What to Expect after Hip or Knee Replacement

As a surgeon, I continue to be surprised by the number of patients who, after recovering from a knee or hip replacement, tell me that they chose not to consider a hip or knee replacement for a long time because they just didn’t know what to expect. This is commonly followed by patients telling me “I wish I hadn’t suffered with severe hip/knee pain for so long before I finally saw you.” 

It’s natural to be hesitant when considering surgery, but I hate to hear that someone needlessly suffered with hip/knee pain for a prolonged time because of inaccurate perceptions of joint replacement surgery. The best part of my job is knowing that I can offer patients a treatment that is safe and will drastically improve their quality of life. 

Part of our job as surgeons is to accurately inform patients about the non-surgical and surgical options available to treat their hip/knee pain and allow patients to choose the treatment that is right for them, armed with that accurate information. 

Below are common misconceptions and fears many have surrounding hip/knee replacement and what you can really expect following the surgery:  

Pain

The most common reason people defer joint replacement is because they believe it’s going to be too painful. Pain control after joint replacement has seen drastic improvement over the last decade and we now utilize multimodal pain control; which is the means of choosing multiple medications and pain treatments that all work together to manage post-operative pain. Post-operative pain is well controlled, resolves quickly and does not interfere with recovery when these techniques are utilized. Ultimately, the goal of joint replacement is to eliminate pain and the vast majority of patients reach this goal. 

Recovery

We have found that patients who have prolonged stays in the hospital or nursing homes after joint replacement generally have higher complications and worse outcomes. We now use rapid-recovery protocols to get patients moving and walking immediately with improved pain control, allowing patients to go home quickly after surgery. Of course, each patient is different and a discussion with your surgeon will determine the most appropriate plan for you after surgery. 

Activity

A main goal of joint replacement is to return patients to a level of activity that improves their quality of life. The limitations that patients face immediately after surgery due to swelling, pain, healing of the incision are short-lived. Once past the immediate recovery of surgery, patients are expected to return to normal activities of daily living - getting dressed, climbing stairs, etc - and progress to those activities that they enjoy (walking, cycling, golf, and other recreational activities). Most patients return to pain-free, unrestricted activity after joint replacement. 

Complications
 
While complications can occur with any surgical procedure, joint replacement has entered a period of historically low complication rates and exceptionally high success rates. This is due to many factors, but a major factor is careful evaluation of patients prior to surgery and optimizing each patient specifically to reduce their risk. Additionally, many surgeons are fellowship trained (an extra year of training in joint replacement) to utilize techniques and pathways that contribute to risk reduction and improved outcomes. Of all surgical procedures performed in the U.S., hip & knee replacement are among the safest and highest in success, drastically improving patients’ pain and quality of life. 

Age

Many patients fear that their age makes them a poor candidate for joint replacement. While age can play a role in many aspects of joint replacement, age alone is typically not a reason to exclude patients from joint replacement. Younger patients considering joint replacement have different considerations than more elderly patients. Discussion with a joint replacement surgeon can address the specific aspects of your care that are influenced by age. 

COVID-19 

A recent unique issue is the effect the coronavirus pandemic has had on scheduling elective surgery, including joint replacement. Despite the challenges the healthcare system has faced during the pandemic, most facilities have developed safe and effective processes to allow for safe elective surgery. This typically includes following CDC guidelines, use of Personal-Protective Equipment (PPE), pre-operative COVID-19 testing, minimizing the length of stay in the hospital/nursing facility, separating COVID patients from others in the hospital, and careful planning of orthopaedic surgery to allow a safe return to performing joint replacements. 

While there are many things to consider before deciding to proceed with a joint replacement, I hope that this information is helpful in giving realistic expectations for recovery after joint replacement surgery. My final recommendation is to find a surgeon that you are comfortable with, who will listen to you, and will help choose the right treatment for you at the right time. 

Dr. Andrew Pepper is a joint replacement surgeon and will begin seeing patients in Spring 2021. To schedule an appointment with Dr. Pepper, please call 844-407-4070.