Like any surgical procedure, when you undergo a hip or knee replacement, you will need to go through a recovery period. This gives the body a chance to heal and aids in producing the best results.

Recovering from a hip or knee replacement can take a long time. However, there are some things you can do at home to help speed up your recovery. Below, you’ll discover five tips to speed up your recovery and get back to full mobility.

1. Start your joint replacement recovery before your operation

If you want the fastest recovery, it’s a good idea to make a start before you even undergo the operation. Strengthening up the leg muscles prior to surgery through various exercises, will greatly help to improve recovery. Pilates is a particularly great form of exercise for strengthening the leg and pelvic muscles.

You will also be advised to stop smoking as this can compromise tissue healing after surgery, as well as increasing the risks. Similarly, losing weight can also help to make the recovery faster and easier.

2. Focus on light exercise

After the surgery, you will need to rest the body for a period of time. However, as soon as you can complete light activities, it is time to start adding exercise back into your routine.

Gentle, light exercise will help to keep the blood flowing throughout the body, improving circulation. Healthy blood flow to the surgical site is important for healing. Light exercise will also help to build up strength in the body.

3. Look at what you eat

Ensuring you eat a healthy, balanced diet is also important to your recovery. As the body heals, it needs nutrients to recovery. By eating a varied diet packed full of protein, fruits and vegetables, it’s going to help you heal faster as well as feel better overall.

You should never attempt to lose weight or diet during your recovery. Without the right nutrients, healing will be delayed, and you will also be at a greater risk of infection.

4. Use a physiotherapist

Your surgeon will typically suggest physiotherapy to help with your recovery. A physiotherapist knows exactly which exercises you should and shouldn’t be doing. They will be able to focus on exercises that strengthen the legs and the core.

While you can do light exercises at home, when you use a physiotherapist you know that you are doing the most effective exercises safely.

5. Follow your surgeon’s advice

The best way to speed up your recovery after a hip or knee replacement, is to follow your surgeon’s advice. It’s tempting to want to skip some pieces of advice, but unless you follow it completely, you won’t get the best results.

While it is possible to speed up your recovery, be mindful not to push yourself too hard. If you ignore your surgeon’s advice or you overdo it with the exercise, it could delay healing and actually slow down your recovery.

A new study carried out by researchers in Denmark, has revealed the true rate of hip dislocations following total hip arthroplasty. A known complication of the procedure, the study suggests the rate of hip dislocations is up to 50% higher than first thought.

Here, we’ll look at what the study found, alongside patient and surgeon factors that could impact the risk.

Understanding the hip dislocation study

The large cohort study published in The Journal of Bone & Joint Surgery, included all hospital contacts in Denmark within two years, who had a total hip arthroplasty. It had a five-year inclusion period and is believed to have revealed the true rate of hip dislocations.

The researchers wanted to develop a more comprehensive and thorough method for assessing the actual incidence of dislocation. Between 2012 to 2014, 31,105 patients underwent a total hip arthroplasty in Denmark. The researchers discovered that 1,861 dislocations occurred in 1,079 total hip arthroscopy procedures. This corresponds to a 2-year incidence of 3.5%. Over 40% of the patients identified, suffered at least two dislocations. The majority were also found to suffer dislocations within three months of the procedure.

As well as looking into the incidence rate of dislocations, the study also looked at the causes of dislocation. Several patient-led and surgical-led factors were identified.

Patient-led factors

The following patient-led factors were discovered to link to dislocation risk:

• Age
• Gender
• General health

Patients aged 65 and under had a lower risk, whereas those aged 75 and over had an increased risk of dislocation; men were shown to have a lower risk than women; patients in good health also had a reduced risk.

An additional patient-led factor not mentioned in the study is spinal problems. Patients who suffer with stiff spines and previous spinal fusion are also known to have an increased risk of dislocation.

Surgeon-led factors

The surgical factors identified in the study included the surgical approach used and the femoral head size.

