What is Rehabilitation Like After Hip Replacement Surgery?

Last updated on August 7th, 2020 at 03:51 am

If you’re considering hip replacement surgery, one of the key areas you’ll discuss with your healthcare professional is your post-operative recovery. 

Dr David Slattery has extensive experience in complex hip surgery, with specialisations in minimally invasive muscle sparing hip replacement and hip arthroscopy. Central to his practice is patient communication – to that end, Dr Slattery has prepared this article outlining a few key points about post-operative rehabilitation and recovery after hip replacement surgery. 

Is rehabilitation necessary?

Rehabilitation after an operation can help you return to your previous level of activity sooner. Hip replacement is a major operation which your body needs time to recover from. Following a proper rehabilitation program can ensure that your body has the best chance of recuperating after the surgery, strengthening the muscles around your new joint and allowing you to get back to life. 

What is involved in rehabilitation? 

Rehabilitation can take various forms depending on the specific needs of the patient after surgery, but broadly can encompass a programme of rest, targeted exercise, physical therapy and assisted movement. You’ll begin exercising before you’re upright, doing basic seated exercises while in hospital in order to begin to strengthen the surrounding muscle. From two weeks after your operation, more vigorous – but still low-impact – exercise such as a stationary bike, with hydrotherapy recommended from four weeks. 

Additionally, you’ll be required to walk with the assistance of crutches or a walker for up to four weeks. Walking on your new hip is one of the best ways to strengthen it, so walking for exercise purposes is recommended from eight weeks onwards. Expect to see a slow return to all activities and pre-operative levels of strength and balance over the following months, with some patients taking a full year to regain everything. 

What is enhanced recovery after surgery & can it help me? 

Enhanced recovery after surgery is a series of evidence-based practices employed before, during and after a procedure in order to help patients recover as quickly and as fully as possible. Within the context of hip replacement surgery, enhanced recovery after surgery could look like following a nutrition plan prior to the operation, regional rather than general anaesthesia during the operation, and early mobilisation and avoidance of opioids after surgery. 

According to a 2016 New Zealand study, use of enhanced recovery after surgery procedures for hip replacement patients reduced median hospital stay by a day without compromising the quality of healthcare provision. Every enhanced recovery after surgery programme is different and is responsive to the individual goals and needs of the patient – Dr Slattery will help determine what is to be included in your programme during consultation. 

If you’d like to know more, contact Dr Slattery’s rooms to make an appointment.

References:

  1. Soffin, E. and YaDeau, J. (2016). Enhanced recovery after surgery for primary hip and knee arthroplasty: a review of the evidence. British Journal of Anaesthesia, 117, pp.iii63.
  2. Stowers, M., Manuopangai, L., Hill, A., Gray, J., Coleman, B. and Munro, J. (2016). Enhanced Recovery After Surgery in elective hip and knee arthroplasty reduces length of hospital stay. ANZ Journal of Surgery, 86(6), pp.475-479.

 

How Long Does It Take to Recover from Hip Replacement Surgery?

Total Hip Replacement Surgery

Hip replacement is major surgery, requiring a careful and considered approach to ensure the best and speediest path to recovery. Regardless of what stage you’re at – whether you’re pre-operative and considering hip replacement, a few days out of the hospital or several weeks into your recovery– you’ll most likely have a lot of questions. Dr David Slattery wants to make the hip replacement surgery recovery process as streamlined as possible for every patient, ensuring that they fully understand what they need to do at each stage of their recovery to achieve their optimal health outcomes. 

To help you more fully understand your path to recovery after hip replacement, Dr Slattery has prepared this article addressing a couple of common questions he receives from patients during their recovery. Read on and be a more informed patient. 

How does recovery from hip replacement work? 

Recovery from hip replacement is similar to recovery from any other major surgery – your doctor and other healthcare professionals will work with you to develop a phased recovery plan that gradually returns you to your normal activities.

