Prehab before knee replacement could lead to better results

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prehab before knee replacement

We’re all aware of the necessity of rehabilitation after knee replacement surgery, but what about the steps we can take before we even go under the knife? It’s something that’s been on my mind throughout the year, as I’ve been preparing for my own knee replacement procedure later this month. And according to a study in New York that was published in November, it seems that a ‘pre-habilitation’ programme – which involves being counselled by a peer coach – could really help patients and lead to a better, faster recovery.

The study found that using a peer coach – deemed as a patient who has already gone through the procedure and has been trained to provide personalised pre- and post-knee replacement support – can make a huge difference to a patients’ mind-set, can openly discuss what happens before, during and after the operation and steer them towards developing good habits.

It’s a methodology that has worked very well in other areas of medicine, particularly in the field of diabetes. And although the two issues are very different, the thinking goes that both issues require a radical change of lifestyle habits and a positive attitude – and nothing works better than having close contact with someone who has already been through the procedure.

Thirty-one patients were examined during the study, ranging in age from 65 to 89 – all of whom had undergone a knee replacement at least 12 months earlier with a good outcome. They were questioned on a range of issues, notably their experiences with a peer coach. The study group’s discoveries were as follows;

The fear factor

Many patients with osteoarthritis delayed knee replacement for many years, often until the pain became very bad. Not only that, but the majority had no idea about the best way to prepare for knee replacement surgery, and ultimately didn’t prepare at all.

Second-time patients are better prepared

Many of the patients were about to undergo their second knee replacement procedure – and this time they felt they had learned what was expected of them this time around. “Patients with high outcome expectations who had undergone a previous knee replacement learned from their first experience and reported feeling motivated to engage in physical activity for muscle strengthening before their second knee replacement,” said Dr Iris Navarro-Millan, principal investigator of the study. “They expressed that their own experiences made them more informed, self-efficacious and physically active to prepare for their surgery.”

First-time patients are prepared to listen

Understandably, the people undergoing knee replacement surgery for the first time were very keen to listen to other patients about preparation and recovery and being given the opportunity to talk to patients who had gone through the procedure removed a lot of apprehension about surgery.

A thumbs-up for peer coaching

Not only were new patients more than open to the idea of peer-coaching, but the study discovered that certain patients were already doing it off their own bat – and were finding it very rewarding. After all, doctors can only tell you what’s going to happen: people who have already undergone the procedure can tell you what to really expect.

So, what advice would I give you, as someone about to undergo surgery? Well, I’ve been seeing a personal trainer this year – partly to put off having to have the replacement for as long as possible, but now that surgery is imminent, to ensure my muscles are as good as they can be because when it comes to as swift a recovery as possible, you can’t have enough muscle.

Post-surgery, I’ll be able to give advice both as a surgeon and fellow patient. For more advice on knee surgery and robotic knee replacement, call 0203 195 2443 to arrange a consultation.