What happens after the joint replacement? 

More and more people are undergoing joint replacement surgery in order to reduce joint pain and improve function. The most common joint replacement procedures are for hip and knee osteoarthritis.

So it was interesting to read the results of a recent study that investigated how hip or knee replacement impacts physical activity levels. This study was a systematic review*, which means that the authors looked at multiple published clinical trials and analyzed the overall results. The conclusions of the review were that 6 months after undergoing joint replacement, there was no discernable increase in physical activity levels in those undergoing the surgical procedure. In other words, physical activity before the procedure was about the same as after the procedure. After 1 year, there is some, but very limited, evidence for increases in physical activity levels. However, compared to health adults, those undergoing joint replacement were significantly less physically active.

In their discussion, the authors suggest that although people with advanced osteoarthritis are motivated to have surgery because they want to experience less pain and to improve their function, this often does not translate into increased physical activity. There is evidence that people who undergo joint replacement have less pain post-surgically. It seems, though, that increasing physical activity requires more than surgery; it requires behavioral change. 

This is where physical therapy comes in. Many people who have undergone joint replacement want to increase their physical activity. Physical therapists can work with them one-on-one to improve joint function, and to create the behavioral change necessary for meeting their goals for physical activity.

Physical therapy should always be part of a comprehensive program for osteoarthritis. Interventions prescribed by physical therapists improve joint health, reduce pain, and increase function.  

Marcia Spoto PT, DC, OCS

*Arnold JB, Walters JL, Ferrar KE. Does physical activity increase after hip or knee arthroplasty for osteoarthritis? A systematic review. JOSPT. 2016; 46 (6): 331-342.