Prehab: Pave The Way To Joint Replacement Success

You and your doctor have decided the time is right for joint replacement surgery. Whether it’s your knee or hip, it seems other treatment options just aren’t working anymore. The good news is that joint replacement surgeries for knee and hip have improved drastically over the past 10 years – and continue to do so.

Best of all, it’s not just the technology, equipment or surgical procedures that have advanced. It’s also the care before and after your surgery that helps pave the way to healing.

Patients can improve their odds for a successful surgery by actively preparing for the procedure through diet and exercise, a tactic called “prehabilitation,” a new evidence review shows. Surgical patients who prehabbed had fewer complications and shorter hospital stays, also recovered better and had a higher quality of life, researchers reported Jan. 22 in The BMJ.

“One approach we have found to be successful is scheduling ‘prehab’ appointments with individuals who are scheduled for knee or hip replacement surgery,” said Tanya Partin, a physical therapist at Franciscan Health Mooresville. “Prehab before joint replacement gives our patients and their families confidence and peace of mind about what to expect and how to best prepare for surgery and recover more quickly.”

What Is Prehab?

The term “prehab” refers to a preop (before your surgery) visit with a physical therapist. During that visit, you and your physical therapist will cover three main areas:

1. Exercise and activity before your surgery
2. What to expect while you’re in the hospital
3. How to set yourself up for success after surgery

Exercise And Activity Before Joint Replacement Surgery

Many individuals who ultimately have joint replacement surgery have likely, at some point, participated in physical therapy. That familiarity will help when meeting with a physical therapist before your surgery (but success doesn’t hinge on that experience).

During your prehab appointment, your physical therapist will share exercises you should do at home to improve your strength, flexibility and range of motion before surgery.

“I can always tell when patients have done their exercises before surgery,” Partin said. “It makes a real difference. They are stronger and more flexible immediately after their surgery, and that helps them recover that much faster.”

Research backs this up. The BMJ study found that exercise before surgery was associated with a 50% reduced risk of complications,

What To Expect While In The Hospital

Your physical therapist will also share what you can expect while you’re recovering in the hospital immediately after your surgery. Fortunately, many advances in hip and knee replacement lead to less pain, faster recovery and fewer complications. That translates to a much shorter hospital stay.

“Many individuals who come for a joint replacement surgery can leave that same day or the next day,” said Partin. “Since we don’t have as much time in the hospital as we used to, we can prepare patients on when they may be asked to get up after surgery.”

While you’re in the hospital, a physical therapist will cover important information about what your exercise plan is at home and your physical therapy schedule.

How to set yourself up for success after surgery

During your physical therapy pre-op appointment, you’ll also learn strategies and tips that can help speed your recovery. Not only does this help reduce the amount of information provided immediately after surgery, but it can help you better prepare for surgery and feel confident and empowered headed into your procedure.

Here are a few examples of what a physical therapist may share during your prehab appointment:

• Have assistive devices ready to go. Canes, walkers, elevated toilet seats, a reacher and dressing aids can help you move through your day more safely and comfortably post-surgery.
• Remove fall hazards. Pick up throw rugs, tuck cords and move anything that could cause you to trip before you come home from the hospital. Learn more about preventing falls at home.
• Arrange for a caregiver. You shouldn’t be alone for the first week after surgery. Ask a family member, friend or neighbor to stay with you or check in on you regularly to make sure you are recovering safely.
• Limit trips up and down the stairs. Partin recommends going up and down steps no more than twice each day: Once coming down in the morning and once heading up to bed in the evening.

“There is a lot of research that shows being prepared, attending prehab and doing recommended exercises make a significant difference in your outcome after surgery,” Partin says.  “It might not seem like a few stretches or preparing your home will make a big difference, but what we see – and what science tells us – is it does matter.”

Improve Your Recovery From Joint Replacement Surgery

Participating in prehab before joint replacement surgery can improve recovery. Meet with our physical therapists and discover what it takes.