Improving Outcomes for Hip or Knee Replacement Surgery
Is chronic pain and mobility loss causing you to consider a knee or hip replacement? You can take active steps to improve the success of your total joint replacement if you make specific lifestyle changes before the procedure.
When to Consider Total Joint Replacement
Chronic pain can result when the cartilage that lines the ends of the bones becomes worn or damaged from arthritis or fracture. Your orthopedist may recommend total joint replacement if nonsurgical treatments like physical therapy, medication and modified activities fail to relieve your pain and disability.
Knee and hip replacements are the most common joint replacements. However, replacement surgery can be performed on other joints like the wrist, shoulder, elbow and ankle.
Having a Successful Total Joint Replacement Procedure
Matthew Abdel, MD, a Mayo Clinic orthopedic surgeon who specializes in hip and knee replacement, said patients can take an active role in having a successful surgery. Dr. Abdel suggests following these tips to improve the success of a knee or hip replacement:
- Find safe ways to lose weight. Even losing 20 pounds can make a significant difference in the outcome of surgery. Talk to your doctor about your body mass index. Your target body mass index is less than 40 kilograms per square meter (kg/m2).
- Make sure chronic conditions like diabetes are under control. Ask your primary care physician about glycemic control. Your HgA1C should be less than 7.5 before you have hip or knee replacement surgery.
- Do not use nicotine products. Your hip or knee procedure will be more successful if you stop smoking cigarettes and cigars and do not use chewing tobacco at least six weeks before surgery.
- Stop taking narcotics. Cease taking all narcotic pain medication at least 14 days before surgery.
- Reduce or stop using alcohol. Heavy alcohol use can alter the effects of anesthesia.
- Call your doctor about illness. Patients who become ill with a cold, fever or influenza in the days before surgery should contact their doctor.
Obesity, Bariatric Surgery and Joint Replacement
Obesity is one of the highest risks of joint replacement surgery because it increases the likelihood of post-surgical complications like instability and infection. Dr. Abdel and his colleagues conducted a study showing patients who had bariatric surgery to help them lose weight still had significant complications after the joint replacement procedure.
“We think it may have something to do with the bariatric patients’ underlying system, such as their gut microbiome and underlying genetic host variation,” Dr. Abdel said. “Even though they lost the weight, the soft tissues and underlying collagen status were still of their original nature.”
What May or May Not Help Knee or Hip Replacement
Certain changes will not improve the outcome of total joint replacement, like using wound creams, taking vitamins and supplements or using electrical stimulation. Other changes like pre- or post-operative physical therapy may or may not be effective in improving knee or hip replacement outcomes.
Call a Local Orthopedist for Consultation
If you are experiencing persistent joint pain, call your orthopedist. At your appointment, you can discuss options for physical therapy, medication or surgery if necessary.