Movement promotes wound healing after joint replacement
Exercise is a key component of wound care after hip and knee surgery. It can help prevent infections, improve blood circulation, reduce swelling and pain, and promote healing of the surgical site. By following a tailored exercise program and proper wound care instructions, patients can recover faster and enjoy better outcomes from their joint replacement surgery.
How many knee and hip replacements are done each year?
A 2019 USA study projected increases in total joint arthroplasty 2020-2040. It seems that demand went up during the pandemic, but supply was dramatically reduced. So we have a BIG backlog in most countries, not just the USA. We are eager to see these 2019 estimates adjusted:
Hip
34% in 2020 to 498,000
75% in 2025 to 652,000
129% in 2030 to 850,000
284% in 2040 to 1,429,000
Knee
56% in 2020 to 1,065,000
110% in 2025 to 1,272,000
182% in 2030 to 1,921,000
401% in 2040 to 3,416,000
Ref: Singh JA, Yu S, Chen L, Cleveland JD. Rates of total joint replacement in the United States: future projections to 2020–2040 using the National Inpatient Sample. J Rheumatol. doi: 10.3899/jrheum.170990
Movement promotes healing of wounds?
Caring for a wound is something that most of us experience. Be that a graze from a skateboard accident as a child or an incision from a knee replacement when we are older. Most see skin care as a passive ‘outside-in’ experience, applying creams and dressings, but in fact a lot happens from the ‘inside-out’.
Movement can play a vital role in recovery after hip and knee surgery, not just for the muscles and joints, but for wound care as well. Movement can help prevent infections, improve blood circulation, reduce swelling and pain, and promote the healing of a wound.
Movement boosts the immune system
One of the main benefits of movement after hip and knee surgery is that it can prevent infections by boosting the immune system and reducing the risk of blood clots. According to the NICE guideline on joint replacement, patients should be given medication to minimise blood loss during surgery, which can also lower the chances of infection. However, exercise can further enhance this effect by stimulating the production of white blood cells and preventing the formation of clots in the veins.
Movement promotes circulation
Another benefit of movement after hip and knee surgery is that it can improve blood circulation to the wound area, which is essential for delivering oxygen and nutrients to the tissues and removing waste products. This can speed up the healing process and reduce the risk of complications such as delayed wound closure, wound dehiscence, or necrosis. Movement can also help reduce swelling and pain by improving lymphatic drainage and reducing inflammation.
What type of exercises are appropriate?
The type and intensity of exercise after hip and knee surgery depends on the individual patient's condition, goals, and preferences. However, some general guidelines are to start with gentle range of motion exercises, such as gently bending and straightening the joint, ankle pumps, and heel slides. These exercises can help prevent stiffness, restore mobility, and prepare the joint for more advanced activities.
As a wound heals and the pain subsides, patients can gradually progress to more challenging movements, such as weight-bearing exercises, resistance exercises, balance exercises, and functional activities. These exercises can help strengthen the muscles around the joint, improve stability and coordination, and enhance the quality of life. Better quality movement generally leads to better mobility and a lower risk of undoing all the good work of the surgeon and the rehabilitation team. Having a new hip or knee might feel like being on training wheels initially. Building up balance and confidence in movements like squats is important for recovery of the affected leg, and also for taking the load off the unaffected leg. Chances are, the ‘good leg’ has been working overtime for a while.
Exercise immediately after hip and knee surgery should be done under the guidance of a physiotherapist or a healthcare professional who can monitor the patient's progress and adjust the exercise program accordingly. Patients should also follow the instructions on wound care, such as keeping the wound clean and dry, changing dressings regularly, and avoiding soaking or rubbing the wound. Patients should report any signs of infection or complications to their doctor immediately, such as fever, redness, warmth, pus, or increased pain.