Recovery after Total Knee Replacement in Arizona

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Each year, thousands of people undergo total knee replacement (TKR) surgery. This procedure is done to replace damaged portions of the knee, including cartilage and bone ends. The most important part of surgery is the recovery.

Hospital Recovery

  • Bandages/drains – The knee will have a bulky elastic bandage dressing on it. Depending on the situation, some patients have a small drain inserted at the surgical site to remove excess blood and fluid that accumulates. The bandage is removed 1-2 days after surgery, and the drain is usually removed within 3 days of surgery.

 

  • Incisions – The incisions must be kept clean and dry. Sutures or staples are removed in 7-14 days.

 

  • Continuous passive motion (CPM) – A CPM machine is used to move the knee in physical therapy1regular motion. This helps the knee regain flexion.

 

  • Activities – Nurses will help you get out of bed and back in bed while in the hospital. You are encouraged to walk to the bathroom using a walker, crutches, or cane.

 

  • Deep breathing – After surgery, you must perform deep breathing exercises to rid your airway and lungs of mucus. This involves taking several deep breaths every hour.

 

  • Physical therapy – The physical therapist works with you to improve range of motion and strengthen muscles. The therapist assists with sitting at bedside, transferring in and out of bed safely, climbing stairs, walking with a cane or walker, and performing exercises without the CPM.

 

  • Pain management – The nurses will administer pain medicine to keep you comfortable.

 

Home Recovery

  • Preparation – Before going home, you need to arrange for a ride home, and have someone available to help you for a few days. It is a good idea to have plenty of gauze and tape ready, as well as pre-made meals, ice, and water. You will need to have a recliner or an ottoman so you can elevate your leg. In addition, you should remove all loose cords and rugs from walkways.

 

  • Physical therapy – The therapist continues to work with you after you go home. As the days progress, you will increase your frequency and distance of walking. Most patients are on a straight cane within 3-5 days of surgery.

 

  • Pain management – To control pain, take prescribed medications before pain gets too severe. In addition, avoid any alcoholic beverages while you are taking these medicines. We recommend taking pain medicine at least 45 minutes before physical therapy sessions, so the medicine will take effect.

 

Dos and Don’ts after Knee Replacement Surgery

 

  • Do position the knee comfortably as you perform daily activities.
  • Do use an ice pack if swelling occurs.
  • Do walk and perform range of motion exercises each day.
  • Do elevate the leg often to reduce swelling.
  • Don’t twist the knee.
  • Don’t jump or put any sudden stress on the knee.
  • Don’t put a pillow under the knee.

 

Fast-Track Recovery Protocol

 

During the last decade, many medical facilities have implemented fast-track protocols for total knee replacement. A fast-track protocol will reduce the length of hospital stay.

 

In a recent study involving fast-track recovery, researchers evaluated patients during the first 6 weeks after total knee replacement. They found that 28 of the 30 study participants were satisfied with a short hospital stay. It was determined that quality of life at 6 weeks discharge was the same for fast-track patients as those who stayed longer at the hospital.

OSPI in Gilbert AZ offers top knee replacement surgeons providing rapid recovery procedures. Most insurance is accepted, call today!

Resources

Van Egmond JC, Verburg H, & Mathissen, NMC (2015). The first 6 weeks of recovery after total knee arthroplasty with fast track. Acta Orthop, 86(6), 708-713.

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Overview of Partial Hip Replacement

Partial Hip Replacement in Gilbert AZ

 

With a partial hip replacement, also called a hemiarthroplasty, only the patients femoral head (top of thigh bone) is replaced. The prosthetic component will rotate in the natural hip socket. This procedure is used for patients who do not need replacement of the joint ModularEndoprosthesissocket (acetabulum).

How is the partial hip replacement different from total hip replacement?

The partial hip replacement surgery is less invasive than total hip replacement. With the partial procedure, only the ball of the femur must be replaced, and the joint socket is left alone. This surgery is used for patients who require replacement of the femoral head.

What are the reasons for a partial hip replacement?

Breaking or fracturing a hip can lead to breaks through the femur, which often displaces the femoral head. When the fracture occurs within the hip joint, it is called a femoral neck fracture. The upper portion of the femur is surrounded by muscle, and it has better blood supply than the neck. The partial hip replacement is used to repair damage that occurs after these injuries. A fracture of the femoral head or neck can lead to significant pain and loss of normal function.

Usually, patients who are good candidates for a partial hip replacement are those who have no significant underlying arthritis and people with healthy cartilage. A partial hip replacement is seldom used for patients with serious hip damage. Another use of a partial hip procedure is to repair damage in patients who already have a total hip replacement.

Can elderly people have this procedure?

uncemented-bipolarIntracapsular fractures of the femur account for the majority of fractures in older patients. The goal of surgery is to return the patient to his/her pre-fracture functional state. Partial hip replacement was studied in older people in a recent clinical study. Researchers found that all study participants returned to their pre-fracture level of activity after the procedure. In addition, they found that hemiarthropasty was a viable option for people age 70 years and older.

