Hip and knee arthritis can be debilitating and limit your ability to perform normal activities. Arthritis occurs when the cushioning cartilage in a joint goes away and there is bone-to-bone contact. This contact results in inflammation, stiffness of the joint, and pain in the joint. There are some conservative treatment options such as cortisone injections, anti-inflammatories, and physical therapy but often these are only short-term solutions. The best way to treat arthritis in the long term is total joint replacement surgery.
How is outpatient joint replacement possible?
The technique of total joint surgery has improved greatly over the past few years. These new techniques allow doctors to make smaller, less invasive incisions which results in much faster recovery due to minimal blood loss. Anesthesia techniques have also improved greatly by having new kinds of nerve blockers that better help manage the patient’s pain, as well as help manage their nausea post-op.
Advantages of outpatient surgery
The biggest advantage to having a joint replacement surgery as an outpatient is the fact that patients can recover in their own home. Patients can avoid an extended stay in the hospital, which often allows them to recover faster. Another advantage is that outpatient surgeries are more efficient. Immediately following surgery, patients meet with physical therapists to discuss recovery plans.
The following patient testimonial is from OrthoVirginia patient Vivica, who had her knees replaced. She provides an insight into her own personal experience with an outpatient joint replacement procedure.
Overall experience with outpatient surgery
When I was getting my first knee replaced last May, I was extremely nervous about it, but the pre-op nurse did such a wonderful job answering all my questions which helped me feel relieved. On the day of surgery, I came in at 6:30 in the morning and they took me back quickly to get me ready for surgery. The next thing I knew, they were waking me up and telling me it was time to get out of bed. After that, I met with the physical therapist to create a plan and I was home by 3 o’clock in the afternoon. The great thing about outpatient surgery is the fact that you get to go home afterward. Your family or caregivers can get you what you need when you need it. We were able to get on a real schedule with my pain medication and that allowed me to minimize any pain or discomfort I had and quite honestly, after the first five days or so, it gets tremendously better.
I was really nervous about the pain when I was contemplating getting my first knee replaced. After surgery, we came up with a pain management system to help control the pain. We set an alarm on my iPhone next to my bed, so when it was time for my next pain medication, my daughter would come in and help me take it. One of the best things about outpatient surgery is being able to take control of your own pain management. In a hospital setting the nurses might be busy or have an emergency which means it can be hard to manage the pain.
Before having my knees replaced, I was using crutches to get across the room and could not enjoy family vacations. I had been struggling for five years with very painful arthritis. Since having my second knee replaced in December, I am back to living my everyday life. My family and I recently visited Disney where I was walking almost 18,000 steps with no pain. I also recently played nine rounds of golf while walking the entire course. It has been such a wonderful experience and I can now enjoy my normal life activities.
If you need knee and hip replacement in the same leg, which one do you do first and how much recovery time do you need to wait between them?
Most often, it is recommended that patients get their hip replaced first and then their knee. Physical therapy after a knee replacement can be difficult if your hip movement is painful or limited, so first replacing the hip can help patients have an easier time with physical therapy for the knee. Also, some patients experience severe hip arthritis which can cause the knee to hurt more than it would otherwise. Correcting the hip first may show that the patient does not need surgery on their knee. Patients should wait at least eight to twelve weeks between the hip surgery and the knee surgery to allow time to heal.
How do you know it is time for a knee replacement?
The two key indications that a patient needs surgery are pain and loss of function. X-rays can help determine how severe the arthritis is, but it is important also to consider how it affects the patient's everyday life. Replacing a joint is not an emergency so patients usually will try other treatments to reduce pain like cortisone shots or physical therapy, but eventually the pain will interfere with their lives and they will require surgery.
How long after replacement is it safe to consider a long-haul airline flight?
We recommend waiting about six weeks after having a joint replacement to fly for extended periods of time. There is a higher risk of blood clotting after surgery which can be increased greatly by flying on an airplane. If a patient needs to fly within a month after surgery, we recommend that they take anticoagulant medication to lower the risk of blood clots. They also should get up and move around frequently to ensure that blood is flowing and their joint is healing.
What is the average recovery time for knee and hip replacements?
Recovery from a joint replacement means the patient is back to most day-to-day activities. For most patients, after a hip replacement they are back to doing these activities after three or four weeks. Most knee replacement patients are back to their activities in four to six weeks. Many patients remain sore even after a few weeks of recovery and it can take a few months to get fully back into the activities without any discomfort, but the pain should be gone by then. Patients begin physical therapy almost immediately after surgery to get the healing process started and allow for faster recovery. It usually takes an entire year for a joint replacement to completely heal but most patients are back to normal everyday life before that.
What does the rehabilitation process include?
There are two main focuses with the rehabilitation process: range of motion and strength. Each patient is different, but it is imperative that patients recover their comfortable range of motion. Most of these activities normalize the motions of the knee and hip to allow patients to get back to their everyday lives.