Pre-Operative Physical Therapy Can Improve Post-Operative Results

In the United States, the performance of total joint replacements (TJR) for the lower extremity has more than doubled. In 2004 there were 454,652 total knee replacements (TKR) and 232,857 total hip replacements (THR) performed. As a result of the growing population and obesity crisis in our country it is projected that these numbers are going to keep increasing in the next decade. Joint replacements are the primary treatment option for individuals suffering from severe osteoarthritis (degenerative changes to the cartilage within the joint). Rehabilitation services are a necessary part of an individual’s recovery following surgery in order to decrease pain and swelling, increase range of motion, and increase strength.

There are many factors that can help predict an individual’s outcome following surgery. The individual’s age and activity level prior to performing surgery are the two key factors in predicting your short and long-term outcomes post-operatively. A common long-term finding following joint replacements is lower extremity muscle weakness (especially the quadriceps - large muscle group in your thigh). This can significantly impact an individual’s functional capacity and ability to enjoy life post joint replacement. Loss of overall muscle mass and strength occurs as a result of the normal aging process and has been implicated in the development and progression of osteoarthritis (OA). Research indicates that quadriceps strength is the strongest single predictor of functional limitations in individuals with OA. Following TKR it’s reported that an individual can experience up to 60% of quadriceps strength loss.

Physical therapy can assist you with strengthening your lower extremities and increasing the overall stability of your joints prior to your joint replacement surgery. Strengthening your musculature can increase your functional outcomes and speed up your recovery post operatively.

A few easy steps to improve your post-operative results:

• Participate in pre-operative Physical Therapy - your local Physical Therapist can provide you with an exercise routine consisting of strengthening, range of motion as well as cardiovascular conditioning to increase your overall endurance.
• Functional capacity - increase your daily activity by incorporating low impact aerobic activity such as walking, cycling, or swimming. Avoid high impact activities such as running and jogging.
• Stretching - increase your muscular flexibility by performing daily stretching of your lower extremities. Increased flexibility helps decrease your risk of injury and will help you regain functional mobility quicker following surgery.

If you or someone that you know is thinking about or planning on having total joint replacement of the knee or hip, participating in pre-operative physical therapy may significantly improve your post-operative rehabilitation. Ask your surgeon if pre-operative physical therapy, commonly coined as "pre-hab", is right for you.

Contact Dr. Hamel at drhamel@seacoastsportsinjuries.com with any questions pertaining to this article.