How do I prepare for surgery?

Before hip surgery, you need to arrange someone to drive you home from the hospital, and have someone ready to stay with you for a few days. You will need to prepare your home for discharge. Some things to do include:

  • Remove all loose cords and rugs from walking areas.
  • Secure safety handrails in bath/shower and along stairways.
  • Have pre-made meals and drinks available.
  • Have a firm recliner chair or chair with ottoman.
  • Purchase a raised toilet seat.

What can I expect during recovery?

After a partial hip replacement, a nurse monitors you in the recovery room for 45-75 minutes. Once you are stable and awake, you will be moved to a room or discharged home. Discharge depends on your unique situation, your health status, and the surgeon’s preference. You may need to stay in the hospital for 1-2 nights. You will begin passive range of motion exercises with the help of a physical therapist, and nurses administer pain medications to ease postoperative pain.

Once you are home, you must keep the incisions clean and dry, and avoid soaking in a tub or pool until wounds are healed. Expect to use a walker or crutches for a few days. Physical therapy is used to improve hip strength, flexibility, and range of motion. The Mesa orthopedic surgeon encourages frequent movement to prevent blood clots and improve recovery.

The top orthopedic surgeons in Arizona are at OSPI, serving Mesa, Gilbert, Chandler, Tempe, Queen Creek and surrounding areas. Call today!

Resources

Marya SKS, Thurkral R, & Singh C (2008). Prosthetic replacement in femoral neck fracture in the elderly: Results and review of the literature. Ind J Orthop, 42(1), 61-67.

FAQs on Total Hip Replacement

If you suffer from hip pain, stiffness, and limited physical activities, you may need a total hip replacement. When the hip is damaged from a fracture, long-standing arthritis, or other conditions, the cartilage wears away and pain occurs. Hip replacement surgery is a successful surgery for improving functionality.

What are the reasons for getting a hip replacement?

The decision to have a total hip replacement (THR), also called total hip arthroplasty (THA), is made by you in conjunction with your primary care doctor, your family members, and your orthopedic surgeon. There is no age or weight restrictions for canstockphoto13092914this procedure, and most patients are 50-80 years old. This surgery may be for you if you have:

  • Hip pain that affects everyday activities, such as bending or walking.
  • Hip pain that occurs at rest, and often interferes with sleep.
  • Hip stiffness that affects the ability to move or lift the leg.
  • Pain that continues in spite of usual therapies (medicines, physical therapy, and injections).

What causes hip pain?

The most common causes of chronic hip pain and disability are:

  • Osteoarthritis – This involves wearing away of protective cartilage that covers the bone ends. Without adequate cartilage, the bones rub against one another, which leads to stiffness and pain.
  • Rheumatoid arthritis – This autoimmune disease causes synovial membrane (joint lining) inflammation and damage to the cartilage. The recurrent inflammation permanently damaged the joint.
  • Post-traumatic arthritis – After a hip fracture or injury, the cartilage is damaged, which leads to chronic hip pain.
  • Avascular necrosis – Any injury to the hip can limit blood flow to the head of the femur (thigh bone). A dislocation or fracture can lead to avascular necrosis, where the lack of blood causes the bone to collapse.
  • Childhood hip disease – Some infants are born with hip problems. While the hip conditions are treated during childhood, they may cause arthritis later in life.

What happens during the total hip arthroplasty?

During the hip replacement procedure, the damaged cartilage and bone are removed and replaced with artificial components (called prostheses). The steps include:

  • Replacing the femoral head – The damaged upper portion of the femur is removed and replaced with a metal stem. The prosthesis is placed into the center of the femur and either “press-fit” into the bone or cemented there. A metal or ceramic ball is used to replace the femoral head.
  • Replacing cartilage surface of socket – The hip socket is called the acetabulum, and it is removed and replaced with a metal socket. Screws or cement is used to hold this component in place.
  • Inserting the spacer – A ceramic, metal, or plastic spacer is positioned between the new femoral head (ball) ad socket. This allows for a smooth gliding motion.

What home planning should I do?

Before having a total hip replacement, you should arrange to have someone drive you home from the hospital. In addition, you may need someone to stay with you for a few days. The following items can help you with activities after surgery:

  • A raised toilet seat
  • Securely fastened handrails in bath or shower
  • Handrails along stairs.
  • Reclining chair or stable chair with ottoman
  • Long-handled sponge
  • Shower hose
  • Shower chair
  • A “reacher” that lets you grab objects
  • Firm pillows

What can I expect during recovery?

You may need to stay in the hospital 1-3 nights. The nurses will work with you to control pain, and a physical therapist starts to work with you to help you learn exercise to improve hip flexibility and mobility. The orthopedic surgeon wants you to get up and walk around (with help) as soon as possible. You should be able to resume normal activities within 3-6 weeks after surgery. Sutures or staples will be removed 7-14 days after your surgery. You must avoid getting wounds wet, and use bandages to prevent irritation to the wounds.

