Knee VS Hip Replacement

 Don't get me wrong - surgery is surgery. Nothing to minimize. There will always be risks; but most often the benefits outweigh these risks. There are a few important things to remember prior to surgery:

Pick the surgeon that you TRUST. The one that you have a decent rapport with. Now; not all surgeon's have a "great" bedside manner - this is different that the trust and rapport. You should feel confident in asking questions and understanding the answers. 

Tell the surgeon you fears - be honest. 

Tell you surgeon your goals. A great surgeon will tell you the realities. I remember my first knee replacement in 2015. A friend was getting the same surgery from a different surgeon/practice. This person stated that that he/she could be back on an indoor cycle within 3 weeks; perhaps teaching. The surgeon I was talking to stated that his recommended recovery for "teaching" would be 8 - 12 weeks. He then stated, "I could tell you what you want to hear, but who will you be mad at if it doesn't happen"? "I would rather you beat my timeline than have you mad". I chose this surgeon. I also beat his timeline 😄

Tell your surgeons about any concerns you might have with your health - even if you think it might not be significant. Be safe - not sorry.

Be honest in your diet, medications (including supplements), alcohol intake. No one is here to judge. Knowledge is power and the opportunity to make recommendations prior to your surgery.

Be honest in your exercise routine - even if you have none. The "knowledge" thing again! At times, the surgeon will recommend "Pre-hab" to get you ready for the surgery and recovery work.

Be realistic with your expectations and goals. Knee or hip replacement is MAJOR surgery. You will be cut, sawed and hammered. This hurts and also causes damage to soft tissue. It takes time for soft tissue to heal. Therefore --- GIVE YOURSELF TIME TO HEAL! Nothing is worse than a setback. These can be prevented by listening to your surgeon and physical therapist.

And speaking of Physical Therapist....ask your surgeon to prescribe this so that you have one lined up immediately following surgery. For all my replacements I had in home PT until I had my staples removed and was cleared to drive. I then went to outpatient.

And speaking of Physical Therapy....find a therapist that is knowledgeable in replacement recovery. Also find one that listens to you and understands "where you are coming "in" from" and your goals. I interviewed 3 service providers when I had my first knee replacement - YES...I truly interviewed. I went to each provider and saw the environment. I talked to the Physical Therapist and asked questions to see if he/she heard me. I asked "who" I would be working with; the PT or PT Assistant. I chose the therapist "best" for me and he turned out to be the very best. I have been with him through ALL of my surgeries and any issue that benefits from PT. Your surgeon may not always recommend PT, especially in the beginning of recovery however you can advocate for yourself. Also, if you begin to work with a PT and are not "feeling" it then ask for a change. You are the customer!!

Final thought regarding PT. You may think that some exercises are "super easy" and wonder why you have to do them. Please realize that there is always a reason for the exercise that may not be obvious. If I was not sure the reason, I asked.

So...we have covered before surgery thoughts and questions. Now let's talk about recovery.

I am cautiously saying that hip replacement is easier then knee replacement recovery. Why cautiously? Everyone is different. Every surgery is different. In my 2 hip replacements (Left - September 2020 and Right - April 2022) each recovery was different. In one I had more pain and less bruising and swelling. In both I was able to walk without assistance within about 10 days; however I took a cane with me for longer walks. I found the PT to be less intense. Now I did not say "easier". PT was different and always took into consideration risks for dislocation. I had posterior approach for both replacements. Due to this I had 90 degree precautions for 6 weeks each time. I think I was more nervous about this than anything else prior to surgery. However, maintaining the precautions was relatively easy. 

PT for hip replacement focuses on range of motion (within any precautions) and gaining strength in weakened muscles. Remember, soft tissue also has to heal and although you may "feel great"  you may be overdoing. Signs of this are swelling, fatigue and increase in pain.

As I stated earlier, some exercises may seem "super easy" and you may think why am I doing this. Physical Therapists are trained to "recover" following surgery or injury. Even small movements have a purpose; triggering nerves, tendons, ligaments and muscles. Firing all to work together.

Knee replacement PT can be very challenging. You have to work through the swelling and pain; all within reason. There is a "window of time" to gain working flexion and extension. And working on this is work!

Be realistic in your goals. If you know what your flexion was before surgery ask if this will be achievable after. If not, talk to PT about what flexion will allow you to do the activities that are important to you.

Extension is important to achieve to "zero" so it does not affect your gait. At times, extension is compromised prior to surgery due to not being able to use your leg as you wanted/needed. If you had contractions in the hamstring prior to surgery, gaining extension may take more work. My PT advises that this is achieved with lower weight that allows you to relax for an extended period of time with the leg extended however the knee area is not supported.

My recent knee replacement has been a bit challenging. I was advised that swelling would affect range of motion; therefore I was very diligent in elevating and icing. This helped. PT is challenging. Trying to get a "good bend" (flexion) felt like sausage casing exploding when being cooked😎 I continue to work on flexion at 7 weeks post op.

The key to a successful recovery - knee or hip - is listening to your surgeon, PT and your body. Be kind to yourself. A good PT will listen to you, your concerns and your goals. He/she should be able to "talk you off the ledge" if having a bad day and help your find patience. I have a great PT😄

Try not to worry about changes in weight. Everything will balance out. You need to fuel your body as you heal. Eat as healthy as possible.

Remember this is YOUR recovery. Try not to compare to others.

And a final note:

You will get through this. Having both knees and hips replaced I have tried to be positive even on days that I wasn't feeling this. I continue to remind myself that recovery is a journey. As I have said before "This is a marathon not a sprint".

Next: Update on knee recovery!