Knee and Hip Replacement Surgery – preparation and home rehabilitation

Let's make a quick detour. You take your car to the tire shop because the tires are worn out. You get a new set (how expensive depends only on how "premium" you choose).

But on whom does the longevity of the new tires depend the least? The mechanic!

The damage to your tires can be caused, for example, by a worn suspension – even with new tires, they will wear out quickly. If you go to drag races and deliberately burn the rubber on the asphalt... well... no point complaining to the service, because those failures were entirely due to you!

Now compare that to your surgery. In the hospital - if your condition allows - they can replace the worn joint in a few hours. The wound is closed, the effects of anesthesia wear off and you're discharged. "That was the service, and you got the new tire from them!"

From that point on, your recovery no longer depends on the surgical team, nor does how usable your leg will be or whether your old complaints will disappear.

Those things depend on what condition you arrived in for surgery, whether you lost the extra kilos, whether you do the rehabilitation exercises. If you didn't deal with these... well... why would your condition improve?

What determines the success of knee or hip replacement surgery?

Preparation

Numerous studies show that patients who come prepared for surgery achieve indisputably better outcomes.

Think it through: your knee has been tormenting you for years. You move less and less, so your thigh muscles waste away and weaken, joint movements become limited. By the time you have surgery, your knee is collapsing, it's excruciatingly painful, you barely move from your armchair. They do the operation, your wound heals quickly. But you cannot get out of the armchair. Your weakened thigh trembles, your knee buckles, it is unstable, and your gait is uncertain. Months later the situation still hasn't improved.

The stability of joints is provided by the strength of the muscles around them. For the knee, mainly the thigh and calf muscles; for the hip, the thigh, buttock and partly the abdominal muscles surround the joint from the sides, top and bottom. If these muscles are strong, they hold the joint stably.

If before surgery you have already been "resting" those muscles for a long time, if you go into the operation with wasted muscles, if you did not prepare your muscles for surgery, then after the operation they will not be able to support you! In other words, you may have the prosthesis, but you can still move only as limited as before the surgery.

So what makes you prepared?

Essential elements of preparation include starting physiotherapy and physical therapy at least 2–3 months before the operation.

How you will be after surgery depends on the muscles doing the movement — the "pre-existing" muscles you bring into the operation. It is a fact: the stronger the muscles you have at the time of surgery, the faster you will "get back on your feet."

It is often already noticeable in the first hours after surgery if someone paid attention to targeted exercise, physiotherapy or physical therapy beforehand (for example muscle stimulation).

For physiotherapy, consult a physiotherapist or movement therapist, and consider acquiring a muscle stimulation device. With that you can treat yourself in the comfort of your home.

Stimulating the large muscles (e.g. thigh, buttock, abdomen, etc.) with muscle stimulation is not rocket science! The treatment itself is completely risk-free.

Read my article on Application of muscle stimulation in practice. Click here.

Because knee and hip replacement surgeries are generally planned, you usually know the expected date months in advance. In the surgical team, besides the doctors, there is often a preparatory physiotherapist. They will teach you the exercises and inform you how much and at what intensity to perform them.

In some places you may even receive online videos! Nothing could be simpler than starting the video on your computer and doing the exercises.

Surgery

The surgical team therefore works with "what you bring in."

The worse the condition you come in — i.e. the weaker your muscles, the greater your excess weight, the stiffer your joints, the less trained your heart, lungs and metabolism — the higher the surgical risk and the likelihood of complications, and the lower the chance of full recovery.

So if you neglected yourself and did not prepare, then despite excellent surgical performance, the probability of success is inherently lower.

During operations, the less invasive the procedure (that is, the smaller the incision and the less muscle damage caused), the faster the recovery. Generally, surgeries performed with such techniques are more expensive (because they require greater expertise and top equipment).

Rehabilitation

After knee or hip replacement surgery, you are usually "get up" the same day. This happens as soon as the numbness and clumsiness after anesthesia subside, and you have regained clear consciousness and the ability to concentrate.

The professionals directing your rehabilitation will tell you step by step what needs to be done in the coming period. They will inform you about in-hospital group physiotherapy, ways and rules to improve circulation (venous exercises, bandaging, compression stockings, Bemer therapy, etc.).

First you will perform some exercises lying down. Then sitting at the edge of the bed, and after a few minutes practice standing up and walking with a walker.

Within a few hours after surgery you may already be able to walk independently. This can be a very uplifting feeling. The previous pain is gone, you can "put weight on" your leg. You no longer (or only minimally) rely on other people's help.

This ideal state is achievable if you prepared properly!

If you neglected preparation, the rehabilitation period can take many weeks or months.

So it is worth preparing for a planned surgery and paying great attention to rehabilitation.

Doctor or patient. Whose role is more important?

Most patients believe that the success of the surgery depends almost entirely on the surgeon. The medical team's role is very important, but it represents only one — admittedly important and most visible — "slice" of the task.

However, success largely depends on the patient!

If the patient expects the doctor to solve all their problems, they reduce the chances of success. If they properly prepare for the surgery and diligently perform the rehabilitation tasks, they greatly increase the probability of success.