Patient Education Tip Sheet on Knee and Hip Replacement: From the AGS Foundation for Health In Aging

Nearly 700,000 Americans have hip or knee joint replacement surgery every year. And that number is expected to rise dramatically in the coming decades as the nation’s Baby Boomers reach retirement age. Knee and hip replacement can ease pain and improve movement and function in joints damaged by disease or injury. The surgery—in which damaged or diseased parts of the joint are replaced with metal or plastic substitutes—has a very high success rate. That said, there are some risks. A small percentage of people who have the surgery, for example, develop joint infections. And recovery after surgery takes several weeks. Healthcare staff, however, take steps to prevent complications and speed recovery. And patients who prep for surgery and follow through with physical therapy afterward can further boost their odds of a good outcome.

Here, from the American Geriatric Society’s Foundation for Health in Aging is advice for older adults considering joint replacement surgery:

Ask yourself some questions. If you have joint pain but can keep it under control with small lifestyle changes, by taking a pain reliever such as acetaminophen (Tylenol), or with physical therapy, you may not need surgery. If, on the other hand, you answer, “yes” to the following questions, you may benefit from joint replacement surgery:

• Does joint pain make it hard for you to sleep?
• Is the knee or hip pain keeping you from doing things you want to do, like visit friends or travel?
• Do everyday activities, such as standing from a sitting position or walking up stairs, hurt?

Discuss your symptoms and your options with your healthcare provider. If your provider thinks you might benefit from joint replacement surgery, he or she will refer you to an orthopedic surgeon who does hip and knee replacement surgery.

Learn more about surgery. Among other things, the surgeon and his or her staff will describe the surgery, benefits you can expect based on your age and health, and risks. Don’t be shy about asking questions. Make sure you understand what the surgery involves, how you should prepare for it, what kind of anesthesia you might need, how long you’re likely to be in the hospital, what kind of physical therapy you should get afterward, what your pain relief choices are, and how long recovery is likely to take.

Ask about less invasive surgery. Minimally invasive hip replacement surgery involves fewer and smaller incisions than traditional surgery. Minimally invasive knee replacement surgery involves a smaller cut than the traditional procedure. Patients who have less invasive surgery usually have shorter hospital stays and shorter recoveries. In general, people who are healthier, in better shape, and younger are more likely to be candidates for this surgery than those who are sicker and older. Ask your healthcare provider if you might be a candidate.

Tell your healthcare provider about all the medications you’re taking. Don’t forget over-the-counter drugs, vitamins, herbs, and other remedies. You may need to stop taking certain medications or supplements before and after surgery. If so, your healthcare provider may recommend substitutes.

Do you smoke? Ask your healthcare provider how to cut down or quit before surgery. Among other things, smoking can slow healing and recovery after surgery. Talk to your healthcare provider about strategies that can help you quit. In one study, patients who stopped smoking six to eight weeks before knee or hip replacement surgery had half the rate of complications of those who didn’t quit.

Exercise. Ask your healthcare provider to recommend safe and appropriate exercises that can help you get in shape for and recover more quickly after surgery. Stretching, aerobic and strength training exercises can all be helpful. Among other things, doing exercises that strengthen your arms and upper body before surgery can make it easier to use a walker or crutches during recovery. Research suggests that exercising can also speed the healing of wounds in older people. If movement is painful, water exercises in a warm swimming pool are often a good bet.

Eat right. Some older adults don’t get enough protein, and essential vitamins and minerals in their diets. To boost the odds of a better outcome from surgery, your healthcare provider may suggest that you take nutritional supplements before and after surgery or see a dietician.

Try to lose excess weight . Some surgeons require patients who weigh more than 300 pounds to lose weight before surgery, since obesity can lengthen recovery. Exercising and eating right can help you slim down if necessary.

Make physical therapy your top priority. Following through with recommended physical therapy is absolutely essential. Patients who do so are less likely to have pain and complications during recovery than those who don’t. They also tend to be able to walk sooner.

Get more information about knee and hip replacement surgery from: The FHA’s “Aging in the Know” website: https://www.healthinaging.org, The Arthritis Foundation website: www.arthritis.org, The American Academy of Orthopedic Surgeons website: www.AAOS.org, The American Association of Hip and Knee Surgeons website: www.aahks.org. 

The above is among the most recent in the AGS Foundation for Health in Aging’s series of easy-to-understand health “tip sheets” for older adults and their caregivers. All of the tip sheets, and all other information on the FHA’s free public education website, www.healthinaging.org, can be downloaded, printed, and distributed to patients and others at no cost. Other tip sheets in the series cover such topics as geriatric syndromes, advance directives, immunizations for older people, maintaining cognitive vitality, falls prevention, and avoiding caregiver burnout.