Dr Slattery uses enhanced recovery techniques to expedite your recovery, what used to be many weeks in hospital recovering is now only a matter of days.  Patients are up and mobilising day 1 after the procedure with the assistance of physiotherapy, and a frame or crutches.  From there you steadily progress to being independent with simple activities such as getting dressed, going to the bathroom and moving around the house.  Your recovery involves constantly progressing activities and movements. Initially ankle pumps, leg raises, and heel lifts are done and then progressing to balancing and strength activities using resistance bands.  These build up over time to independent walking without a gait aid.  Most patients are off their crutches and walking well by 4-6 weeks post op.  Overall, it may take up to six months to completely return to all of your previous activities – especially if you’re involved in strenuous activities such as running or cycling.  

What kind of pain can occur after hip replacement surgery? 

If you’ve previously had arthritic pain in your hip, it’s likely to be greatly reduced or eliminated after the surgery, but surgical pain can persist for some time afterwards. Patients report different levels of post-operative pain after total hip replacement. Dr Slattery will be able to advise you on the most suitable course of action to manage surgical pain during your recovery. Patients may require either over-the-counter or prescription painkillers during this period – this will be discussed with by Dr Slattery during your post-operative consultations. 

Is recovery different if this is my 2nd hip replacement surgery? 

Recovery after revision surgery for a total hip replacement can take longer due to a range of factors. Other than the extra time required, recovery after a second hip replacement does not differ significantly in mechanism. Like your first time, you’ll be prescribed a series of exercises to do, be given instructions for what positions and activities to avoid and be provided with crutches or a walker to assist you once you’re capable of walking. 

If you have any further questions about your recovery, Dr Slattery is available for consultation. Call our rooms at Glenferrie Hospital on 03 9819 6934 to book an appointment. 

What is Robotic Knee Replacement?

Last updated on August 7th, 2020 at 03:54 am

Recent advances in technology are changing the way many orthopaedic surgeons – including Dr David Slattery – are conducting common procedures. Key amongst these is the rise in the use of robotic knee replacement as an option for patients suffering from various forms of arthritis as well as other conditions. But what is it, and is it right for your condition? 

In this blog, we take a look at what sets robotic knee replacement apart from traditional methods, helping you determine whether it’s something worth discussing with your medical professional. 

Greater precision & customisability 

Robotic knee surgery involves the usage of computer-controlled tools to assist in the selection/creation of the prosthesis and the cutting required to fit the prosthesis. The procedure may vary based on the specific system selected by your orthopaedic surgeon, but broadly robotic knee surgery takes place in three stages:

  1. Modelling – Your surgeon will make a 3D scan of the knee, allowing them to select a prosthesis that more precisely fits your anatomy. This step is either done preoperatively in conjunction with a CT scan or intraoperatively by direct surface mapping. As part of this step, the range of motion and stability of the joint will be simulated, helping to ensure a better match between patient and prosthesis. 
  2. Surgery – During the surgery itself, the surgeon uses the robotic system to assist in cutting into the bone and positioning the implant. Real-time imaging ensures that small – but crucial – revision cuts can be made intraoperatively to ensure the best possible fit. Throughout the process, surgical cuts are compared to the chosen simulation, minimising the risk of surgical error. 
  3. Testing – After components have been placed, the robotic system assists the surgeon in checking the range of movement and stability against the simulation, letting the surgeon know immediately if revision is required. 

A specialist orthopaedic surgeon with experience in robotic surgery

Dr David Slattery is proud to offer patients the ability to work with an orthopaedic surgeon trained in robotic knee replacement. Having successfully performed hundreds of traditional knee replacements, Dr Slattery is excited about the increased accuracy and customisation of treatment offered by robotic methodologies, believing they could result in better patient outcomes under the right circumstances. 

