Quality of life for millions of people worldwide has been improved by relieving pain and restoring function and motion by Total hip and total knee replacements in patients with arthritis. People with successful joint replacements are able to stand, walk, rest and participate in recreational activities with little pain.
Based on the patient’s unique medical history and physical and mental condition prior to surgery, the surgeon should be able to guide expectations about the level of function after surgery. Setting high expectations that are unrealistic can lead to dissatisfaction with the final result. In today’s competitive healthcare environment, patients contemplating TKA are bombarded with images and perceptions of rapid recovery, return to normal life, and high levels of function following TKA. This undoubtedly fuels unrealistic expectations that can contribute to patient dissatisfaction. There are preparatory steps that can be taken to make the overall experience smoother.
Pain relief improved walking ability, and return to sport are among the most common patient expectations. Other expectations include improvement in psychological well-being, sexual activity, social interactions, and gainful mobility. Despite the good range of motion and function, still, a few patients are not really excited- maybe expectations and speed delivery are way unrealistic. Perfection is hard to define and can be ever-changing. It’s important for both patients and surgeons to be upfront about their expectations and the risks of joint replacement surgery in order to avoid surprises. Most common causes of dissatisfaction, such as residual pain, stiffness, and failure to return to high levels of function, can be expected following normal and well-performed TKA. The overwhelming majority of patients who have joint replacements do very well and consider it a worthwhile experience. It takes time to get better. Stay focused on the end goal. Here are a few thoughts to plan recovery…
Pain- Pain is a valid fear and unfortunately is an unavoidable part of the surgery. Despite outstanding advances in medical care and surgical treatments, the act of creating an incision, removing damaged parts, and implanting the component will cause pain. It’s always helpful to come to grips with the fact that this will not be a pain-free process. The goal of your surgical team is to lessen the amount of pain in a safe manner using pain killers, physiotherapy, ice packs and gentle massage.
For patients undergoing surgery to the lower limb (such as the hip or knee) having someone to count on during the initial days after surgery is important. Think of someone you trust who’d be willing to help you. That family member or good friend can also help keep you motivated and keep your spirits up during the recovery process. If you know someone who’s had a hip or knee replacement before, consider asking them about their experience. They’ll understand what you’re about to go through and might be able to provide unique insight.
Staying in the hospital– The duration of your hospital stay can vary. Most patients having hip or knee replacements don’t need to stay in the hospital very long. During that time, they work with physical therapists to ensure you can move around and perform basic day-to-day functions. When certain goals are met, patients go home to continue recovery.
Returning to life– The million-dollar question, when will I be active again? Returning to your normal routine depends on what that routine includes. The majority of patients begin putting their full weight on the hip or knee the day of surgery. It will be uncomfortable at first, and gradually improve as the muscles and tissues around the joint heal and get stronger. You can usually walk right away. In fact, it’s believed that early mobility may help reduce the risk of blood clots in your legs, which can be a dangerous complication. Depending on the way your surgery is performed, there may be some positions or motions your surgeon will want you to avoid for a period of time during the healing process. Patients with sedentary or office jobs may be able to go back to work fairly quickly, sometimes the week after surgery.
Ultimate outcome– “When will I be normal?” The definition of ‘normal’ is tough. Joint replacement surgery can do a great job alleviating pain and restoring function, barring surgical or post-surgical complications. That said, nobody can take away the fact that you and your joints have lived a lifetime together, and that you’re about to undergo a major operation. If you expect a perfect outcome, you will have a high chance of being disappointed. Residual pain, stiffness, prosthetic noses, and difficulty with stairs can persist for up to 12 months following surgery. It is not uncommon to see delayed presentation patients struggle with activities such as stairs, kneeling, and squatting. Return to sports like golf, dancing, swimming is another functional goal that is highly valued by patients undergoing surgery. Although a return to low-impact activities is feasible and recommended following knee or hip replacement, a return to preoperative levels of sporting activities cannot be guaranteed.
The take-home message is that it is paramount to discuss the expectations for pain relief and function with the surgeon before undergoing a total joint replacement to make sure both patient and surgeon are on the same page. It takes most people around 3 months to return to most activities, and it can take 6 months to a year to make a full recovery and regain full strength.
In other words, recovery takes time. The success rate of the knee or hip replacement is high, but it is crucial to have realistic expectations.