Do THA procedures work?

Total hip arthroplasty has been proven to decrease pain and increase function in persons with severe hip arthritis. In one clinical study, researchers evaluated THA in people who are in their 80s. They found that 80% of study participants were pain-free after recovering from surgery, and could walk without assistance at the follow-up. They concluded that total hip replacement was safe and effective for elderly people.

The top hip replacement doctors in Arizona are with OSPI. They offer anterior approach procedures that are available outpatient or next day going home. Call us today!

 

Recovery after Carpal Tunnel Surgery

carpal tunnel syndrome2

One of the most common operations done today is carpal tunnel surgery. The goal of surgery is to relieve pressure on the median nerve. For many patients, improvement is noticed right away. For other patients, the pain stops, but full recovery of sensation is not always possible.

What will my sensation and strength be like after surgery?

Most patients describe a tingling or numbness after the carpal tunnel procedure. The return of sensation depends on severity of nerve compression, duration of symptoms, general health, age, and circulation. In severe cases, decompressing the nerve may not help gain full recovery of sensation. There are many reasons why the hand with carpal tunnel does not feel as strong as the other hand. This is often related to decreased sensation, which improves after carpal tunnel release. While some muscle recovery is likely after surgery, it is not always possible to regain full function.

What can I expect immediately after surgery?

After carpal tunnel surgery, you will be in a small surgical dressing with a piece of plaster splint in place along the wrist. Most of the palm and fingers are free, however. A nurse monitors you in the recovery room before you are discharged home. You will feel some soreness and numbness of the affected region. You will return to the doctor’s office in 4-7 days to have the surgical dressing removed. If sutures are present, they are also removed.

What happens to the cut ligament after surgery?

After carpal tunnel surgery, the cut ligament heals, filing in the gap with new tissue. By preserving normal palmar tissue, less new growth of tissue fills in, which makes your palm feel normal.

Can I use my hand right away?

After your carpal tunnel surgery, you are encouraged to use your hand immediately, especially your fingers. You will have a dressing on the area, which must be kept clean and dry. For showers, you should cover the area with a plastic bag.

How long does it take to heal?

The time of healing varies from patient to patient, as no two people are alike. However, most people can perform light activities in 1-2 weeks, and heavy activities within 4-6 weeks. Most people only are off from work for 5-10 days. While you may feel better early on, it is advisable not to overdo it, as this may delay a full recovery.

Will I be in a lot of pain?

Many people report that recovery from carpal tunnel surgery is not painful, and they get by taking only over-the-counter pain medicine, such as Advil or Aleve. However, the surgeon will give you a prescription for pain medicine to ease your discomfort. If you take care of your hand and wrist, your pain will be minimal.

Will I need physical therapy?

Physical therapy is used to relieve palm stiffness and discomfort. The therapist works with you through range of motion exercises and helps you perform flexibility and strengthening activities.

What can I expect immediately after surgery?

After carpal tunnel surgery, you will be in a small surgical dressing with a piece of plaster splint in place along the wrist. Most of the palm and fingers are free, however. A nurse monitors you in the recovery room before you are discharged home. You will feel some soreness and numbness of the affected region. You will return to the doctor’s office in 4-7 days to have the surgical dressing removed. If sutures are present, they are also removed.

What can I do to relieve pain and recover sooner?

Hand exercises with a stress ball are important in the first few days after surgery. Be careful to not overdo this, however. Gradually increase your tolerance for squeezing and gripping, and move your finger often to avoid stiffness and tendonitis. You may benefit from use of a cool splint, which protects the area while providing reduction of swelling.

OSPI offers top orthopedic surgeons in Gilbert AZ who offer all types of general orthopedics, carpal tunnel release, joint replacement and more. Call us today!

What you need to Know about a Total Knee Replacement

A total knee replacement, also called a knee arthroplasty, involves resurfacing and replacing portions of the bones. The decision to have a total knee replacement is made between you, your family, and your orthopedic surgeon.

The Four Steps of a Total Knee Replacement

There are four basic steps to a total knee replacement procedure. These are:

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  • Prepare the bone – The damaged cartilage surfaces at the ends of the tibia and femur are removed along with a small amount of underlying bone tissue.
  • Position the implants – The removed bone and cartilage are replaced with prosthetic components that recreate joint’s surface. These parts are cemented, or press-fit components are used that grow into the bone.
  • Resurface the patella – The undersurface of the kneecap is cut and resurfaced with a plastic button.
  • Insert a spacer – A medical-grade plastic spacer is inserted between the prosthetic components to create a smooth gliding surface.