With nearly over aa decade of practice in Orthopaedic Surgeryas an orthopaedic specialist, Dr Slattery is ready to answer any questions you may have about knee replacement – including your suitability for robotic surgery. If you’d like to discuss your health with Dr Slattery, please contact our offices. Dr Slattery is available for consultations across Melbourne – Glenferrie Private Hospital, The Avenue Hospital, Heidelberg, and Brighton and the Royal Children’s Hospital – as well as remotely via telehealth services. Should you wish to book an appointment, please contact our Glenferrie Private Hospital rooms on 03 9819 6934. 

FAQs

Is robotic knee replacement better?

Robotic knee replacement offers both advantages and disadvantages over traditional surgery. Robot-assisted surgery offers higher precision and more accuracy than conventional methods of total knee replacement and allows better intra-operative fine tuning of the knee replacement. Note that as this is new technology, this accuracy has not been proven to make a difference in the long-term survival of the implant, but it is likely to in the future as we obtain more longitudinal data on robotic knee replacement

This methodology does have its downsides, however, as the high costs of equipment (typically exceeding $1 million for the hospital) and specialised training required to use the technology limits its deployment. 

Dr Slattery will recommend the most appropriate method of knee replacement for your circumstances. 

Does Medicare cover knee replacement?

Yes. Within the public system, Medicare fully covers the cost of knee replacement but does not cover robotic knee replacement. Medicare will cover the cost of the hospital admission and the prosthesis/implants as well as surgeon, anaesthetist, assistant costs. In the public sector, typical waiting times for a joint replacement are between 12 and 18 months.  

In the private sector, Medicare can still pay some of the costs towards a knee replacement, but there are significant out of pocket costs, between $15,000 and $20,000 if you do not have private health insurance.

How much can I walk after knee replacement?

While initially pain will limit the amount of walking you are capable of doing in the post-operative period, most patients can start walking after knee replacement surgery immediately, albeit assisted by crutches for the first few weeks. 

Over time, as muscle strength improves and pain decreases, the amount of walking you can do increases. By six weeks you should be transitioning off crutches.  Once the rehabilitation is complete you should be able to walk as much as you like on your knee, without discomfort or pain.  

Are double knee replacements recommended?

Double knee replacements in medically well patients can be done, but there are higher risks of DVT and an increased need for blood transfusion and potentially longer hospital admission (typically between five and seven days) compared to single sided knee replacement.  

If double knee replacements are contemplated, then it is essential that patients are assessed thoroughly preoperatively by a physician to ensure that they are as medically fit as possible prior to knee replacement surgery. Dr Slattery will be able to provide advice on your suitability for a double knee replacement.  

 

What is an Orthopaedic Surgeon?

Last updated on May 10th, 2020 at 10:33 pm

Pain in your tendons, joints or muscles can have a significant impact on your day to day life. From stopping you doing the activities you love to making something as simple as driving, shopping or working painful and difficult, long-term pain can stop you being your best.

Fortunately, there is help. Many Australians experiencing pain in these areas find value in speaking to an orthopaedic surgeon. These professionals can help you understand the underlying cause of your back, knee or hip pain, helping you overcome it and return to the things you love the most.

Dr David Slattery is devoted to helping his patients make more informed choices about their bodies and their health, so his team has prepared this short article explaining what it is an orthopaedic surgeon does, what their area of practice is, and how they can help you.

A broad area of treatment

Orthopaedic surgeons are one of the most commonly seen medical specialists in Australia, and with good reason. Orthopaedics is concerned with conditions involving the musculoskeletal system – that is, bones, muscles, cartilage, tendons, ligaments, joints and other connective tissue.

With such a broad area of practice, many people will find themselves speaking to an orthopaedic surgeon at some point in their life in relation to a wide variety of conditions from arthritis to carpal tunnel and certain fractures. Patients suffering from sports injuries, certain infections, or tumours may be referred to an orthopaedic surgeon, with many specialising in a certain area of the body such as the foot and ankle or the spine, or on a certain demographic through paediatrics or sports medicine.

