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The pros and cons of hip and knee replacements

Here at 1st Step we regularly work with clients with hip and knee replacements.

When I used to work for the NHS I was part of a multi-disciplinary team that worked with patients on their recovery journey post-surgery. What tends to happen is that once you have seen the physiotherapist and consultant at the set times post-surgery, there can then be long gaps in between each appointment. Once discharged you can then all too often be left on your own, unsure if you are doing things correctly.

This is where 1st Step has been coming in, helping with specialist exercise support in either low-impact or chair-based classes. Sometimes, if agreed by your consultant, this can be as soon as two weeks post operation. And because I have a thorough understanding of the process it gives clients the reassurance they need that they are exercising correctly.

We have regular discussions with our clients who have had hip or knee replacements, who are on the list, or who may just be considering have the operation done.

And while 1st Step can help you through your recovery period if you decide to go ahead, making that decision is a big one. So let’s look at some of the pros and cons and knowing them may make the decision a little easier for you.

The pros of knee or hip replacement

High success rate

Total hip and knee replacement are seen as one of the most successful operations that medicine has to offer. In the right patient it can be an effective, safe, and durable way to treat many of the problems that come with severe arthritis of the hip and knees.

Relieving your pain

This is the greatest benefit that the procedure offers and the main reason for surgery. A hip replacement can provide a dramatic reduction in pain, with almost all patients getting complete, or near complete, relief from arthritic hip pain.

Improved mobility and hip and knee function

After the reduction in pain, increased mobility is the next major benefit. A hip or knee replacement should allow you to get back to walking without restraint. The improved function should also help significantly with other typical problems linked to arthritis such as going up the stairs, putting on socks, getting up from a chair, etc.

Long-lasting effect

A hip replacement is a long-lasting approach to treat the problems that come with severe hip arthritis. Current evidence shows that 80-85% of hip replacements are still working 20 years after they were inserted.

The cons of hip or knee replacement

An artificial hip isn’t as good as a natural hip or knee

It has some limitations. For example with a knee replacement extreme positions such as putting weight on your knees are limited. And for a hip replacement, crouching and crossing legs aren’t optimal because of the risk of displacement of the hip joint, especially within the first few months of recovery.

This is going to be something you need to consider. Is your pain bearable and would you like to lean on your knees, or prefer to lose that option and be more pain free? We find that everyone has different priorities and surgery should only be considered when other options such as exercise and having correct pain relief, have been explored.

Change in leg length

Occasionally after total hip replacement one leg may feel longer or shorter than the other. Even though your orthopaedic surgeon will endeavour to keep leg lengths equal, minor differences may take place as a consequence on ensuring the stability of the hip, which is the main concern of the surgeon.

An experienced surgeon will know to balance the question of the hip stability and the length of the legs, but the end result will depend on your own anatomy and condition.

Replaced joints can still wear down

Although it depends to a degree on what material is used for the replacement, after 15- 20 years it may need changing again. This is why if you are quite young (under 65 years old) the NHS is reluctant to operate as you may need another one in your life time. At the end of the day, it does come down to cost, unless you can have it done privately.

Whatever your reasons are for having joint replacements, you must seek medical advice and make an informed decision.

Here at 1st Step we are currently running online 1-2-1 sessions and classes that can help you through, either pre- or post-surgery. And remember, if you are strong BEFORE your surgery your recovery rate will be better.

If you would like to know more contact us on or call us on 07846 597460 for a free 15 minute consultation.

1st Step Rehab Fitness and Support

Making exercise accessible for all

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