One in five Americans over the age of 65 has had a joint replacement, says Dr. John Xenos, orthopedic surgeon and principal of Colorado Orthopaedics in the Sky Ridge Medical Center in Lone Tree.
Xenos, who has replaced 10,000 joints during his career, tells patients that once that new joint is in place, post-operative therapy “can mean the difference between a good outcome and a great one.”
Zachary Fox, physical therapist and clinical director of Rocky Mountain Spine and Sport’s Parker Clinic, agrees. “For some, accomplishing simple tasks around the home after therapy is good enough,” Fox says. “But we want our patients to leave the clinic feeling well enough to do more — to resume sports if they want, to socialize, to enjoy more hobbies.”
Fox’s patient, Susan Schmidt, is leading an active lifestyle again after she received a total hip replacement in January 2017. Schmidt credits the surgery and physical therapy for giving her a “whole new perspective on life.”
Post-Op PT Matters
Post-operative therapy is essential to fully restore normal movement in the joint and prevent any further impairments. Physical therapy usually begins the day of or after joint replacement surgery and is critical to helping prevent life-threatening complications such as blood clots.
“Patients who don’t complete physical therapy may experience prolonged pain, stiffness and swelling of the joint, which delays recovery and may ultimately lead to failure of reaching their goals,” Fox says. “We want them to keep moving.”
Prior to surgery, Schmidt was sedentary and in too much pain to be active. But just four months after surgery, she and her son walked four miles for the Arthritis Foundation. A month later, Schmidt hiked seven miles.
“I know I need to move more no matter what,” Schmidt says. She wears a watch to remind her to stand, and she aims to get on the treadmill for 30 minutes, five times a week.
Individualized PT Plan
Post-op physical therapy isn’t a one-size-fits-all protocol. “Every patient is unique, and the plan of care reflects each individual’s specific needs and capabilities,” Fox says.
For example, the hip and knee joints have different structures and functions. “The hip is a stable, ball-and-socket joint, and some individuals just need general motion such as daily walking,” Fox says. “But the knee, a hinged and significant weight-bearing structure, requires a more complex plan of care, involving both motion and gradual strengthening.”
PT Before Surgery Helpful Too
Many medical experts including Xenos and Fox also encourage patients to have therapy before surgery, which is often referred to as “pre-habilitation,” to reduce post-operative care and achieve better results.
Schmidt had physical therapy before her surgery and attributes her recovery in part to building muscle strength beforehand. Fox describes it as “stronger in, stronger out.”
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