Anyone who prepares for joint replacement surgery in a targeted manner improves the chances of success. Physical medicine specialist Tobias Homburg knows how to heal the best knees, shoulders and hips.
When they need an artificial joint, most patients appreciate a top-notch surgeon. Many also consider outpatient residency or inpatient rehabilitation at a desired clinic at an early stage. However, what is often not taken into account: the optimal preparation for the procedure is also important. “Thorough preparation reduces the risk of post-operative complications and saves valuable rehabilitation time,” emphasizes Tobias Homburg, Head of the Therapie.Welt Clinic in Munich-Bogenhausen.
Joint replacement surgery: improving wound healing and preparing for rehabilitation optimally
The physiotherapist, who also takes care of the national biathlon team, has developed a special concept for joint replacement patients. Among other things, it consists of building blocks such as a training programme, physical therapy, nutrition and lifestyle tips, knowledge on wound healing and Brain Train, an innovative exercise program for the brain. Our strategy is to optimize wound healing and prepare for rehabilitation optimally. In principle, we shift part of the rehabilitation to pre-operation,” explains Homburg.
Analysis of muscle, inflammation markers, and hormone status
The program is designed for each patient. The basis is the analysis of his current state of health. Experts check the condition of the affected joint with muscles, tendons and ligaments – eg, paying attention to signs of inflammation, mobility and function. In addition, the state of the hormone, immune system and nervous system is also taken into account. Eating habits, lifestyle, sleep and stress levels are also emphasized. Based on the results, we create an individualized intervention plan. In addition to treatments in practice, it also includes many procedures that the patient can implement in daily life, including training and nutrition guidelines, ”explains Homburg.
Physiotherapist Tobias Homburg: Patients can affect wound healing
After the operation, the main concern is to stimulate wound healing. Therefore, if possible, all harmful factors should be eliminated in advance and positive effects promoted. We explain to patients how they can influence wound healing themselves. For example, cold can be a way to relieve pain. But if you cool the wound too much, the metabolism suffers – which in turn is very important for wound healing,” explains Homburg and mentions some key points in surgical preparation:
Training: Good muscle speeds up rehabilitation after joint replacement surgery
Scientific analyzes show that good muscles around the prosthetic joint speed up post-operative rehabilitation and improve long-term function of the prosthesis. The rule of thumb is this: Before the operation, you should reach about 90 percent of the strength of the healthy contralateral joint—that is, the other knee, hip, or shoulder. In rehabilitation, the patient often has to perform exercises and movements that were already difficult for him before the operation. This must be trained extensively in preparation. This way you can fully focus on the operated joint during rehabilitation.
Lifestyle: An increased level of stress prior to joint replacement surgery is a poison to the healing process
If the stress level is high, countermeasures should be taken in time before the operation. You can influence the autonomic nervous system with some exercises. This controls, among other things, breathing, heartbeat, and metabolism. “Specifically, it has to do with activating a specific part of the nervous system—the so-called parasympathetic nervous system.” It promotes the healing and regeneration process. On the other hand, when the other part of the nervous system, the sympathetic, dominates, the vessels constrict. As a result, less oxygen and nutrients reach the surgical area. This can have an unfavorable effect on wound healing,” explains Homburg.
Nutrition: Vitamin C helps heal ligaments, tendons, skin and muscle sheaths
Wound healing can also be positively affected by conscious diet or nutrients. Omega-3 fatty acids help end the inflammatory phase. “Among other things, vitamin C is important for connecting connective tissue fibers, for example in ligaments, tendons, skin and muscle sheaths,” says physiotherapist Homburg.
Brain training: training with visualization techniques brings real effect
The patient must practice this technique before the operation in order to be able to perform it immediately after the operation. This is a mental strategy that uses the brain’s imagination. Similar techniques are used by professional athletes, such as skiers. Before setting off, they ran across the entire road in their heads. Brain training is about imagining certain movements – as if you were actually doing them. “This means that the patient can take the first steps in rehabilitation during the acute phase of inflammation without putting pressure on the hip, knee or shoulder and interfering with the healing process,” reports Homburg. “For example, if the patient is not yet allowed to run, he can already perform the first lap in his mind. This training with the so-called visualization techniques has a real effect: you will get fit faster later when you are already running.
This article only contains general information on the relevant health topic and is therefore not intended for self-diagnosis, treatment or medication. It does not in any way replace a visit to the doctor. Unfortunately, our editors are not permitted to answer individual questions about clinical images.
