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Joint Replacement

Joint replacements are surgeries conducted to replace bony human joints with prostheses to restore function and minimise pain. Every year in Australia, over one-hundred thousand surgeries are performed to replace knees and hips alone. Other joints like the shoulders, the elbows, and ankles can also be replaced, but hip and knee surgeries are by far the most common. People elect to undergo joint replacement surgeries for many reasons, but the most common is because the joint is painful to use because of age-related weardown of one of its component parts. Taking the knee as an example, the most common reason for a knee replacement is to ease pain caused by arthritis.

Joint replacements are surgeries and so will require post-surgical physiotherapy, which will usually be provided as part of your care either as a hospital or rehabilitation inpatient, by visiting a recommended clinic, by physiotherapy service at your home, or a combination of these. Joint replacement requires specific rehabilitation and management given that surgeries to the knees, the hips, and the shoulders all have potential to affect how people navigate their homes, undertake their work, and care for themselves. For this reason, your physiotherapist will usually communicate directly with the consult and management team overseeing your procedure, to relay any concerns and so that your primary clinician or consultant can communicate any specific orders or precautions to your treating therapist. 

Physiotherapy assessment and management is important to provide patients with education and orientation regarding the nature of the surgery and its benefits, risks, outcomes and timecourse so that people can make informed decisions. Often, physiotherapy management in joint replacement will involve prehabilitation of the joint before surgery occurs. Undergoing exercise and conditioning before surgery puts the limb in as strong a position it can be before the procedure, which has been proven to improve the speed and quality of recovery following the operation. Prehabilitation is also useful to manage symptoms in anticipation of an operation being undertaken, given that public system waiting lists can be long and changes can occur during that time. 

Physiotherapy input following joint replacement is important for two reasons. Firstly, because surgical procedures require causing damage to the body to achieve a therapeutic aim, rehabilitation will focus on restoring the limb to as good a functional state as it can be before undertaking heavier exercise or returning to work and life. Rehabilitation will be patient-and joint-specific but may include manual therapy, progressive exercise therapy, swelling management, gait re-education, and postural correction. Your physiotherapist will use a combination of techniques to come up with an individualised rehabilitation plan, guided by your needs and deficits, as well as the surgeon’s protocol. 

Secondly, physiotherapy rehabilitation is necessary to minimise complications such as stiffness, pain and weakness. During the process of healing, scar tissue formation and inflammation can make moving and getting around painful, and if not managed correctly, can be inhibitive to exercise and affect a patient's outcomes. Following surgery, the combination of inflammation, pain, and post-operative orders can result in weakness of the muscles around the joint, firstly due to their injury as part of the surgical process, then due to lack of use due to precautions, and even potentially for longer periods of time if the use of the injured limb is compensated for by the use of the opposite side.

Management of your discomfort depends on its causative factors, how it feels and changes during the day, what makes it better and worse, and the length of time you have been experiencing that pain. All of these factors will be addressed in your initial assessment, which is the first step toward managing and minimising any pain or discomfort. The treatment you receive will be tailored to address the specific cause of your discomfort, and will focus on minimising pain, maximising your ability to move pain-free, and developing a plan to minimise the risk of a flare-up in the future. 

At Atlas Physio, we will provide you with education, structured management, and ongoing monitoring of your pain both in-clinic and out. Contact us to arrange an assessment, and to take the first step on a course of corrective care today.

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