Joint Replacement Surgery and Pain

by Cory Calendine, MD, Orthopedic Surgeon

A major issue when people are thinking about hip and knee replacement is how painful is it going to be directly after surgery and throughout the process.  Well, if you ask enough people, you might hear some horror stories, but I want to give you some reassurance and shed a little light on where we are now in Orthopedics, and really, how far we have come from even a few years ago. We didn't always have the techniques we have access to now for pain control.

Today we have techniques that we call pre-emptive (or preventative), meaning we try to treat your pain before you are actually experiencing the discomfort. Believe it or not, when you show up for your hip or knee replacement, we give you medicine to help with your pain before the procedure even begins. This allows us to get ‘in front of’ the pain, and stay ahead of it through your procedure. This is critically important in your ability to ambulate after surgery, participate in therapy and ultimately how well you do - not to mention, you're not miserable which is really important to us. 

We work to minimize our use of narcotic pain medications.  We’ve learned certainly with the opioid crisis, that narcotics are not our friend, and there can be huge challenges and risks to people adapting to or becoming addicted to opioid pain medications. We minimize the use of opioids and make full use of non-opioid pain medications such as Tylenol and anti-inflammatories. We are able to optimize pain control by utilizing periarticular injections and nerve blocks to treat your pain. By minimizing your need for narcotics, you are able to get back to your life sooner - and with less pain. 

It used to be that joint replacement surgery meant you were in the hospital days upon days, and one major reason for those prolonged hospitalizations was because of the pain.  Because our pain control techniques today have evolved and improved, greater than 80% of joint replacement patients go home after only one night in the hospital and many today are able to return home the same day of surgery. It's important to get back to your quality of life as quickly as safely possible, so I hope if you're struggling with joint pain and the loss of quality of life you won’t let the fear of pain keep you from taking that next step toward healing.

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The Benefits of Effective Pain Management

Minimizing pan is a top priority of any joint replacement surgical plan. The benefits of optimizing pain relief include:

Increased patient comfort. Joint replacement is a major surgery and each patient has some degree of post-operative pain - aggressively managing that pain provides improved patient comfort.

Earlier mobilization and physical therapy. A patient with limited pain is much more likely to get out of bed and begin rehab exercises. Under the guidance and recommendations of your surgeon and/or physical therapist, post-op activity and exercise can help shorten duration of pain, reduce scar tissue development, increase joint range of motion, and contribute to a more successful recovery.

Decreased risk of deep vein thrombosis (DVT). Many joint replacement patients are at increased risk for developing a deep vein blood clot. When pain is controlled, patients will ambulate earlier and more often - decreasing the risk of DVT.

Earlier hospital discharge. Pain control has previously been the reason for prolonged hospitalization following joint replacement. Improved peri-surgical pain control methods mean shorter hospital stays - with some joint replacement patients going home the same day of surgery.

Check back soon for more detailed information on peripheral nerve blocks and multimodal analgesia. Please share the information you have found helpful and subscribe to the Bone Health and Harmony Blog below for regular updates on bone and joint health topics. Follow us on social media for daily news and update.

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Cory Calendine, MD is an Orthopaedic Surgeon and founding partner of the Bone and Joint Institute of Tennessee at Williamson County Hospital in Franklin, TN. Dr. Calendine is an expert in Joint Replacement, specializing in Hip and Knee Surgery. From diagnosis through treatment, the Orthopaedic Surgical experts at the Bone and Joint Institute use the latest techniques and technology to improve care for people with musculoskeletal problems. For more information, please contact our office or schedule your appointment today.  

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