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Advice for positive outcomes after hip, knee replacement surgery

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ROCHESTER, Minn. >> 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.

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

Abdel said 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.

>> 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 a hemoglobin A1c of less than 7.5 before surgery. You also want to have excellent glycemic control during the time surrounding the surgery.

Some lifestyle changes do not improve outcomes of hip and knee replacement surgeries, said Abdel. Those include taking herbal supplements and vitamins, applying wound creams and using electrical stimulation devices.

The number of patients worldwide who are overweight or obese is on the rise, and some patients have weight-loss surgery before their joint replacement surgery. But Abdel and fellow researchers recently showed that patients who have bariatric surgery before hip or knee replacement surgery continue to have substantial complications after surgery.

The researchers reviewed outcomes of hip and knee replacement surgery in people who had weight-loss surgery first. These patients had more complications than patients who just had joint replacement surgery, regardless of whether they had low or high body mass indexes. The complications, which included infection and instability, affected the procedures’ success.

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