Candidates for a Total Knee Replacement

People who will benefit from a total knee replacement include those with:

  • Severe knee pain and stiffness that affects mobility and everyday activities, such as climbing stairs, walking, and risking out of chairs.
  • Moderate to severe knee discomfort with resting.
  • Chronic knee swelling and inflammation that doesn’t improve with medications or rest.
  • Knee deformity, such as bowing out or in of the knee.
  • Inability to improve after conventional treatments (physical therapy, medications, and cortisone injections).
  • Age of 50-80 years.

Orthopedic Evaluation

When you visit the orthopedic surgeon, an evaluation is done. This involves:

  • A medical history – The surgeon gathers information about your past and present conditions and surgeries.
  • Physical examination – This involves assessing the knee motion, strength, stability, and overall leg alignment.
  • X-rays – These images determine the extent of damage and deformity in the knee.
  • Other tests – Includes blood tests, MRI scans, and CT scans.

Preparing for Surgery

The orthopedic surgeon and you will schedule your total knee replacement after reviewing the procedure risks and benefits with you. Several tests are used to determine surgical fitness, including an electrocardiogram, laboratory tests, and urine evaluation. You need to notify the doctor of all your medications, as certain agents that thin the blood must be held for several days.

 

If you live alone, you need to make arrangements to have someone assist you when you come home from surgery. In addition, you should make some modifications to your home. The following items may help with daily activities:

 

  • Secure handrails on stairways
  • Safety bars in the bath/shower
  • A raised toilet seat
  • A stable shower chair
  • A stable chair with a firm seat cushion, a footstool, and a firm back
  • Removing all loose rugs, carpets, and cords

 

The Surgery

 

You will be given general anesthesia, which means you will be asleep and in no pain. After numbing the knee structures to help with post-operative pain, the surgeon makes incisions around the knee. If an arthroscope is used, a small camera and surgical tools are inserted into the incisions. The damaged bone and cartilage are removed, and then new metal and/or plastic implants are positioned. After making all resurfacing changes, the incisions are closed with sutures.

 

After Surgery

 

After the total knee replacement procedure, you are monitored in the recovery room for several hours. Once you wake up, you are moved to a hospital room. Most patients only stay overnight at the hospital, but this depends on your health status, the procedure, and the surgeon’s preference. Rehabilitation begins while you are in the hospital. A physical therapist works with you to help move the nee, and teaches you exercises to restore knee movement, flexibility, and strength.

 

Exercise is an important aspect of home care, especially during the first couple of weeks after total knee replacement. You gradually are able to resume normal activities of daily living, and advance to more rigorous activities after 3-6 weeks.

FAQs on Outpatient Knee Replacement (Rapid Recovery)

Outpatient joint replacement surgery does not require an overnight stay at the hospital. This procedure is known as a rapid recovery surgery, which means the patient is back to usual activities soon after the surgery.

What is knee replacement surgery?

Outpatient knee replacement surgery is a surgical procedure in which the damaged, worn joint surfaces are removed and replaced with artificial components (prosthesis). This rapid recovery procedure is done on an outpatient basis, allowing the patient to go home soon after the surgery.

Who is a candidate for rapid recovery knee replacement surgery?

Your doctor may consider this knee replacement procedure if you:

  • Have severe pain that limits your daily activities
  • Suffer pain that is not relieved with physical therapy, medications, and knee injections
  • Have an active lifestyle that requires you to be on your feet
  • Are in relatively good health otherwise
  • Have a high level of motivation during the rehabilitation process
  • Good family support

What are the benefits of rapid recover knee replacement surgery?

The benefits of outpatient knee joint replacement surgery include:

  • No overnight hospital stay
  • Earlier mobilization
  • Rapid recovery
  • Fewer complications
  • Improved pain scores
  • Increased patient satisfaction

How do I prepare for the rapid recover knee replacement procedure?

Before surgery, the doctor will do some preliminary tests and have you hold certain blood-thinning agents for several days. You should arrange to have someone drive you home, and leave all valuables at home. When you arrive at the surgical center, a nurse explains the procedure, and you must sign a consent form. After changing into a procedure gown, the nurse places an IV catheter in your arm.

How is the rapid recovery joint procedure performed?

The rapid recovery knee replacement procedure is performed almost the same as traditional joint replacement surgery. Smaller incisions and less tissue manipulation allows the patient to recover at home instead of in the hospital. The procedure is done under general anesthesia. The surgeon makes 1-2 small incisions, removes damaged joint components, and inserts the prosthesis. After making necessary repairs, the incisions are closed with sutures.

What can I expect after the procedure?

You will be monitored in the recovery area for around 1 hour. After being discharged, a nurse comes to the patient’s home to monitor the condition, and a physical therapy visits several days a week to instruct the patient on flexibility and range of motion exercises. We emphasize ambulating and weight-bearing as tolerated with a cane or single crutch. Pain medications are only to be used as needed, and we stress the use of short-term anti-inflammatory drugs.

What do the research studies show?

