Restrictions After Hip and Knee Replacement

I write this a few hours after returning from a Class V whitewater rafting trip on the Penobscot River in northern Maine and a day after hiking in Baxter State Park on some of their more moderate trails. As some of my patients know, I have two hip replacements that I required due to early onset arthritis coupled with some strenuous periods of wear and tear on my body. When I first discovered at age 46 that I would need to have both of my hips replaced, I immediately thought of all of the unaccomplished dreams that I might never be able to pursue. Despite doing joint replacement for a living, when it came to me, I thought my active life was over…..Far from it. In fact, many people with arthritis have been living with stiffness and pain for quite some time and still engaging in moderately strenuous activity despite the pain. If anything, hip and knee replacement enable patients to return to all manner of activity with substantially less pain and better function.

So are there any restrictions on modern joint replacements? Fortunately scientists, engineers and surgeons have worked over the past 3 decades to improve the durability of modern implants to the point where failure from mechanical implant loosening and material wear is increasingly rare in the first 2 decades of use. Obviously, a higher level of activity can impart greater wear on the implant but we expect modern implants to last 20-30 years permitting a high level of use and some abuse. We do recommend against repetitive impact loading such as distance running or sports that may require repetitive jumping. Almost all other activities we do not restrict.

Patients should realize however that a return to a high level of activity requires significant rehabilitation of muscles, tendons and ligaments that have been weakened and stiffened by months or years of progressive degeneration. While joint replacement can restore comfort and motion early after surgery, strength and function taken longer to recover and require a substantial commitment by the patient to achieve the goals of a high activity level. In other words, you can lead a perfectly normal life in terms of your desired physical activities but you have to get your body in shape to be able to achieve that goal. Picture who you want to be and what you want to do when your pain is gone. This is what our AVATAR program can help you accomplish.

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