source: Institute of Arthropathy, Peking University
Author: Hou Yunfei and Lin Jianhao , Peking University People’s Hospital
Q : Doctor, I have been to many hospitals. Doctors say my knee has reached the point of joint replacement. I’m a little worried, if my joints are replaced with artificial ones, can I still walk or even exercise ?
It is believed that such a problem is very common for both patients and orthopedic surgeons. Coinciding with the recent publication of the article ” Activity Recommendations After Total Hip and Total Knee Arthroplasty ” in the top journal “Journal of Bone & Joint Surgery-American Volume ” , today we are based on this article. Talk about sports after joint replacement.
The answer to this question is undoubtedly yes. Patients with osteoarthritis have reduced activity due to pain, leading to increased all-cause mortality. In layman’s terms, life lies in exercise, and in the case of exercise, all organ systems in the body operate effectively and metabolize.
When the patient does not exercise due to pain, the operation tends to stagnate, and substances harmful to the body are easily deposited in the body, increasing the incidence of cardiovascular and cerebrovascular diseases and malignant tumors. The top medical journal ” Nature Metabolism ” has also published an article discussing this view.
Therefore, one of the purposes of joint replacement surgery is to relieve pain and improve joint function of patients, and promote patients to participate in sports and maintain a healthy lifestyle.
Q : Doctor, I think the WeChat exercise program is very useful. How many steps to take a day is very intuitive. How many steps do you think I should take a day ?
In a May 2019 paper published in JAMA, researchers surveyed more than 18,000 older U.S. women ( average age 72 ) from 2011 to 2015 to study the relationship between the number of steps taken and mortality. It was found that the higher the number of steps per day, the lower the risk of death, and until the number of steps per day reached 7,500 steps, the risk of death neither decreased nor increased. It appears that walking 7,500 steps a day is best for longevity in older adults.
Although the conclusions of this article are based on research results of American women, it does give you a general reference.
Q : Is it ? I think 7500 is a lot. I feel like walking 3000 steps a day is my limit now.
The article just now was based on foreign data. What about our own data ? In 2015 , we studied the daily walking steps of patients undergoing knee replacement surgery in our unit, and found that at 6 weeks after the operation, the patients daily Walk 3000 steps, 4000 steps per day at 3 months after surgery, and 5000-6000 steps per day at 6 months and 1 year after surgery . The ability to ascend and descend stairs also returned to a satisfactory level at 3 months postoperatively . Therefore, after the problem of joint pain is solved, the average daily steps will also increase.
Q : Doctor, will it affect the life of my prosthesis if I do not move properly ?
In this recently published article, experts advise against high-intensity confrontational physical activity for patients after joint replacement. These movements increase the risk of injury to patients, and biomechanical tests have shown that movements such as resistive activities and squatting after knee replacement increase prosthesis wear and theoretically affect prosthesis life. In the absence of long-term follow-up data, squats and other high-intensity activities are not recommended. Activities like walking, swimming, etc. can be done and are good for your health.
Question : Doctor, is there anything else you want to tell us ?
Due to the limited space, I will finally introduce the two most effective activities after hip and knee replacement. Straight leg raises should focus on quadriceps after knee replacement, and gluteus medius should focus on straight leg raises after hip replacement
We often preach to patients in outpatient clinics that joint replacement can solve the problem of pain and improve joint function at the same time. In fact, this is only one of the primary goals of joint replacement. To allow patients to take part in more sports and social activities after pain relief, have a positive lifestyle, and comprehensively improve their physical and mental health is the ultimate goal we need to pursue !
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