A group of researchers studied the safety and feasibility of outpatient knee replacement surgery in a group of individuals with unicompartmental knee osteoarthritis. All 105 patients (100%) were discharged on the same day of surgery, and none of them required readmission to the hospital. The researchers concluded that rapid recovery knee replacement was a feasible, safe procedure for the majority of patients.

In a review of 4,500 total hip and knee replacements, researchers found that following a strict multimodal enhanced recovery protocol reduced the 30-day death rate, length of hospital stay, requirements for blood transfusion, and chance of heart attack, stroke, and pulmonary embolism. The protocol involved behavioral, procedural, and pharmacological modifications, such as use of certain medications before surgery and physical therapy after surgery.

Resources

Cross MB & Berger R (2013). Feasibility and safety of performing outpatient unicompartmental knee arthroplasty. Int Orthop, 38(2), 443-447.

Malviya A, Martin K, Harper, I, et al. (2011). Enhanced recovery program for hip and knee replacement reduces death rate: A study of 4,500 consecutive primary hip and knee replacements. Acta Orthop, 82(5), 577-581.

How is an Outpatient Joint Replacement Possible?

Outpatient total joint replacement, also called total joint arthroplasty (TJA), is now being performed in the U.S. at many medical facilities. These surgeries are only done on people who are healthy and have a high motivation during the recovery period. Orthopedic surgeons all agree that outpatient rapid recovery joint preplacement is the wave of the future.

Who is a candidate for outpatient joint replacement surgery?

Your primary care physician should agree that you are medically able to tolerate the outpatient procedure. In addition, the orthopedic surgeon must deem you a suitable candidate for the surgery. Optimal candidates include:

  • Those persons in fairly good health.
  • Anyone with mild-moderate joint damage.
  • People who are motivated during rehabilitation.
  • Persons with a supportive family.

What are the advantages of the outpatient total joint arthroplasty procedure?

The benefits and advantages of rapid recovery outpatient joint replacement include:

  • Reduced chance of hospital-acquired infections
  • Reduced hospital stay
  • Increased patient satisfaction
  • Reduced cost to the healthcare system

When did outpatient joint replacement become a possibility?

Over the last 20 years, new protocols regarding arthroplasty have allowed for a decreased length of stay in the hospital. These pre- and post-operative protocols, along with improved surgical techniques, make going home soon after the procedure a realist option.

What is involved in the outpatient joint replacement protocols?

A successful rapid recovery joint replacement procedure involves:

  • Orthopedic assessment – This consists of a medical history and comprehensive physical examination. It is important for the surgeon to motivate the patient and explain the home situation.
  • Preoperative medical clearance – This decreases risks and complications following the orthopedic surgery. The patient must undergo certain laboratory and diagnostic tests to assure he/she is able to undergo the procedure.
  • Preoperative physical therapy assessment – This allows the physical therapist to educate the patient regarding what to expect after the surgery. This involves how to use crutches or a cane, how to move the surgical extremity, and exercises to help with range of motion and flexibility.
  • Preoperative education – This is done to reduce fears and anxiety. The doctor informs the patient about the procedure, expected pain management protocols, and what to do at home. Reading material is given to help further educate the patient about the procedure and post-surgical recovery period.
  • Analgesia – The anesthesiologist makes the patient comfortable before and during the procedure. For a total joint replacement surgery, the patient will receive pain medications to control pain after the procedure.
  • Rapid rehabilitation pathway – This is started immediately after the procedure, and patients have the option to go home the same day. This involves following rehabilitation protocols set by the operating surgeon.

What is the success rate for outpatient total joint replacement surgery?

In a recent study, 181 patients reported decreased pain scores following surgery. The procedure improved range of motion in the patients’ knees and enhanced quality of life. Furthermore, the success rate of the procedure is around 97%, with the majority of patients reporting high satisfaction with their surgical experience.

Is the rapid recovery joint replacement surgery cost effective?

One of the main reasons for outpatient surgery is reducing costs after surgery. In a recent study, researchers examined costs with outpatient joint replacement compared to traditional surgery. They found a reduction in cost by around $8,000 based on non-itemized bills.

Resources

Aynardi M, Post Z, Ong A, Orozco F, Sukin DC. Outpatient surgery as a means of cost reduction in total hip arthroplasty: a case-control study. HSS J Musculoskelet J Hosp Spec Surg. 2014;10(3):252-255. doi:10.1007/s11420-014-9401-0.

Berger RA, Sanders SA, Thill S, et al. (2009). Newer Anesthesia and Rehabilitation Protocols Enable Outpatient Hip Replacement in Selected Patients. Clin Orthop Relat Res, 467(6), 1424-1430.

