Arthritis: Knee and Hip Arthroplasty

Area of Science:

• Orthopedic Surgery
• Rehabilitation Medicine

Background:

• Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are common procedures for degenerative joint diseases.
• These surgeries significantly improve pain and function for millions annually in the US.

Purpose of the Study:

• To outline the standard pre-operative evaluation, surgical protocols, and post-operative management for TKA and THA.
• To discuss common complications, risk factors, and rehabilitation strategies to optimize patient outcomes.

Main Methods:

• Review of pre-operative assessments including history, physical exam, labs, and imaging.
• Description of rapid recovery protocols involving early mobilization (4-8 hours post-op).
• Overview of multimodal analgesia (nerve blocks, opioids, NSAIDs, acetaminophen) and VTE prophylaxis.

Main Results:

• Periprosthetic joint infection (1-2%) is a key risk for revision, influenced by obesity, diabetes, and smoking.
• Early mobilization and multimodal analgesia facilitate faster recovery and reduced VTE rates.
• Rehabilitation focuses on range of motion, strength, gait, and balance, with most patients resuming activities in 6 weeks.

Conclusions:

• TKA and THA are effective for joint pain and dysfunction.
• Rapid recovery protocols, comprehensive pain management, and dedicated rehabilitation are crucial for optimal patient function.
• Patients typically achieve 90% capacity by 3 months and full recovery within 1 year post-surgery.