05/2017 KIPLINGER’S PERSONAL FINANCE 69POON WATCHARA-AMPHAIWAN
KipTipCoping Until
Surgery
If you’re not ready for joint replacement,
your physician may recommend alterna-
tives. Among the strategies that will no-
ticeably diminish symptoms: avoiding
high-impact exercise; taking nonsteroi-
dal anti-inflammatory medications, such
as ibuprofen; and losing a moderate
amount of weight. Your physician may be
able to help you manage joint pain, stiff-
ness and swelling by removing fluid from
the joint, injecting a corticosteroid (such
as cortisone) into the joint or prescribing
supervised physical therapy, which many
insurance companies will require you to
try before they will authorize replace-
ment surgery for a knee or hip.
Arthroscopy, a procedure usually used
to repair cartilage, ligaments or tendons
in a joint, works best when it’s performed
soon after an injury. But it’s seldom ben-
eficial if you’re suffering from moderate
or advanced arthritis of the hip or knee,
and it is neither a prerequisite nor a sub-
stitute for joint replacement.says Pagnano, although some doctors
recommend it. Knee patients may ben-
efit more from therapy because knees
can become stiff after surgery, and
bending the knee is key to achieving
a good range of motion sooner rather
than later, says Haas. Most patients
don’t need more than one session of
physical therapy per week for the first
four to six weeks after replacement.
About 2% of knee-replacement pa-
tients will develop scar tissue adhe-
sions on the joint, resulting in stiffness
and pain that require more treatment.
It’s generally safe to walk, hike, ride
a bike, swim, dance and play tennis
after knee and hip replacement, but
avoid running, which pounds the
joints, as a routine exercise. ■straight home and not to an inpatient
rehab or skilled nursing facility. At
home, you’ll lessen your risk of infec-
tion and be encouraged to return to
your usual routine sooner.
If your surgery was uncomplicated,
you won’t need specialized nursing
care, but you may need some help with
normal daily activities during the first
three to 10 days after returning home.
Arrange for your spouse, a family
member or a friend to help. (If you
don’t have social support, or you have
multiple medical conditions, you may
have no choice but to go to rehab or a
skilled nursing facility.)
Most total hip replacement patients
don’t need a formal program of physi-
cal therapy after they return home,