Lovald ST, Ong KL, Malkani AL, et al. Complications, mortality, and costs for outpatient and short-stay total knee arthroplasty patients in comparison to standard-stay patients. J Arthroplasty. 2014;29(3):510-515. doi:10.1016/j.arth.2013.07.020

Smith, A.J., Wood, D.J, & Li, M. G. (2008). Total knee replacement with and without patellar resurfacing: a prospective, randomized trial using the profix total knee system. Journal of Bone and Joint Surgery, 90(1), 43-49.

FAQs on Outpatient Hip Replacement (Rapid Recovery)

Rapid recovery outpatient hip replacement surgery is fast becoming a common orthopedic procedure. This surgery involves the replacement of damaged hip joints with metal or plastic parts (called prosthesis). With advanced, proven-safe techniques, it is now possible to perform this procedure on an outpatient basis.

Is this surgery common?

Total joint replacement surgery will increase during the next decade, with 80 million baby-boomers coming of age. This means around 1 million total joint replacements will be performed in the U.S. each year.

How is the outpatient procedure different than traditional surgery?

Outpatient rapid recovery hip replacement surgeries use the same implants as traditional surgery, but involve smaller incisions and new exposure techniques compared to traditional procedures. This type of procedure is less invasive to the bones and tissues involved, and allows the patient to go home the same day instead of staying overnight.

Who is a candidate for outpatient hip surgery?

The rapid recovery hip replacement procedure is less invasive to the bones and tissues, involving a much shorter hospital stay. It is indicated for:

  • Damage to the hip due to autoimmune disease or accidents
  • Erosion of the joint cartilage
  • Bone death that leads to destruction of cartilage
  • Persons who are motivated during the rehabilitation process
  • People who are in good health

How is the outpatient hip replacement surgery done?

The patient is put out with general anesthesia. The surgeon makes 1-2 small incisions to make necessary repairs. The tendons and muscles are separated to expose the femoral head (thigh bone top) and the hip socket. Lesser tissue movement is involved. The stem and ball prosthetics are fitted into the joint once the hip socket is cleaned. The hip then can be rejoined with the surrounding tissues brought back to normal position. Because the incisions are small, there is less tissue trauma, allowing for a faster recovery.

What are the benefits of the rapid recovery hip replacement procedure?

The benefits include:

  • Less scarring
  • Smaller incisions
  • Less blood loss
  • Shorter hospital stay
  • Shorter recovery period
  • Less tissue trauma
  • Earlier return to work

How is pain controlled during the procedure?

The first stage of pain control begins before the procedure. The patient receives medications that are already working when the patient awakens after surgery. The second stage of pain control occurs during the procedure. The patient is given an anti-inflammatory medicine into the hip tissues, as well as a long-acting local anesthetic. The final stage of pain control is following surgery where the patient receives medicines that target different pain pathways to minimize the use of narcotic agents.

What can I expect after the rapid recover hip replacement procedure?

Following the outpatient procedure, you will be monitored by a nurse for around 1 hour. Once you are stable, you are discharged home, where a nurse comes to visit you. A physical therapist will work with you on range of motion and flexibility activities soon after arriving home.

How effective is rapid recovery hip replacement?

The success rate of hip replacements for 10 years is around 95%, according to studies. For 20 years post-procedure, the success rate is around 85%. In a study involving 150 same-day hip surgery patients, all but 6 patients were highly satisfied with their experience (a success rate of around 97%). Overall, most same-day procedures offer a cost-effective, safe alternative to traditional hip replacement surgery.

Resources

Berger RA, Sanders SA, Thill ES, Sporer SM, Della Valle C. Newer anesthesia and rehabilitation protocols enable outpatient hip replacement in selected patients. Clin Orthop. 2009;467(6):1424-1430. doi:10.1007/s11999-009-0741-x.

3 Top Ways an Orthopedic Doctor Can Help You through the Pain

Orthopedic doctors treat injuries and diseases that affect the musculoskeletal system. After they diagnose your injury or disorder, they’ll create a treatment plan that could include medicine and/or surgery. They may also recommend physical therapy to restore movement, and function to your body and to prevent further issues.

Orthopedic doctors help you overcome pain, compromised functionality, fatigue and anxiety. Here are the top ways an orthopedic doctor helps you through the pain.

Treat Multiple Problems

Experienced orthopedic doctors offer a wide range of treatment and care related to all forms of orthopedic problems involving the shoulder, elbow, hand, wrist, hip, knee, ankle, leg, and foot.

Offer Several Solutions

The best orthopedic doctors provide a wide range of solution for all musculoskeletal problems. That includes –

  • Complete joint replacement of the ankle, knee, hip, or shoulder
  • Arthroscopic surgery for the knee, ankle, shoulder, or elbow
  • Surgical procedures related to fractures
  • Treatment of sports injuries resulting in damage to cartilage, ligaments, or bones
  • Carpal tunnel syndrome treatment through endoscopic carpel tunnel release surgery
  • Anterior approach hip replacement procedures
  • Joint restoration surgery

Patient Centric Approach

Orthopedic doctors know that for the patient and their family, procedures such as surgery, can produce anxiety, confusion, and insecurity. That is why they adopt a patient centric approach and customize the treatment plan keeping your specific condition, symptoms and state of health in mind.