A range of options available

Despite the title, orthopaedic surgeons commonly use both surgical and non-surgical (also known as conservative) methods to treat conditions. These conservative treatments can include medication, physiotherapy and rehabilitation, exercise and manipulation of the affected area among others. Orthopaedic surgeons will ideally only pursue surgery as a last resort, striving to help restore your quality of life without the interruption of a stint in hospital. The result – where successful – is a return to a fuller range of pain-free mobility without the potential complications of surgery, helping you return to the activities you love sooner.

A compassionate orthopaedic surgeon for Melbourne

A practicing orthopaedic specialist since 2010, Dr David Slattery has helped to restore the mobility of hundreds of patients, helping them regain the ability to play with their kids, return to the sports they love and live life the way they want.

Dr Slattery believes that surgery should only be performed when absolutely necessary, and that many musculoskeletal conditions can be comprehensively addressed through conservative methods. He prides himself on taking a patient-centred focus to his practice, acting as a partner in your health ensuring that you are actively engaged in the decision-making process at every stage.

Should surgery be required, Dr Slattery’s specialisations in hip replacement, hip preservation and reconstruction, knee replacement and lower limb sports surgery will ensure that you are provided with the full range of options open to you. Dr Slattery will be able to tailor treatments to ensure the best fit for your needs and goals in the hopes of meeting your expectations for recovery.

Dr Slattery is available for consultations across Melbourne – Glenferrie Private Hospital, The Avenue Hospital, Heidelburg, Brighton and the Royal Children’s Hospital – as well as remotely via telehealth services. Should you wish to book an appointment, please contact our Glenferrie Private Hospital rooms on 03 9819 6934.

Is Hip Replacement Surgery a Good Idea at Age 45?

Last updated on January 28th, 2020 at 11:42 pm

Hip replacement is often thought of as a surgery for the elderly. The association of hip replacement with the elderly means that many patients below a certain age likely do not consider themselves candidates for the surgery.

That’s an assumption for a number of reasons as we’ll explore in this blog. Broadly, advances in prosthetic technology mean that age is factoring less and less into the decision to embark on hip replacement surgery, with patients of all ages experiencing significant and long-lasting arthritic pain relief after the procedure. If you’re 45 or younger and wondering if you should discuss hip replacement with your doctor or should seek a consultation with an orthopaedic surgeon, we want to help you make a more informed choice about your health. Read on and better understand.

The biggest factor if you have arthritis, is your degree of disability and pain related to your hip. Hip replacements are performed from teenagers onwards if they have severe symptoms and hip arthritis that is non-responsive to other treatments.

Note that this is general advice, and your situation may change depending on your needs as a patient, the nature of your complaint as well as the presence of any complications or comorbidities and other factors including lifestyle and age.

Increased implant durability

Previously, doctors and surgeons have expressed anxieties about pursuing hip replacement in younger patients. In brief, healthcare professionals were concerned that early surgical intervention would start a sequence of multiple operations, requiring replacement and revision at regular intervals throughout the patient’s life.

The hip is one of the hardest-working joints in the body, offering a wide range of movement and responsible for the bearing of a great deal of force. An improperly selected or implanted prosthesis can quickly deteriorate,

What can’t I do after a hip replacement surgery?

Previously, doctors and surgeons have expressed anxieties about pursuing hip replacement in younger patients. In brief, healthcare professionals were concerned that early surgical intervention would start a sequence of multiple operations, requiring replacement and revision at regular intervals throughout the patient’s life.

The hip is one of the hardest-working joints in the body, offering a wide range of movement and responsible for the bearing of a great deal of force. An improperly selected or implanted prosthesis can quickly deteriorate, causing additional pain for the patient and requiring costly and time-consuming revision surgery.

These fears of endless revisions were not unfounded during the early days of hip replacements, when they only lasted for a short duration of time and there were high rates of complications with revision surgery . As hip replacement surgery has advanced with rapid progress in implant materials and insertion techniques, they are lasting longer and longer. Hip replacements put in today should last at least 15-20years before they require exchange.

