Moger: Joint replacement information

Some considerations to take into account when confronted with joint replacement surgery.

I recently attended a very informative workshop regarding joint replacement surgery presented by Kelowna General Hospital physiotherapist Laura Dyck.

As a fitness instructor and personal trainer working with seniors, I felt it would be helpful information for those considering or on the list for joint replacement surgery.

Here are a few quick stats:

• more women than men undergoing joint replacement

• KGH has five surgeons doing joint replacement surgery

• there were approximately 14 to 15 surgeries per week

• 850 joint replacement surgeries were done at KGH in 2014

There are many indications for joint replacement including congenital or childhood hip problems; acute or old fractures which lead to post-traumatic osteoarthritis; and inflammatory arthritis

About 85 per cent of hip and knee  replacements are due to degenerative osteoarthritis.

Some of the signs that you may need to joint replacement include:

• pain

• decreased activity including exercise and activities of daily living

• physical deformities

• decreased range of motion

• poor sleep pattern

• chronic fatigue or depression

• decreased quality of life

The goals of joint placement include:

• relieving pain

• providing motion

• reacting to a deformity

• realigning of the joint for an improved quality of life

It used to be that a new joint would last 10 to 15 years, but now joint replacements are lasting 20 to 25 years.

Some precautions a  physiotherapist will educate you on following a hip replacement’s three-month post-operative period will include:

• no internal hip rotation

• no hip flexion beyond 90 degrees

• no hip adduction

Some precautions to consider after a total knee replacement include:

• no kneeling or knee bends

• no twisting of the knee

• weight bearing only as tolerated

It’s very important to keep your knees moving as soon as possible so scar tissue does not lay down haphazardly.

Once you’re healed three months plus, the exercise progression for a total hip or knee replacement should focus on muscle strengthening, increasing aerobic capacity, improving balance and gait, increasing range of motion and special attention to functional activities.

After a knee replacement, it is very important to strengthen the quadriceps muscles and also maintaining and progress in the knee flexion and extension.

When it comes to having a hip replaced, it’s especially important to strengthen the hip abductor muscles, including the gluteus medius and minimus.

After receiving joint replacement surgery, staying active and following a specific exercise routine after surgery is important to prevent deconditioning.

“It should be stressed with both hip and knee populations that arthroplasty components are subject to loosening with time,” according to the Canadian Physiotherapy Association recommendations on post joint replacement surgery.

“Compliance with the regular exercise program and joint protection principles will increase the lifespan of the fixation and delay for the need for surgical revision”

It is also important to note that a pre-operative exercise program can greatly improve postoperative outcomes after joint replacement as well.

For more information on joint friendly pre- and post-operative exercise classes on land and in warm water, please call 250-317-3508.