ExerciseFrom The PhysioJoint ReplacementsOsteoarthrtis

Preparing for surgery

When you are considering elective surgery such as a total hip of knee replacement, we know the fitter you go into surgery, the better your post operative recovery will be.

You might find this video useful:

We have some tests that we do to help determine outcome and best advise you on the next step. We use a TUG test (timed up and go) and a hand grip strength. This helps us determine what some of your needs and and how best to help you get through the recovery period.

Small things like being familiar with post op exercises, being more mobile can aid your post op recovery. Making an appointment with a physio pre-op can enhance post-op outcome. We mostly advise this if you are weak, or have a history of falls.

Activities to do in advance

Try maintain as active as possible. Sometimes even if you hip or knee is very painful, doing some upper body strengthening can be helpful. Also speaking to a physio they may be able to help with some exercises in advance.

Some research into patient preparing for hip and knee replacements found that those patient who struggled with mobility, even by increasing their activity within their home in the weeks leading to surgery made a difference.The best way to strengthen your legs in preparation for surgery is to walk regularly. Don’t be afraid to walk while waiting to have your surgery – it won’t harm your knee or hip joint. Follow the “two hour” pain rule: If your joint hurts for longer than two hours after your walk, you have done too much. Do what you can to manage the pain and walk a bit less the next day.

Besides walking, your surgeon may recommend that you do some regular pre-operative exercises. Some are aimed at strengthening your arms and shoulders, which will help you cope with crutches or a walker after surgery. Others will help maintain the strength of your leg muscles. The exercises should take about 20 minutes to complete, and you can do them once per day.

We have two video with some exercises to help with general mobility and strengthening.

General mobility:

General strengthening:

Thinking about your home

In preparing for going home you can make sure there are not things that you can trip over etc. You can prepare for this by removing loose carpets etc. In our article on falls prevention we discuss those things and there are useful resources and things to check in your home.

Things for hospital

  1. footwear: make sure you have appropriate footwear. Shoes that have a back, non slip rubber sole that are not too tight (you feet often swell post surgery). The shoes should be easy to get on and off. Often wearing comfortable shoes is best instead of going out and buying shoes/ slippers specifically for the surgery.
  2. loose fitting clothes: have comfortable clothes. For the men, make sure you have loose boxer shorts. long pants sometimes don’t fit over the bandage. For the ladies loose fitting pants or nightie is useful. You will walk around the ward, so have clothes that you are comfortable walking around in.
  3. crutches and walkers:This is dependent on you, and some of the pre-op scores, and also you fall history. Mostly we can advise you based on some of the pre-op scores. It is not unusual for people to sometimes go home with both. All these items can be obtained in hospital, but may if a friend has, then you can borrow them from a friend too.
  4. showering: If you feel unsteady, then you can put a plastic garden chair in the shower for when you go home.

Healthy Lifestyle

Much of management of arthritic conditions is also eating healthily. It is a good reminder to perhaps have some meals in the fridge for when you go home. If friends ask what they can do to help, why not ask someone to prepare you a meal. While preparing for surgery, try eat real food. You can also see a dietitian if you need further advice.  You may also find our previous article helpful

Prior to surgery

  • Please let us know if your health changes
  • If you have any scratches, mosquito bites etc on the leg- no matter how insignificant you think this may be- it might mean your surgery needs to be postponed.
  • Try to get some good nights sleep in the weeks before surgery. Rest is equally important in recovery.
  • Don’t plan surgery if it is a very busy of stressful time at work, or if going through a major life changing event e.g. death in the family, or moving house. Sometimes it would be better to postpone your surgery by a few weeks or months.

 

Resources

https://arthritis.ca/treatment/surgery/knee-replacement-surgery

https://arthritis.ca/treatment/surgery/hip-replacement-surgery

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