Pain Management and Rapid Rehabilitation

Total hip and knee replacement are truly miracles of modern medicine. The pain relief and improvement in function are amazing. However, the surgery is a painful and unpleasant procedure for patients to undergo. Much work has been done since 2001 to improve the patient experience by reducing the pain they experience and speeding up their recovery process. This has led to new anesthesia and pain management protocols that significantly reduce the pain experience for the patient. Patients start their rehabilitation within hours of their surgery and are allowed to walk, sit in a chair, and do therapy exercises immediately. With these improvements, patients regain independence more rapidly and can be released to home much earlier than before. Some patients can now be done as outpatients and be returned to home on the day of surgery, while most still stay one to two nights in the hospital, depending on a number of factors.

Pain medication is needed after these procedures and it is important to determine which medication works best for each patient. Some patients are allergic or non-reactive to certain medications and it may be helpful to determine this before surgery. For this reason, we are experimenting with genetic testing that can help determine a patient’s sensitivity to certain medications before surgery, and selecting specific medications for their postoperative pain management. We believe this will lead to an even better patient experience following hip and knee replacement.

While these efforts will lead to a quicker return of function, the healing after joint replacement goes on for several months and patients may expect to see a gradual improvement for up to 6 months or more as the soft tissues in the body continue to heal.