Training and the Artificial Joint | John Petrizzo

[stef]

"This article is intended to serve as a guide for those of you who may be considering having a joint replaced, are training with an artificial joint, or are responsible for the training of someone with an artificial joint. My hope is that it will provide you with more insight into how the procedures are commonly performed, what to expect during the recovery period, and how you can successfully manage your training after a total joint replacement."

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[Fred Barnes]

Thanks John for an excellent review on the topic of Total joint arthroplasty and training. There is much confusion in the literature as to the benefit of incorporating resistance training with total joint arthroplasty. It seems to me that a rational approach to training with the motivated individual who understands the risks as well as the obvious benefits of strength training is the way to go.
Thanks
Fred Barnes. MD FACS FAAOS

[larorc]

Thanks for the article. I am a 58 year old male. I had a 6cm tumor in the left distal femur, and in 2012 they performed a distal femur replacement - basically a total knee replacement but removing about the lower 1/3 of the femur.

I found starting strength about 3-4 years ago and have tried to do NLP several times in my garage gym - no SSCs anywhere near me and online coaching doesn't appeal. What I have been able to do has helped me tremendously, but the left quads are still visibly much smaller than the right. As you mention in the article I was putting much of my weight on the right leg in the squat and avoiding the bad leg.

I went to a squat camp a couple of years ago and Dr Sullivan dialed my squat way back and had me go back up in 1 lb increments. That worked pretty well and I __think__ I'm able to maintain decent form in the process.

I was just glad to see your article and have a reference and some validation for where I am in the process.

Thanks again.

[John Petrizzo]

Thanks John for an excellent review on the topic of Total joint arthroplasty and training. There is much confusion in the literature as to the benefit of incorporating resistance training with total joint arthroplasty. It seems to me that a rational approach to training with the motivated individual who understands the risks as well as the obvious benefits of strength training is the way to go.
Thanks
Fred Barnes. MD FACS FAAOS

Thanks so much, Dr. Barnes. I agree completely!

[John Petrizzo]

No problem! I am happy you found the article to be helpful and also happy that you were able to have Dr. Sullivan help get your training on track.

Good luck with your training!

[Lost and Found]

The complexity of the shoulder joint seems to make it's replacement a tougher decision with much more guarded expectations regarding weight training or other activities after surgery when compared to hip and knee.

[John Petrizzo]

The complexity of the shoulder joint seems to make it's replacement a tougher decision with much more guarded expectations regarding weight training or other activities after surgery when compared to hip and knee.

I agree completely. While I have successfully worked with many patients following a total shoulder replacement, it certainly is a more complex rehabilitation than either the hip or the knee.

[Ridgeback303]

Thanks for this timely article. I'm a 56y.o. female scheduled for TKR on the right side in mid August. It is somewhat complicated by the bed to remove a very large cyst (3+inches long x 1.5" diameter, with an "arm" that extends over into the lateral joint/nerve space).

The cyst has greatly reduced my ROM, causing squats to take on somewhat of a rotational aspect, and subsequent loading of the left side. Left knee was scoped 3wks ago to repair a badly torn meniscus too.

I'm looking to restart lifting prior to the TKR to regain some strength, but due to the ROM restrictions, can't squat to parallel. I have no access to a public gym, but do have a well set up barbell home gym. Any suggestions?

[John Petrizzo]

Thanks for this timely article. I'm a 56y.o. female scheduled for TKR on the right side in mid August. It is somewhat complicated by the bed to remove a very large cyst (3+inches long x 1.5" diameter, with an "arm" that extends over into the lateral joint/nerve space).

The cyst has greatly reduced my ROM, causing squats to take on somewhat of a rotational aspect, and subsequent loading of the left side. Left knee was scoped 3wks ago to repair a badly torn meniscus too.

I'm looking to restart lifting prior to the TKR to regain some strength, but due to the ROM restrictions, can't squat to parallel. I have no access to a public gym, but do have a well set up barbell home gym. Any suggestions?

I am sorry to hear about your current situation, but it sounds like you are managing things pretty well given the circumstances. I would recommend setting up a box through the greatest available pain-free ROM that allows you to stay somewhat symmetrical and squat to that height until after your surgery in August. It is not an ideal situation, but is sounds like you are going to beat up your left knee more than you need to if you continue to try and force yourself through the full range right now. After your surgery in August, slowly lower the height of the box and then remove it once you are back to a full range of motion.

I hope that helps!

[Ridgeback303]

I am sorry to hear about your current situation, but it sounds like you are managing things pretty well given the circumstances. I would recommend setting up a box through the greatest available pain-free ROM that allows you to stay somewhat symmetrical and squat to that height until after your surgery in August. It is not an ideal situation, but is sounds like you are going to beat up your left knee more than you need to if you continue to try and force yourself through the full range right now. After your surgery in August, slowly lower the height of the box and then remove it once you are back to a full range of motion.

I hope that helps!

Thank you so much for the suggestion. I will try to find an appropriate height box.