To know more about how orthopedic doctors help you through the pain, call OSPI Arizona at 480-899-4333.

FAQs on Accelerated Rehab after ACL Reconstruction

Accelerated rehab after (ACL) anterior cruciate ligament reconstruction offers significant benefit to younger, active adults and athletes, who cannot afford prolonged downtime.  Customized to individual patient needs, it helps in rapid recovery, faster recuperation, less discomfort, and quick return to training.

What is accelerated rehab?

Accelerated rehab refers to faster recovery and post-surgical recuperation without compromising the healing process. It accelerates the restoration of the full movement of the knee and its biomechanical strength allowing return to work sooner than traditional rehabilitation ensures.  The recovery duration is almost halved.

The key element of accelerated rehab is the reduced recovery time after ACL reconstruction.  The rehabilitation regimen in designed in such a way that it provides all benefits of traditional post-surgical rehab, but with significantly reduced downtime.

Patients are able to achieve full functional movement of the knee as soon as possible without any risk of future reinjury or compromise with their physical safety.

What is ACL reconstruction?

The anterior cruciate ligament or ACL prevents extreme, inward twisting of the knee joint and ensures its stability. However, excessive load or stress, too much landing pressure, sudden knee maneuver, forceful contact, excessive knee joint twisting, or sudden change of direction ruptures or damages the ligament. This leads to restricted knee mobility and pain requiring surgical reconstruction of the ligament.

ACL reconstruction involves rebuilding of the damaged ligament. The torn ligament is removed and a new ligament is rebuilt from tissue harvested from patellar or quadriceps tendons.

What is the need for a structured post-ACL reconstruction rehab?

Rehabilitation after ACL reconstruction is key to restore the lost knee joint structural and functional strength and avoid the risk of reinjury. It helps reduce inflammation, increase biomechanical motion in an orderly manner, and restore optimum knee joint agility and strength equal to the uninvolved knee and with focus on patient safety and freedom from injury. This also provides psychological boost to reinforce physiological attributes to lead an injury-free life and have better muscle leg control.               

Why should I go for accelerated rehab after ACL reconstruction?

Going for accelerated rehab after ACL reconstruction offers a number of benefits, including

  • faster recovery
  • reduced post-surgical downtime
  • career saving for athletes , as they are able to return to sports
  • best suited for young people undergoing ACL reconstruction
  • progressive approach to post-ACL surgery rehab
  • improved final outcome in lesser time frame recovery
  • return to excellent stability and strength and full range of motion and function in quickest possible time
  • custom-made rehab protocol ensures low chance of postoperative complications, such as knee joint pain and stiffness
  • maximum outcome following ACL reconstruction

 

How good is accelerated rehab compared to traditional rehab?

Researchers suggest a number of benefits associated with accelerated rehab after ACL reconstruction when compared to traditional rehab. It assures early healing, faster muscle activation, reduced time for rest and recuperation, and faster return to work. The recovery time is almost halved allowing athletes to resume their career without any difference in long-term knee joint stability offered by traditional rehab.

Accelerated rehab ensures early knee muscle control. Studies indicate such early control is vital to regain complete quadriceps muscle strength without any flaw. The multi-modal approach of accelerated rehab ensures early pain relief and decreased dependent on painkillers.

A Spanish study links accelerated rehab after ACL reconstruction to greater muscle force, faster compensation for muscle atrophy, reduced hamstring muscle strains, and better muscle isokinetic performance. This plays a crucial role in subduing swelling, allowing enhanced knee agility and strength, and providing good range of movements.

According to a 2011 study reported in the American Journal of Sports Medicine, accelerated rehab after ACL reconstruction produce same benefits as traditional rehab while reducing the downtime considerably. Functional performance, knee strength, and proprioception achieved by accelerated rehabilitation are no way inferior to non-accelerated rehab.

How is a regimen for accelerated rehab after ACL reconstruction developed?

Accelerated rehabilitation after ACL surgery takes into cognizance three factors – the actual condition of a patient, the surgical process, and the ability to cope with accelerated rehab. Based on these considerations, a customized, scientific, and multi-modal regimen is developed. The approach focuses on early healing, rapid recovery, swift regaining of knee strength, faster return to normalcy, and prevention of reinjury.

What are important components of accelerated rehab after ACL reconstruction?

  • Advanced pain management
  • Progressive rehabilitation to help patients up and moving sooner than expected
  • Comprehensive and customized planning and education
  • Early discharge and post-operative care
  • Rapid Recovery coaching
  • Expert orthopedic guidance
  • Regular follow-up

What does accelerated rehab after ACL reconstruction include?

Accelerated rehabilitation after ACL reconstruction is a multi-faceted approach that includes several techniques to ensure rapid and swift recovery.

