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What Are the Hidden Impacts of Orthopedic Surgeries

Orthopedic procedures are essential in restoring mobility, alleviating pain, and improving overall quality of life. For instance, someone with chronic hip pain may regain the ability to walk comfortably after a hip replacement. However, while these surgeries often deliver remarkable results, they come with their own set of challenges—some of which may not be immediately apparent.

In this blog post, we delve into the less-discussed impacts of orthopedic surgeries.

Risk of Complications Such as Infections

Orthopedic surgeries, like any invasive procedures, carry inherent risks, including complications such as infections. Proper post-operative care and adherence to medical advice are crucial for mitigating many of these risks.

As medical implants become increasingly common, inquiries about potential metal allergies related to these devices are also on the rise. 

An expert from Stanford School of Medicine told Medical Xpress there is an increase in patients inquiring about metal allergies. These concerns are related to metal implants, such as joint replacements, rods, pins, screws, and plates. They also include neurological and cardiac devices like pacemakers and dental devices.

Approximately 10% of Americans will receive a medical implant at some point in their lives, and millions report experiencing metal allergies.

A common cause of allergic contact dermatitis is nickel exposure. When the skin is exposed to an allergen, this condition develops, resulting in symptoms like blisters, hives, discomfort, rash, itching, and dryness.

Diagnosing such allergies can be challenging, as individual immune system responses to allergens can vary significantly.

Long-Term Mobility Issues

The journey back to full mobility after orthopedic surgery often proves more complex than many patients expect. While modern surgical techniques continue to advance, complete recovery remains an intricate process influenced by numerous factors.

Many patients discover that their post-surgery mobility differs from their pre-injury capabilities. Some find themselves adapting to new movement patterns or limitations, particularly in cases involving joint replacements or complex fracture repairs. Range of motion may remain restricted, and certain activities might require modification or assistance.

Physical challenges commonly include:

  • Persistent stiffness, especially in the morning or after periods of inactivity
  • Reduced strength in the affected area and surrounding muscles
  • Balance and coordination adjustments
  • Weather-related discomfort or sensitivity
  • Compensatory movement patterns that can affect other joints

Risk of Post-Surgical Depression 

Surgery often prompts questions about post-recovery life, such as if you can return to work or enjoy hobbies. These concerns, combined with physical limitations, can reshape identity and heighten the risk of depression. Recovery is typically long, isolating, and painful, further impacting mental health.

Chronic pain and mental health disorders share a bidirectional relationship through overlapping brain regions and neurotransmitter pathways. Anxiety and depression are known predictors of poor surgical outcomes in orthopedic trauma patients. Per the study published in the Annals of Medicine & Surgery, screening tools like PHQ-9, GAD-7, and SF-36 can assess mental health. The tools can also guide personalized care. 

Challenges such as chronic pain, psychological distress, and traumatic limb loss amplify mental health risks. Opioid use for pain management, though common, can worsen depressive symptoms and lead to dependency. 

Another study published by the NIH analyzed over 780,000 patients from 2004 to 2021. It found that hip fracture surgery had the highest rate of new-onset postoperative depression at 18.8%. This was followed by thoracotomy (16.1%) and cardiac surgery (12.6%).

Additionally, confirmed hip fracture surgery patients were 1.56 times more likely to develop depression compared to laparoscopic cholecystectomy patients. Addressing these risks through integrated mental health and pain management strategies is crucial for recovery.

Strategies for Minimizing Hidden Impacts of Orthopedic Surgeries

Preparing for Surgery: Physical and Mental

Engaging in prehabilitation exercises and counseling can significantly benefit both physical and mental well-being before surgery. 

A study titled “Prehabilitation for Patients Undergoing Orthopedic Surgery: A Systematic Review and Meta-analysis” analyzed 48 randomized clinical trials involving 3,570 participants. Key findings from this research published in JAMA Network include:

  • Enhanced Function: Prehabilitation was shown to improve preoperative function and muscle strength.
  • Quality of Life: It positively impacted health-related quality of life (HRQOL), especially for patients undergoing total knee and hip replacements.
  • Postoperative Improvements: Functional outcomes were better at 6 weeks post-knee surgery and at 6 months after lumbar surgery.

The study advocates for the adoption of prehabilitation programs to optimize recovery and suggests further research to validate these findings.

Importance of a Multidisciplinary Care Approach

A collaborative approach involving orthopedic surgeons, physiotherapists, and dietitians ensures comprehensive care. 

In addition, involving a Psychiatric Mental Health Nurse (PMHN) can be beneficial. PMHNs are registered nurses with specialized training in mental health, enabling them to support individuals facing psychological challenges. Their qualifications include advanced degrees, such as accelerated BSN online programs and PMHN programs.

According to Rockhurst University, their advanced nursing education and training equip them to assess, diagnose, and treat a diverse array of mental health issues. This expertise enables them to provide valuable support to patients facing psychological challenges during their surgical preparation and recovery.

Role of Physiotherapy in Holistic Recovery

Physiotherapy plays a crucial role in the holistic recovery process following orthopedic surgery. It focuses on restoring physical function, enhancing mobility, and alleviating pain, contributing significantly to overall well-being. 

To address particular areas of weakness or injury, physiotherapists create specifically targeted workouts. A good recovery depends on restoring strength, increased flexibility, and improved joint stability, all of which these exercises facilitate.

Additionally, physiotherapy offers effective pain management through various techniques, such as manual therapy and modalities like ultrasound and electrical stimulation. These approaches help reduce the reliance on medications.

FAQs

What is the most painful orthopedic surgery recovery?

Shoulder replacement, spinal fusion, and knee replacement surgeries are often considered some of the most painful orthopedic recoveries. These complex procedures require extensive rehabilitation and effective pain management strategies, as they involve major joints and critical movement areas essential for mobility.

What orthopedic surgery has the longest recovery time?

Total Knee Replacement (TKR) and Lumbar Spinal Fusion are among the surgeries with the longest recovery times. Recovering from a TKR can take anywhere from three months to a year, depending on factors like age, physical therapy, and overall health.

What happens to the bone when screws are removed?

After screws are removed, the bone may be temporarily vulnerable to re-fracture due to the weakened structure of the affected area. This stage involves additional risks, including infection at the surgical site and nerve damage from the procedure. Complications related to anesthesia may also occur.

Impacts of Orthopedic Surgeries extends far beyond the operating room. They create a complex interplay of social, psychological, and physical changes.

The recovery journey shows that true healing is not just about repairing bones and joints. It is also about adapting to a new normal that transforms both body and mind. 

As medical science advances, our greatest challenge may not be perfecting surgical techniques. Instead, it lies in understanding and addressing the hidden dimensions of recovery that ultimately shape a patient’s success story.

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