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Dear Dr Ganjianpour, thank you for performing my hip replacement surgery. I am very grateful to you. Because of you, I am able to do everything that I want with no more pain.
You are an unbelievable surgeon; you gave me my life back. Thank you for my shoulder surgery and fixing my torn rotator cuff.
I cannot begin to tell you how lucky I am that I was referred to you by my friend. Because of that you were able to make me better with no surgery, good physical therapy regimen and recommendations
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What should I expect immediately after joint replacement surgery?
In the last few years, minimally invasive joint replacement has turned the corner in terms of the outcome after joint replacement. The patients are having this surgery done with a smaller incision, which is about 3-4 inches. There is less muscle cutting and less soft tissue damage, yet they are still obtaining the same prosthetic device that has a high durability for a long period of time. The surgery is performed with special instrumentation, which allows the surgeon to perform the operation with less incision, which is about 3-4 inches in comparison to previous old incisions of 12-15 inches. As a result, this allows the recovery to be much faster and allows the patient to return to work quicker and also have much less pain post operatively.
A lot of the recovery of the patient also depends on the attitude and motivation. There have been numerous studies that show that people who have a stronger attitude and believe in their own abilities to do things necessary for recovery will do a lot better in the long run and will get back on their feet much faster and quicker. The patient will be able to walk immediately after the surgery on the following day and they will start getting physical therapy in order to have proper gait training and step training in order to get back to the normal waling ability.
How many days will I be in the hospital after surgery?
The normal hospitalization time for joint replacement surgery conventionally used to be about 7 to 10 days with the larger incision technique, however, with the minimally invasive joint replacement surgery the patients are able to go home after two to three days of hospitalization. During the course of hospitalization in that short period of time, the patient will be instructed by the nurses and physical therapist on how to get around safely. They will be trained with crutches or walkers to have a safe walking ability so they can get around to the bathroom and be able to manage themselves in and out of bed. Most of the first few days in the hospital are for pain management as well as wound management care and purposes. The patients usually do very well after this operation. In our experience, they are ready to be discharged home after two to three days. In some instances, if the patient does not have proper care or support at home, arrangements are made for the patient in order for them to go to a rehabilitation facility or an acute rehabilitation facility for an extra few days.
How much physical therapy will I need after total joint replacement surgery?
After minimally invasive joint replacement surgery, the physical therapy duration varies from individual to individual. However, the average duration of physical therapy that is recommended for this procedure is about twice a week for four to six weeks. The purpose of the physical therapy is to strengthen the muscle of the leg to include mostly the hip flexors, as well as the joint abductors in order to make sure that the power of the hip muscle girdles have come back to normal or get stronger. It should be noted that prior to performing this operation most people have had a painful limp and as a result of disuse and protection some of muscles of the leg become weak. Therefore, after the operation there is some time spent in the physical therapy department in order to get the original strength of the leg back so the patient can function normally after such operations. However, in general, if an individual does very well and gains their strength of the hip muscles quickly, the physical therapy can be terminated sometimes as soon as two to three weeks.
Will there be much pain after minimally invasive total joint replacement?
The amount of pain post operatively from minimally invasive joint replacement surgery is extremely minimal in comparison to the conventional joint replacement surgery that has a 12-15 inch incision. The pain is substantially less because there is less muscle invasion and cutting and the operation is performed with about a 3-4 inch incision. There are also new pain management techniques that are used in our institution where the patient is also medicated prior to the operation in the pre-op holding area and also the new techniques of pain management after the surgery which in combination all these new techniques pharmacology has diminished the amount of pain the patient experiences after such an operation.
How will I get around after surgery?
After minimally invasive total joint replacement surgery the patient is able to ambulate and walk the day after surgery. Physical therapy will get the patient up and they start walking the hallways. At that point they will also be trained in stair climbing as well as getting in and out the bed, chair and car. With the aid of an assistive device such as a walker, crutch or cane, the patient will be mobile the day after the operation. As the patient’s confidence in their ability to ambulate increases, the walking aid can be put away and the patient may ambulate without any assistive device. In instances where the home environment is not very friendly with the joint replacement, prior arrangements can be made in order to make sure that the patient’s habitat is ready for post operative care. Some of these changes could be relocation of the bedroom to a downstairs unit.
Arrangements of the kitchen and cutlery to lower shelves in the kitchen inorder to make sure they are more easily reachable and accessible, providing bed side commode or special made grabbers for the patients to have accessible at bedside in order to get to the bathroom easily or to be able to reach items around the bed easily. When it comes to driving after joint replacement surgery, the patient will have to wait until they have regained enough muscle power in order to control the foot pedals. The average time recommended by physicians to not be driving is about six weeks. However, there have been instances that the patient may be able to drive as soon as four weeks time or sometimes under adverse circumstances it may be delayed until eight weeks time.
What kind of lifestyle changes will I need to make after surgery?
There is going to be a few lifestyle changes immediately after the operation. The number one in getting around after joint replacement surgery will require use of a walker, crutch or care for several weeks, ranging from two weeks to six weeks. It all depends on how the recuperation of the individual patient is progressing. However, a walking aid would be necessary in order for the patient to gain full confidence after the operation. Dressing after joint replacement surgery could become somewhat challenging at the early stages since the patient with joint replacement operation may have some discomfort with putting their dress or pants on since bending of the knees and joints can be uncomfortable.
There are also certain precautions that need to be obeyed for three months after hip replacement surgery, which include not bending of the joint more than 90 degrees and no internal rotation of the legs more than 40 degrees. This could make dressing a challenge but there are a number of tools for helping the patient get dressed after the operation. Some of these tools include long handled shoe horn, a sock aid, and a dressing stick for pulling your pants up which an occupation therapist can show the patient how to utilize these devices during the course of hospitalization. The way a patient can do personal hygiene and bathing can to a certain degree be altered. The patient will not be allowed to be sitting at the bottom of the tub. They will be advised to use a bench or a shower chair while they bathe and clean themselves. Since most toilets are low, the patient may need to get a special raised toilet seat in order to prevent them from bending their joint more than 90 degrees. In terms of performing house duties and house work, the patient will need some help at the early stages in order to be able to perform their household chores. The patient will gradually start doing some more demanding tasks as the recovery progresses. At the early stages they need to allow someone else to handle the heavy work for a while.
What kind of physical activities will I be able to participate in?
Once the pain in the joints that is caused by the damaged cartilage is relieved by the joint replacement operation and the patient has regained the strength of the leg, the patient should be able to perform the usual activities of daily living that they had been engaging in prior to the operation. It usually takes about four to six weeks for most of the pain and discomfort to get better and the patient to regain the control of the extremity that has been operated on. The patient should be able to start ambulation without an assistive device. They should be able to walk on a regular basis. They can engage in walking, biking, and golfing. Some of the higher activity levels such as playing tennis, jogging, or jumping should be avoided since high impact aerobic can have adverse effects on the joints itself.
How long will my joints replacement last?
The art of joint replacement surgery in the past 40 years has improved significantly. The technique, as well as the material used in the prosthetic devices is made of very highly durable casting polyethylene liners, as well as being made of titanium and cobalt chrome metals. These advances in technology have significantly improved the longevity of the prosthetic device and wear and tear of the joint replacement prosthesis. Most people can expect that their total joint replacement will last about a decade or more. The average expectancy of joint replacement prosthesis is estimated to be between one to two decades. This will provide years of pain-free living that would not have been possible otherwise. The future is bright for those who choose to have a joint replacement surgery to achieve an improved quality of life through greater independence and healthier pain-free activity.
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