When should I join accelerated rehab?

Accelerated rehabilitation begins at the pre-surgery stage. Pre-surgical conditioning is provided to ensure that there is no need for extended downtime after the ACL reconstruction and patients experience minimum pain, regain maximum knee stability, get up and moving soon after the surgery, and respond positively to the rapid recuperation techniques.

During the surgical process, procedures that assure fast recuperation and early return to normalcy are preferred over more invasive ones.

 

How is accelerated rehab after ACL reconstruction performed?

 

Accelerated rehabilitation starts immediately after ACL reconstruction as soon as the patient wakes up in the recovery room. Long-acting anesthetic and anti-inflammatory medication administered to tissues surrounding the knee to block pain pathways and allow the patient to start rehab right from the recovery room without feeling pain. This also minimizes the dependence on narcotic painkillers and reinforces the ability to join the rehabilitation.

 

A combination of physiotherapy, medication, nutrition, and other non-medical therapies is used to lessen complications and fatigue while fast tracking recovery, restoration of knee joint strength, and recuperation. The rehab process continues during the hospital stay and even after the patient is discharged under expert supervision. Continued follow up for a few months ensures the patients is on the right track and remains injury free.

 

Do I need to stay in the hospital during accelerated rehab after ACL reconstruction?

No need to stay in the hospital for the entire duration of the accelerated rehab after ACL reconstruction. You can continue it in consultation with your therapist while recuperating at home. However, you may have visit the therapy center regularly to take a stock of your progress.

Is my therapist licensed?

Yes, all therapists are certified and licensed. Accelerated rehab after ACL reconstruction must be carried on under the guidance of expert and experienced therapists.

Is accelerated rehab painful?

No. Pain management is an integral part of accelerated rehab. It offers freedom from pain and healing after ACL reconstruction at the earliest. As pain and swelling subside rapidly, recovery becomes quick.

Do I need to take any precaution?

Accelerated rehab after ACL reconstruction requires patients to strictly follow the suggestions by therapists. Pushing your knee ligament beyond the level f tolerance may affect the functional strength of the knee joint at the early stage. Usually, muscles shut down after a surgery. Rehabilitation aims at restoring the functional strength of these muscles connecting to the knee. However, excessive stress or forced movements beyond what rehab regimen prescribes may cause chronic knee instability.

Is bracing necessary during accelerated rehab after ACL reconstruction?

The focus on developing protective factors, such as muscular potency, functional movements, and proprioceptive stability, for knee joint reduces the need for bracing.

Does accelerated rehab after ACL reconstruction contribute to knee arthritis?

There is no evidence linking accelerated rehab after ACL reconstruction to knee arthritis. It does not contribute to the degenerative disorder. Proper rehab, rather, has the potential to prevent occurrence of any degenerative disease.

Does the type of graft used influence accelerated rehab?

No, everyone can undergo accelerated rehab irrespective of the type of graft used.  The only requirement is that the graft is of right size, at right tension, firmly fixed, and in compliance to isometric requirements.

Does it help to tackle pain?

Yes, accelerated rehab offers best possible way to get rid of pain and swelling after ACL reconstruction.

How long does accelerated rehab take?

Accelerated rehab almost haves the downtime required for recovery.  Athletes undergoing accelerated rehab after ACL reconstruction returns to training in 4 to 6 months compared to 9 to 12 months required by traditional rehabilitation.

References

Shelbourne KD, Gray T. Anterior cruciate ligament reconstruction with autogenous patellar tendon graft followed by accelerated rehabilitation. Am J Sports Med. 1997;25:786-795.

A Jesus, s Igor, I Fernando, et al. 2015 ISAKOS Biennial Congress ePoster #1321: MRI Study of Changes in Muscle Volume in ACL Reconstructed Knees Following Conventional or Accelerated Rehabilitation Programmes. Clínica San Miguel / Sports Medical Study and Research Center, Pamplona, Navarra, Spain

Beynnon BD, Johnson RJ, Naud S, et al. Accelerated versus nonaccelerated rehabilitation after anterior cruciate ligament reconstruction: a prospective, randomized, double-blind investigation evaluating knee joint laxity using roentgen stereophotogrammetric analysis. Am J Sports Med. 2011 Dec;39(12):2536-48.

Pilot P, Bogie R. Draijer WF, et al. Experience in the first four years of rapid recovery; is it safe? Injury. 2006; 37 Suppl 5:S37-40.

Brownstein, B., Bronner, S. Patella fractures associated with accelerated ACL rehabilitation in patients with autogeneous patella tendon reconstructions. Journal of Orthopaedic and Sports Physical Therapy. 1997;26:168–172.

De Carlo, M., Klootwyk, T.E., Shelbourne, K.D. ACL surgery and accelerated rehabilitation: Revisited. Journal of Sport Rehabilitation. 1997;6:144–156.

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