What is Rapid Recovery Joint Replacement?
Rapid recovery joint replacement is an innovative program for patients undergoing joint replacement surgery that aims to minimize patients’ postoperative discomfort and pain and restore joint function in the quickest time possible.
The rapid recovery joint replacement technique functions by accelerating all aspects of a patient’s recovery process, including physiological, mental, and physical following a joint replacement surgery so as to elevate patient care to the highest level. The physical aspect of recovery involves restoring the patient’s level of strength, range of motion, and overall function. The mental aspect of recovery involves elimination of concerns, revival of self-confidence, and the state of feeling whole and balanced. The physiological aspect of recovery involves taking into account all the crucial body systems, such as respiratory, renal, and cardiovascular, and aim to avoid insult on it during your surgery.
The advanced rapid recovery program is a result of years of research by orthopedic surgeons and research staff as well as utilization of cutting-edge technology from evidence-based scientific studies from around the globe. This technique has led to the evolution of a multimodal approach for management of pain following joint replacement surgery and revolutionized the way that people recover from a joint replacement.
Advantages of Rapid Recovery Joint Replacement
Some of the benefits achieved with rapid recovery joint replacement technique include:
- Significant reduction in pain
- Shorter hospital stay
- Early mobilization and quicker rehabilitation
- Ability to walk within 4 to 5 hours of most knee and hip replacement surgeries
- Use of advanced pain management techniques
- Use of efficient and minimally invasive surgery techniques
- Postoperative planning and support
- Comprehensive preoperative assessment and coaching
- Discharge date is planned prior to the surgery
- Rehabilitation or home care is organized prior to your admission to the hospital
- Care providers are regularly in touch with you even after discharge, keeping track of your progress and recovery
- Physical therapy instructions are provided prior to the surgery to strengthen joints and help accelerate recovery after joint replacement
- Appointment of a personal coach to monitor all aspects of your recovery and decision making
- Preoperative session to eliminate anxiety associated with joint replacement
- Superior overall patient satisfaction
Anatomy of the Joint
A joint is an articulation (junction) between 2 or more bones in the body. The two articulating bone surfaces are covered by smooth tissue called articular cartilage, a firm but flexible connective tissue that allows the bones to slide over each other smoothly and without friction, and also acts as a shock absorber during bone movement. The cartilage is lubricated with synovial fluid, a collection of thick liquid restricted within a joint space which further enables the smooth movement of the bones.
Indications for Rapid Recovery Joint Replacement
Some of the common indications of joint replacement surgery include the following:
- Treatment of arthritic conditions, such as osteoarthritis and rheumatoid arthritis of the joints
- Severe joint pain that limits your daily activities (such as walking, getting up from a chair, or climbing stairs)
- Moderate-to-severe pain that occurs during rest or awakens you at night
- Chronic joint inflammation and swelling that is not relieved with rest or medications
- Weakness and/or loss of joint motion
- Severe joint fracture or trauma
- Failure to obtain pain relief from medications, injections, physical therapy or other conservative treatments
Preparation for Rapid Recovery Joint Replacement
Preoperative preparation for rapid recovery joint replacement will involve the following steps:
- A thorough examination by your doctor is performed to check for any medical issues that need to be addressed prior to surgery.
- Depending on your medical history, social history, and age, you may need to undergo tests such as blood work and imaging to help detect any abnormalities that could threaten the safety of the procedure.
- You will be asked if you have allergies to medications, anesthesia, or latex.
- You should inform your doctor of any medications, vitamins, or supplements that you are taking.
- You should refrain from medications or supplements such as blood thinners, aspirin, or anti-inflammatory medicines for 1 to 2 weeks prior to surgery.
- You should refrain from alcohol or tobacco at least 24 hours prior to surgery.
- You should not consume any solids or liquids at least 8 hours prior to surgery.
- Arrange for someone to drive you home as you will not be able to drive yourself after surgery.
- A written consent will be obtained from you after the surgical procedure has been explained in detail.
Procedure for Rapid Recovery Joint Replacement
The procedure is performed arthroscopically under anesthesia and involves the following steps:
- After adequately sterilizing the surgical area, your surgeon will make 2 to 3 small incisions of about 1/4 inch in length around the joint.
- Through one of the incisions an arthroscope - a narrow tube with a tiny video camera on the end - is inserted to view the damaged joint.
- A sterile solution is pumped into the joint to expand the joint area and create room for the surgeon to work.
- The larger image on the television monitor allows your surgeon to visualize the joint directly and determine the extent of damage and the required treatment.
- Miniature instruments are inserted through other small incisions and the supporting structures of the joints are gently moved out of the way, allowing removal of damaged cartilage and bone tissue from the joint.
- Your surgeon prepares these surfaces appropriately to insert specifically-sized prosthetic components to your joint, which are secured with the use of bone cement or screws.
- With all the new components in place, the joint is tested through its range of motion.
- All surrounding tissues and structures are restored to their normal anatomic position and the scope and instruments are removed.
- Finally, the incisions are closed with sutures and sterile dressings are applied.
Postoperative Care and Recovery
In general, rapid recovery joint replacement will involve the following postoperative care instructions:
- You will be transferred to the recovery area to be monitored until you are awake from the anesthesia.
- Your nurse will monitor your blood oxygen level and other vital signs as you recover.
- You may experience some pain, swelling, and discomfort in the joint area. Pain and anti-inflammatory medications are provided as needed.
- Medications will also be prescribed as needed for symptoms associated with anesthesia, such as vomiting and nausea.
- Antibiotics are prescribed to address the risk of surgery-related infection.
- It is important to keep the surgical site clean and dry. Instructions on surgical site care and bathing will be provided.
- You will be placed on assistive devices such as a splint or crutches for walking for the first few weeks with instructions on restricted weight-bearing. You are encouraged to walk with assistance as frequently as possible to prevent blood clots.
- Refrain from smoking as it can negatively affect the healing process.
- Eating a healthy diet rich in vitamin D is strongly advised to promote healing and a faster recovery.
- Refrain from strenuous activities and lifting heavy weights for the first couple of months. Gradual increase in activities over a period of time is recommended.
- An individualized physical therapy protocol is designed to help strengthen your joint muscles and optimize joint function.
- You will be able to resume your normal activities in a couple of months; however, return to sports may take 4 to 6 months or longer.
- A periodic follow-up appointment will be scheduled to monitor your progress.
Risks and Complications
Rapid recovery joint replacement is a relatively safe procedure; however, as with any joint replacement surgery, possible risks and complications may occur, such as:
- Blood clots
- Injury to nerves and blood vessels
- Implant wear and loosening
- Pain and stiffness
- The need for revision surgery (to address a faulty or problematic prior implant)