Prehabilitation Can Enhance Joint Replacement Outcomes

According to new research published in JAMA Network Open, prehabilitation can significantly improve outcomes for patients undergoing orthopedic surgery.

Why Is Prehabilitation Important?

Musculoskeletal disease is the leading cause of global disability, and surgeons perform an estimated 310 million procedures yearly. An aging population, complicated by the global pandemic, resulted in delays in surgical procedures for millions of Americans. Patients are waiting much longer for routine operations, which can negatively impact them mentally and physically.

Waiting for surgery can be tiresome, but it offers an opportunity for prehabilitation: to improve muscle strength, function and quality of life before the procedure occurs. These three factors significantly contribute to post-surgical outcomes for orthopedic patients. Physicians and therapists have used prehabilitation since the 1940s, but only in the last two decades have they examined how prehabilitation can improve postoperative outcomes.

Benefits of Prehabilitation before Surgery

A group of researchers from Anglia Ruskin University (ARU), Addenbrooke’s — Cambridge University Hospitals NHS Foundation Trust (CUH) and Western University in Ontario, Canada, conducted a meta-analysis of 48 clinical trials that used prehabilitation methods like exercise, acupuncture and pain management among patients who were preparing for orthopedic surgery.

The study found prehabilitation can reduce pre-operative pain, improve muscle strength and increase quality of life for patients awaiting total hip and total knee replacement, as well as lower back surgery.

Benefits of Prehabilitation after Surgery

Prehabilitation also helped with surgery recovery. The study found that patients who prehabilitated had improved joint function in the short and medium term compared with patients who did not prehabilitate. The benefits of prehabilitation were particularly favorable at six-week postoperative visits for knee replacement patients and at six-month postoperative visits for lower back surgery patients.

Researchers suggested at least two sessions per week for four to six weeks for patients awaiting orthopedic surgery. Prehabilitation programs may include supervised and unsupervised sessions, and patients can be confident that there are minimal risks.

“While the results of the study are encouraging and support prehabilitation, it is also important that patients engage in postoperative exercise programs appropriately to achieve optimal outcomes,” said Leica Claydon-Mueller, PhD, associate professor of health services research at ARU (Medical Xpress).

Do You Need Prehabilitation before Your Surgery?

Talk to your orthopedist about prehabilitation programs if you are considering total joint replacement. You certainly want to maintain your mobility and joint strength while waiting for your surgery day. Being conditioned and prepared for surgery will help you manage your pain and streamline your recovery so you can resume your active lifestyle!