Knee Replacements and Hip Replacements
Modern joint replacements have been around since the 1960s and since that time have become the most often performed orthopedic surgery in the world. Today I talk about the development of the joint replacement, some of the latest advances and what patients can expect from Physical Therapy when having a joint replaced.

History
For over 100 years surgeons have tried to solve the problem of arthritis of the hip. Early surgeons tried to relieve the pain and debility of arthritis by replacing worn out joints with materials as diverse as steel, ivory and even pig bladders.  The modern version of the Total Hip Replacement (THA) was introduced in the 1960s. Although not as technically advanced as todays THAs some of them lasted more than 35 years.
In the early 1970s, the modern version of the knee replacement was invented. Previous knee replacements were hinged and did not provide good results. The newer version was called a condylar knee replacement meaning that only the diseased surfaces of the joint were replaced, leaving ligaments, muscles and bones intact to function more naturally. Since that time, many improvements have been made and now over 600,000 knee replacements are performed each year in the USA alone.

Why are Joint Replacements So Popular?
There are many reasons for the increase in the number of joint replacements but the number one reason is their effectiveness:
After a successful joint replacement surgery and Physical Therapy, a patient should be able return to all the activities they formerly enjoyed. Also they will not have to take any further medication to control their symptoms.

Why Choose a Joint Replacement?
When conservative treatments like exercise and medication fail to give good relief of symptoms, a patient is referred to an orthopedic surgeon. Joint replacements are elective, which means the patient and their surgeon have some time to decide when to have surgery depending on the individual circumstances.

Unable to tolerate medication
Medications used to treat arthritis can have side effects, and may be hard to tolerate, especially when taken for many years. Patients who have been advised that a joint replacement is inevitable may decide to have surgery sooner to avoid long term use of medication.

Symptoms becoming worse
The discomfort from a diseased joint can make life miserable and tends to become worse as the disease progresses. Patients with a high pain level may decide to have surgery sooner rather than later.

Loss of function
Many people have active lives including work, playing sports and taking care of others. As joint function starts to get in the way of important activities, patients may decide to proceed with surgery.

Age and overall health
Joint replacements are expected to last 15-20 years, so if the patient is young, say 30s or 40’s they may wait until they are older so as not to require another surgery later in life. That being said, some surgeons consider the risk of having two surgeries is acceptable considering the decades of benefit an artificial joint can provide. On the other end of the spectrum, advanced age and other health conditions make surgery more complicated. Older and sicker patients may decide not to have a joint replaced.

What about Physical Therapy?
There is a lot of rehabilitation following a joint replacement. As the body heals from surgery, there is a relatively short window of opportunity to restore strength and function to get the best possible outcome. If you have a joint replacement, you can expect the following:

Hospital Therapy, a Physical Therapist will visit the patient shortly after surgery to get them out of bed to start walking and exercises. Getting up soon after surgery, reduces the risk of complications such as pneumonia and thrombosis. Physical therapy will continue twice a day until the patient is discharged home.

Home Therapy: After leaving the hospital, a Physical Therapist will visit the patient at their home to continue rehabilitation. Also, they will be able to show the patient how to safely get around the home using a walker or a cane.

Outpatient Therapy: As soon as the patient can drive or can get to an outpatient clinic, Physical Therapy will continue in a gym or clinic setting. Outpatient Physical Therapy is more aggressive and focuses on restoring all strength, range of motion and function. Following Outpatient Physical Therapy, patients are encouraged to return to regular activity and follow a home exercise program prescribed by their PT Patients can continue to see improvement in their new joint for up to a year after surgery.

​Questions?
If you are considering a joint replacement and have questions about rehabilitation, we invite you to stop by one of Jones Physical Therapy offices in Hammond LA or Madisonville LA and chat with one of our licensed Physical Therapists. We can advise you on the rehabilitation process and prepare you for a successful outcome.
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