The importance of personalized care plans in joint replacement recovery

You may think recovery from arthoplasty surgery starts after you've left the hospital, but it actually begins before your knee or hip replacement procedure.
With the right care plan, you and your orthopedic team can develop a personalized approach to your joint replacement preparation, surgery, and recovery that meets your lifestyle, goals, and needs.
It’s easy to assume that your road to recovery begins after you’ve had surgery, but recovery really starts when you take action to address significant joint pain or discomfort by speaking with a care provider.
Dallas Vanorny, MD, PhD, is a native Iowan from Cedar Rapids who specializes in hip and knee arthroplasty, which refers to the surgical reconstruction or replacement of a joint. He says it’s important to understand that while not everyone’s joint problems are the same, certain symptoms--like stiffness or loss of motion--may indicate that your joint needs treatment.
“You may notice, for instance, that your leg doesn’t want to internally rotate as much now,” Vanorny says. “Getting in and out of cars with low seats may be challenging because your hip doesn’t want to flex as high or move outward as much. As time goes on, the symptoms will typically start to get worse.”
What to think about leading up to joint replacement
Once you’re ready to talk to a care provider, document your symptoms, including location and frequency, and activities associated. This information can help your physician better understand your unique condition and work with orthopedic specialists to get you the proper treatment.
If you are considering joint replacement surgery, seek care from a fellowship-trained joint surgeon. “Ninety-four percent of orthopedic surgeons are specialized, so find the subspecialists for the problem that you have,” Vanorny says.
Be sure that the surgeon explains your treatment options, Vanorny notes. Clear communication upfront will allow you and your care team to develop a personalized care plan that focuses not only on the surgery but also discharge and recovery.
“They should be spending time with you. They should be showing you your X-ray. They should be examining you,” he says. “If they’re not doing that, that’s a problem.”

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Personalized recovery after surgery
After your surgery, your care team will work with you on discharge, physical therapy, and more.
Jacob Elkins, MD, PhD, is an orthopedic surgeon who focuses on the specialized surgical and nonsurgical management of severe hip and knee joint conditions in patients with obesity or other bariatrics-related issues.
“Recovery is a very individualized situation,” Elkins says. “What you go through might be very different than what your neighbor or loved one went through.”
The vast majority of hip and knee replacement patients are discharged within 24 hours of their procedure. This means that physical therapy to help you return to your routine may begin right away—even the same day as your operation. Elkins says that while many people have a support system around them after surgery, some patients have limited support at home.
“The physical therapist needs to take that into account to determine the level of assistance you’re going to need after surgery,” he says.
With your discharge, your care team should provide after-surgery instructions, covering everything from incision care and medications to diet and activity.
Elkins says that your team should also discuss with you a plan for returning to work, signs or symptoms of potential complications, and when to contact the clinic or emergency department.
Looking forward and setting expectations
After you leave the hospital, your recovery becomes a long-term effort.
“This is very dependent on your health background and medical history,” Elkins says. “No two people are the same, but it’s important to know that a full recovery lasts several months. It’s important that we discuss with you realistic expectations regarding the first week, the first two weeks, six weeks, three months.”
Physical therapy is a significant element of recovery, particularly for knee replacements.
“We’ll give you information regarding physical therapy,” Elkins says. “For a knee replacement, physical therapy is a critical component of your recovery. For a hip replacement, we may not routinely prescribe it immediately. If you need PT later, we’ll prescribe it.”
Personalized care starts right here
With a highly skilled team that personalizes your care, you can feel secure knowing that your surgery and recovery will get you back to a pain-free life full of your favorite activities. It starts with taking note of your symptoms, asking the right questions of your team, and collaborating with them for better care.