A lateral surgical approach, cemented fixation and a larger femoral head size were all linked to a lower risk of dislocation. The majority of patients included in the study underwent a posterior approach as that is the most common method used in Denmark.

There is a relationship between poor component position and instability. The use of MAKO robotic assistance has been shown to improve the accuracy of implantation. This innovative technology creates 3D models that are patient-specific in order to help pre-plan the procedure. The surgical team are able to accurately plan the position of the components, to fit the patient’s own anatomy and the robot helps the surgeon to execute the plan

Patients who are planning on undergoing a hip replacement need to be aware of the risks of dislocation. This latest study highlights the surgical and patient-led factors which can help surgeons identify the risks involved.  This is important information, as the ability to identify high risk patients helps the surgeon to approach the surgery to minimise the risk of dislocation in each particular case.

A new study has revealed that knee replacement surgery carried out with a tourniquet is more dangerous than other methods. According to the results, patients could be as much as 73% more likely to develop serious complications after the procedure.

Here, we’ll look at what this latest study found and what it means for patients.

Understanding the study

The study, carried out by researchers from the University of Warwick, assessed data from 41 past clinical trials. After combining multiple studies from across the globe, it was revealed that using a tourniquet is more dangerous for patients. It included a total of 2,819 patients, with 5.9% experiencing serious complications.

There is a 73% increased risk of suffering from serious complications after the procedure when a tourniquet is used. The study found that if tourniquets were removed from the procedure completely, it could prevent 1,987 serious complications in UK patients each year. So, what is the tourniquet method and why is it more dangerous?

Why do we use a tourniquet for knee surgery?

The tourniquet is a tight inflatable cuff, wrapped round the top of the thigh, to stop bleeding during surgery.  Surgeons find the surgery easier when there is no bleeding into the wound.  It is usually used for around an hour while the procedure is being performed. However, as the study points out, it has shown to greatly increase the risks of surgery.

Just some of the complications reported through the tourniquet method, are nerve damage, pulmonary embolism and stiffness in the joint. Avoiding the use of a tourniquet, on the other hand, have shown to reduce post-operative pain and speed up the patients’ recovery.

Mr Bridle no longer uses a tourniquet for the vast majority of his knee replacements, choosing instead to focus on alternative methods which reduce complications. Modern anaesthetic techniques, in particular spinal anaesthesia, reduce bleeding. Pain can also be managed in alternative ways, including nerve blocks and the use of local anaesthetic around the knee.

The recent introduction of robotic assisted surgery has been shown to reduce post-operative pain, allow more rapid rehabilitation and achieve better function.

Of course the majority of patients experience no complications after their knee replacement. However, like any procedure, there are risks and complications involved, so reducing the risk, including avoiding the use of a tourniquet, is certainly in the patients’ best interest.

If you are considering undergoing a knee replacement operation, book a consultation with Mr Bridle today.

Knee replacement is an extremely effective treatment for patients with knee arthritis. It is however major surgery, with some risks, which your surgeon will always discuss with you before deciding to proceed to surgery. Non-operative treatment is an important part of managing knee arthritis. A number of treatments are available to reduce pain and improve function. Non-operative treatment is also helpful in helping patients decide when they are ready for surgery. Here we’ll look at some of these treatments and how effective they are.

Study finds steroid injections don’t speed up progression of OA

Steroid and other injections are often used. There have been concerns that steroids can damage the joint and that they may lead to surgery being required sooner. Previous studies had suggested that steroid injections could actually speed up the progression of the disease.

A new study looking at this has found that steroid injections for the treatment of knee osteoarthritis do not hasten the need for a knee replacement. This study, carried out by the Boston University School of Medicine, revealed steroid injections don’t speed up the progression of OA.

This latest research included two large cohort studies. It followed those with knee OA who were receiving either hyaluronic or corticosteroid injections. Rates of radiographic progression, X-Ray visible joint damage and total knee replacements were analysed. A total of 792 knees were analysed, with 647 patients undergoing corticosteroid injections. The other 145 patients were receiving hyaluronic injections.

