Improvements in surgical techniques and joint prosthesis over the past decade have been nothing short of amazing. However, there are two other factors that contribute greatly to a quicker recovery: pain management and peace of mind.
Concerns about post-operative pain after joint replacement precludes many patients, who might greatly benefit from these procedures, from considering them. Just as these replacement procedures have dramatically improved in the past few years – more than one million people in the U.S. have joint replacements each year, making them the most popular surgical procedures in history – managing the pain that might result from these surgeries has also gotten much better.
A Multimodal Approach to Pain Management
Dr. Donald Hohman is a board certified, fellowship trained orthopedic surgeon and is a participating member of the referral line at Texas Health Spine & Orthopedic Center and has innovative ways to help patients minimize postoperative pain. He uses a multimodal approach to pain management.
“Some of the things that I do that are a little unique around pain management involve being ‘ahead’ of pain, even before the patient might experience it,” Dr. Hohman said. “We start patients with anti-inflammatory and nerve medicines before the pain starts. We also use Tylenol liberally. These are all important medicines that work on the different receptors of the brain, the spinal cord and around areas where the patient will have pain transmission. We start to block those signals before there is an incident that might lead to these signals being set off.
“We begin this process before surgery and continue it during surgery, with a similar pain regimen injected directly into the knee or hip and the area around these joints. We continue this process after surgery. Many of the anesthesiologists that I work with are very skilled at developing ‘nerve blocks’ that have made a big difference in my hip and knee replacement patients. This has led to excellent pain control for three to four days after surgery. Often, we can keep the catheter in place on the patient, allowing the pain medicine to trickle in the area of the nerve innervation. Our patients have done quite well with this approach.
“We continue this multimodal approach to pain management for three to four weeks after surgery because it is a continuous process of controlling those pain signals. This minimizes the stress that a patient’s nerves and brain ‘see’ as a result of surgery and results in a better and quicker long-term outcome. The patient is able to rehab more efficiently and effectively when they have their pain under control.
“We have had patients who have gone through the process and have not required any narcotic pain medicine. Their only real pain medicine is Tylenol.
“Normally, it has been my experience that most patients are back home after joint replacement on the same day or the morning after. This depends on our confirming that the home recovery area is safe and that there is the appropriate support at home. We also make arrangements with home health services to check on our patients after surgery.
“Patients generally make the bulk of their recovery within the first three months after their surgery. Every patient is a little different. Some people are dancing in the hallway after three or four weeks and some take longer, but generally, patients recover quite quickly. They continue to make improvements for a year or a year and a half after surgery. The technology and pain management techniques that we use now get patients back in their regular activities quickly and comfortably.”
Peace of Mind Also Speeds Recovery from Joint Replacement
Patients who use the Texas Spine & Orthopedic Center referral line benefit from another ‘tool’ for quicker recovery – peace of mind. The patient navigator is an innovation in modern healthcare that helps remove the stress and anxiety that many patients have about any surgical procedure, including hip and joint replacement. This extremely personal service helps each patient find a physician, manage their health insurance challenges, and helps coordinate care before and after surgery.
Combining advanced surgery with innovative pain management and the personal service of the navigator allows the patient to confidently focus on recovery. Their goal is to help you get better, faster and that’s the primary objective!