Helping you make an informed decision

All of this is to say that if you are considering whether or not to broach the subject of hip replacement with your doctor at the age of 45, it may be a conversation worth having, as many of the risk factors associated with younger-than-average surgery becoming less of a concern.

If you’re interested in taking this discussion further, call Dr David Slattery’s rooms at the Glenferrie Hospital on 03 9819 6934 to book a consultation or request an appointment via our contact form.

SOURCES

What is Rehabilitation Like After Hip Replacement Surgery?

Last updated on February 5th, 2020 at 10:56 pm

Hip replacement is one of the most common surgeries performed in Australia, but common does not mean minor. Like all major surgeries, there is a rehabilitation period immediately after hip replacement. This rehabilitation period is designed to ensure that the surgery is as successful as possible at addressing the condition, helping you regain mobility quickly and effectively.

In this blog, we’ll go through a few key points to be aware of during the rehabilitation period, helping you better understand your needs in this time.

Note that this is general advice, and your situation may change depending on the hip replacement technique chosen by your surgeon, the presence of any complications or comorbidities and other factors including lifestyle and age.

Dr Slattery utilises an ERAS – Early Recovery After Surgery Protocol, which is an internationally validated method of speeding up recovery after hip and knee surgery.  This involves specialised techniques in anaesthesia, physiotherapy and rehabilitation to allow early mobilisation and rapid recovery.

Early days

Advances in hip replacement technology and technique mean that for many patients, hospital stays have been shortened from a week to commonly two or three days. Some patients may be required to stay as many as five depending on the specifics of the procedure.

Depending on the technique used by your doctor as well as other factors, you will most likely be able to get out of bed, stand and walk with the aid of crutches on the first day. Soon after your operation and while still in the hospital, you’ll begin a course of physical therapy, building strength around the new joint so that you can develop mobility with your new hip. Rehabilitation at this stage frequently consists of simple exercises such as ankle pumps, leg lifts, and heel slides, but will soon progress to more strenuous exercises designed to strengthen the muscles around the hip.

What can’t I do after a hip replacement surgery?

Hip replacement surgery is major surgery, and as such during the rehabilitation period there will be things you are advised not to do – or not to do without assistance. Common activities affected by hip replacement surgery include walking, navigating stairs, driving, work, intimacy and exercise, among others. Your ability to resume these activities is affected by a range of factors, including the technique used by your surgeon, the presence of any complications, your level of preparation prior to surgery, your body weight and level of fitness.

As general guidance, patients frequently move to walking with crutches after about two to four weeks, with unassisted walking following after four to six weeks. Note that some patients are advised not to carry their full weight on the affected leg in the weeks after surgery, necessitating a longer period of time on crutches before transitioning to walking unassisted. Additionally, patients will most likely need assistance navigating stairs for the first month after surgery, and your ability to drive will be affected not only by your recovery but by how long you are prescribed pain medication for.

Overall, following the instructions of your physical therapist and doing the exercises prescribed can be beneficial to your recovery, allowing you to return to normal activities sooner.

What if this is my second hip replacement?

For patients having hip revision surgery, rehabilitation is similar to those having initial replacement surgery. Physical therapy will be required, and your medical professional will advise you on the exercises you should be doing and if your level of activity should change compared to the rehabilitation period following your initial replacement.

For advice on your rehabilitation needs following a hip surgery or to discuss your eligibility for hip replacement, please call our Glenferrie Hospital Rooms on 03 9819 6934 to book a consultation with Dr Slattery. Appointments can also be requested via our contact form.

SOURCES

Jayakumar, Prakash et al. “A Patient-Focused Technology-Enabled Program Improves Outcomes in Primary Total Hip and Knee Replacement Surgery.” JB & JS open access vol. 2,3 e0023. 25 Jul. 2017, doi:10.2106/JBJS.OA.16.00023