How to get good outcomes after hip, knee surgery

Total hip and knee replacement surgeries are among the most commonly performed operations in the U.S., with an estimated 1 million of these procedures performed each year. Demand for these surgeries also has been rising globally.

Patients can make lifestyle changes before surgery to improve their chances of successful outcomes, according to Dr. Matthew Abdel, a Mayo Clinic orthopedic surgeon who specializes in hip and knee replacement. However, patients also should be aware that other practices before surgery won’t help outcomes or are still inconclusive.

Encouraging education, maintaining a healthy weight, promoting good nutrition and exercising can help mitigate obesity, Abdel says. This is important since obesity can lead to higher risks of complications after surgery.

Abdel says that if you are facing joint replacement surgery, you can improve surgical outcomes by making these lifestyle changes:

■ Lose weight safely — through diet and exercise — before surgery. The target body mass index is less than 40 kilograms per square meter. However, the closer you can get to 25-30 kilograms per square meter, the better. Even a 20-pound weight loss completed safely before surgery improves outcomes.

■ Stop using all nicotine products, including cigarettes, chewing tobacco and cigars, at least six weeks before having surgery.

After surgery, do not use nicotine products.

■ Stop all narcotic pain medication at least two weeks before surgery.

■ If you have diabetes, make sure you have it adequately under control. Adequate control is defined as HgA1C less than 7.5 before surgery. You also want to have excellent glycemic control in the time around surgery.

However, some lifestyle changes do not improve outcomes of hip and knee replacement surgeries, Abdel says.

Those include taking herbal supplements and vitamins, applying wound creams, and using electrical stimulation devices.

It’s still unknown whether other changes improve outcomes after surgery. Those practices include physical therapy before hip and knee arthroplasty, postoperative physical therapy for total knee arthroplasties, and hip precautions after total hip arthroplasties.

DREAMSTIME/TNS Total hip and knee replacement surgeries are among the most commonly performed operations in the U.S.