The study found that patients undergoing Hyaluronic injections were more likely to have a knee replacement. However, patients receiving corticosteroid injections didn’t show any signs of radiographic progression and did not have an increased risk of needing a knee replacement. The authors concluded that steroid injections don’t speed up the progression of OA like previously suggested.

Understanding non-operative options

In patients with osteoarthritis, a total knee replacement is typically used as a last resort. There are many non-operative treatments available which have shown to have huge success at treating the condition.

Physiotherapy

Physical therapy has shown to provide clinical benefits to those with knee osteoarthritis. A new study has shown that after a year of physical therapy, the majority of patients had less pain and better mobility.

Weight loss

Another thing that can help patients is weight loss. In those who are overweight, the additional weight can put a lot of pressure onto the joints. Studies have shown that overweight patients suffering with knee osteoarthritis, often experience pain relief and enhanced mobility when they lose weight.

Shockwave therapy (ESWT)

This is used increasingly for patients with tendon problems. A recent study has shown that ESWT can also be effective in helping patients with knee arthritis. They looked at patients with arthritic knees and resulting deformity. Interestingly, ESWT was shown to decrease pain in up to 95% of cases and improved the function of the joint. This study raises hoe that this treatment modality may help patients with knee arthritis.

As you can see, there are a lot of non-operative treatments available for patients suffering with knee OA. The new findings in these recent studies confirm the role of non operative treatment and where these modalities fit in, helping patients to achieve relief, without going under the knife.

Undergoing one hip replacement procedure can be daunting enough. However, for some patients, a double hip replacement may be recommended, where both hips are painful and badly damaged by arthritis.

While less common than a single (unilateral) hip replacement, having both hips replaced at the same time (bilateral), can deliver significant benefits to some patients. Here, we’ll look at when two hip replacements may be better than one and what to expect from a bilateral procedure.

What is a bilateral hip replacement?

Hip replacement involves replacing the femoral head and the acetabulum, using artificial parts made of ceramic, metal or a mixture of both. A bilateral hip replacement can be done as a staged, or simultaneous procedure.

With a staged procedure, the hip joints will be replaced one at a time. After the first procedure, the second replacement will be carried out a few weeks later.  In a simultaneous procedure, both hip joints are replaced at the same time.  This approach is cheaper and overall the hospital stay, recovery period and cost is less.

Generally speaking, a simultaneous procedure isn’t recommended for older patients or those who have other underlying health problems. If both your hips are very painful, you should talk to your surgeon to discuss the risks and benefits of each method. They will be able to advise the best technique to match your circumstances.

Why might you need two procedures in one?

A number of conditions can damage the joint, leading to the need for replacement surgery, including osteoarthritis, osteonecrosis, developmental dysplasia and rheumatoid arthritis.  Osteoarthritis in particular frequently affects both hips.  Studies have revealed that 42% of those suffering with Osteoarthritis have it in both hips and of these, around 25% go on to need both hips replaced.

Recovery and results

Patients who undergo a simultaneous procedure will typically need to stay in hospital for a couple of days longer than after one hip, typically 4 or 5 days. Patients are mobilised as soon as possible – on the day of surgery, or the following day.  Pain control techniques are very important to allow this.  Early movement, along with blood thinning medication reduces the risk of clots, which is one of the most significant risks of hip replacement.

Physical therapy is key to achieving best results. A trained physiotherapist will teach you stretches and exercise to improve the mobility of the joints. Recovery time and results will depend upon a number of factors such as age and overall health.

Despite their benefits, double hip replacements are quite rare. Patients who are experiencing pain and mobility issues in both joints should speak to a hip specialist to discuss your treatment options. Mr Simon Bridle will be able to talk through the staged and simultaneous techniques and advise you of which one is better suited to you.