Joint replacement surgery is a common procedure aimed at relieving pain and restoring mobility in damaged or worn-out joints. The most frequently replaced joints are the hip, knee, and shoulder.
- Hip replacement: Often performed due to osteoarthritis or fractures, hip replacement surgery restores function by replacing the damaged joint with an artificial one (prosthesis). It allows patients to walk, climb stairs, and resume daily activities with less pain.
- Knee replacement: This surgery replaces the damaged surfaces of the knee with metal and plastic components, providing relief from pain caused by arthritis or injury.
- Shoulder replacement: This less common surgery is often recommended for patients with arthritis, fractures, or rotator cuff injuries. The shoulder joint is replaced with an artificial one to relieve pain and restore arm mobility.
Other joints like ankles, wrists, and fingers can also be replaced when severely affected by arthritis or injury.
The physiotherapist’s role in post-operative care
Physiotherapists play an essential role in managing recovery after joint replacement surgery. They assess your progress and adapt your treatment plan as needed, teaching you proper movement, pain management techniques, and exercises that promote healing and prevent complications.
For example, after a hip replacement, a physiotherapist will help you regain the ability to walk with a walker or crutches. After a shoulder replacement, the focus is on gentle arm movements to prevent stiffness, while knee replacement patients are guided through exercises to strengthen the quadriceps and support the new joint.
Phases of post-operative rehabilitation
Full recovery time after joint replacement surgery can vary, but typically takes around 3 to 6 months for hip and knee replacements and 4 to 6 months for shoulder replacements, depending on your age and health, activity level prior to the surgery, and the complexity of the surgery. Targeted physiotherapy can significantly improve your recovery time.
Immediate post-operative phase (1-2 weeks after surgery)
In the first few days after surgery, the goal is to manage pain and swelling and start moving the joint:
- Pain management: Techniques such as ice, elevation, and gentle movement are used. After a knee replacement, ice packs help reduce swelling, while hip replacement patients are guided to elevate their leg.
- Mobility: Patients with a hip replacement are taught how to get out of bed and use a walker or crutches. For shoulder replacements, passive arm exercises help prevent stiffness.
- Preventing complications: Exercises to promote circulation and reduce the risk of blood clots. Knee replacement patients, for instance, may perform ankle movements to improve circulation.
Early rehabilitation phase (2-6 Weeks After Surgery)
As the initial pain subsides, the focus shifts to improving joint mobility and strength:
- Range of motion: Gentle movements to restore flexibility. After a shoulder replacement, this involves arm raises and stretches, while knee replacement patients work on bending the knee.
- Strength building: Low-intensity exercises to build muscle around the joint. Hip replacement patients may perform standing hip abductions to strengthen surrounding muscles without straining the hip.
- Balance and stability: Weight-bearing exercises to improve walking ability after hip or knee replacement, or arm exercises for shoulder replacement patients.
Advanced rehabilitation phase (6+ weeks after surgery)
At this stage, the rehabilitation programme becomes more advanced to help patients regain full function:
- Strength and endurance: Hip replacement patients may start squats and resistance exercises, while knee replacement patients focus on functional movements like climbing stairs.
- Coordination and gait: Physiotherapists work on walking patterns to ensure smooth, natural movement after knee replacement. For shoulder replacements, the focus is on improving arm stability and coordination.
- Activity-specific rehabilitation: Tailored exercises for patients aiming to return to their sport or activities, such as swimming for shoulder replacement patients or running for hip replacement patients.
Tools and techniques used in physiotherapy
Physiotherapists use various tools and techniques to aid recovery:
- Manual therapy: Hands-on techniques like joint mobilisation and massage to improve flexibility and relieve tension, which is particularly helpful for shoulder or finger joint replacements.
- Strength and flexibility exercises: For a hip replacement, leg raises and bridges build muscle strength. For ankle replacement patients, ankle stretches and strengthening exercises are prescribed.
- Gait correction: After knee replacement, physiotherapists ensure patients walk correctly without straining the new joint. For shoulder replacements, posture correction helps maintain proper arm movement.
Physiotherapy is a vital part of the recovery process after joint replacement surgery. By strengthening the muscles around the joint, it promotes stability and lowers the risk of future injuries, which is especially important for those who have undergone knee or hip replacements. By reducing pain and improving mobility, physiotherapy enhances the overall quality of life for all joint replacement patients, regardless of the joint involved.
