Exploring non-surgical treatment options before joint replacement surgery

Professor Kim Bennell, physiotherapist 

A common misperception is that once you have  osteoarthritis there's nothing much that can be done and you're really heading toward  having to have a joint replacement at some  stage and while some people do need to have a  joint replacement really that's reserved for people who have tried all of the other treatments  and really given their best to work through home program and if then that doesn't work and it's  not effective then to progress on to joint replacement. Even if people are going to have a joint replacement it's really important to become as fit as you can for the surgery which will help you get through the surgery better and will help the rehabilitation afterwards as well so  even before the surgery getting fit, improving the muscle strength, improving your fitness, improving  the range of motion is really beneficial and in fact in some cases what we found is people have  been on the waiting list and they haven't even tried all of the exercises and so forth that they could do and people have then tried them while they're on the waiting list and have found that they haven't needed to have surgery. 

Professor Rana Hinman, physiotherapist 

One of the things that's really important to consider and I think most people realise this anyway when they see a surgeon and decide that arthroplasty or joint replacement is the way they want to go is that there's quite a commitment required from the patient in the leadup to the surgery but particularly in those months afterwards to commit to their rehab program. It would be great if we could see more people doing this  in the pre-operative phase and putting such an intensive effort over such a time span not  immediately pre-joint replacement but earlier on, after their diagnosis of arthritis and long before they get to the point where they're actually where really they're starting to look at there's no other options for managing their condition other than a joint replacement, but actually  putting that amount of effort into a non-surgical rehabilitation program, dedicating their time to weight loss controlling their weight,  increasing their physical activity and really  focusing on building good muscle strength and general body fitness and I think we'd probably  hopefully see quite a reduction in the number of people who would need to have joint replacement after they dedicated such a such an effort to that sort of a program. 

I think it's just a way  in that people think and assume that  such a dedication will come with a surgical  procedure but we really do need to shift the way people with arthritis are thinking about  their condition and get them doing that way before we're considering joint replacement and I  think we'd see you know improvements in outcomes across the board for everybody.

Matthew Williams, physiotherapist 

If you're in line  to receive a hip or a knee joint replacement it's strongly advised that you see your physiotherapist  and engage in an exercise-based program in the leadup to your surgery this is what I do as part  of my profession and what I found is that up to 16% of individuals who were going to go on and  have their surgery after engaging in the program that I set no longer needed to have surgery as  a result of their injured hip or knee joint.