physical therapists that will come to you in those first couple of weeks. You will work with them, but also have work that you will need to do on your own to kick off the healing process.

After the first two weeks, you will follow-up with your physician. Your incision will be checked, your range of motion assessed, and your overall well-being will also be addressed. Ideally you are expected to use a walker for the first week followed by a cane for the second week. Your medications will be checked at this visit as well.  At this point you will either begin outpatient physical therapy, or be instructed to follow a home program depending on your strength and range of motion.

Six weeks after surgery you will follow-up with your physician once again to check on your healing. At this point, barring any major setbacks, you will now be released from care for the year. At that one year mark you will return for an x-ray and follow-up appointment, and then again at five years. Your physician will tell you if you ever have questions or concerns, please get into the office as soon as possible. You are not on your own after that six week appointment! Your physician’s office is always there when you need them, and will not hesitate to see you even if just to remind you of your postoperative precautions or other details you may have forgotten.

You are now ready to embark on a journey of regained mobility, but only if you do the work that is necessary. It is a big decision to make to have a joint replacement surgery, and you need to have a good support system and truly listen to your physician, we all wish you much success!