A painful, stiff hip or knee can keep a farmer from being productive on the farm. Even simple tasks such as daily chores or walking from one location to another can be painful and delayed. When all attempts to alleviate the pain have been exhausted, a physician may recommend a total joint replacement. Approximately 150,000 total hip replacements and 90,000 total knee replacements are performed annually to relieve pain and increase mobility. In most cases orthopedic surgeons can conduct a hip or knee replacement with an artificial joint that will work like a normal joint and relieve pain during physical activities.
Several conditions can lead to chronic joint pain and disability, requiring hip or knee replacement. The overwhelming majority of hip or knee replacement surgeries are necessitated by arthritis. A number of other factors contribute to joint disease including family history, developmental abnormalities, repetitive injuries and obesity.
Three Types of Arthritis Result in Joint Damage
- Osteoarthritis is a degenerative joint disease that leads to the breakdown of joint cartilage. When cartilage is destroyed, raw bone surfaces rub together.
- Rheumatoid arthritis is an inflammatory condition and autoimmune systemic disease that can cause damage to joints and severe deformity, leading to disability.
- Traumatic arthritis results from a serious injury or fracture. The cartilage becomes damaged and over time, causes pain and stiffness.
What is a Hip or Knee Replacement?
A hip replacement is a procedure used to replace worn cartilage. The ball of the femur (thigh bone) is replaced and the socket of the pelvis that holds the ball is resurfaced with a special plastic or ceramic material. A hip replacement can eliminate pain and allow for easier movement with less discomfort.
A knee replacement is a resurfacing of the end of the thigh bone and the end of your shin bone with a metal and plastic covering. It replaces cartilage that has worn away over the years. For individuals who have become bow-legged or knock-kneed, it can also straighten their legs to a more natural position. A knee replacement can eliminate pain and discomfort by allowing for easier movement of the joint.
When to Have Hip or Knee Replacement Done
Farmers never have a good time to be away from the farm. In this case, joint replacement requires an extended period of recovery time and rehabilitation. There are many factors that can contribute to recovery time, but typically patients can return to normal activities within 1 to 6 months. Planning ahead and preparing a timeline of essential farming activities will help the healthcare provider, and plan for providing assistance and alternative methods to complete required daily and seasonal farm tasks.
In some cases patients put off having a hip or knee replaced until it is an absolute last option. This situation can cause a secondary injury because of overcompensation on the other side of the body causing further damage to the opposite hip or knee. Fixing one joint can reduce the stress on the opposite joint and decrease the potential to have both joints replaced. Keep in mind that each case is different, and the doctor will recommend the best course of action based on individual conditions.
Rehabilitation and Recovery
Hip or knee replacement recovery time can vary; however, a general timeline for either procedure can look similar to the following table.
After surgery
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Day 1–2 |
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Day 2–3 |
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Day 3–5 |
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Day 4–7 |
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Week 3–6 |
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Week 5–6 |
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Week 10–12 |
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Month 4–6 |
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Keep in mind
- It is normal to have a low-grade fever for a few days after surgery. The fever will usually go away before or just after leaving the hospital.
- Immediately after surgery, it is normal to feel some pain and discomfort. However, the pain will probably go away relatively quickly and individuals will soon be up and moving again. In fact, most doctors like to get their patients mobile as soon as possible after the operation.
- Physical therapy will be challenging after joint replacement surgery. It is very important to take therapy seriously because the more diligent the patient is during this phase of recovery, the sooner the patient will regain mobility and return to daily activities. If discomfort during therapy is a problem, talk with the therapist about coordinating pain medication and therapy.
Activities
- Walking and Stairs—During recovery, there will be a progression from using a walker or other assistive devices. The patient with no problems will graduate to walking on his or her own. Eventually the patient will be allowed to climb stairs. In most cases, patients begin with smaller-height steps and gradually progress to standard-height steps.
- Driving—The ability to drive depends on progress during recovery and which side of the body the joint was replaced. Right knee and hip replacements tend to experience a longer delay than left side replacements. Driving heavy equipment will have its own set of circumstances to overcome, such as getting in and out of the cab, changing gears, sitting for long periods of time, and operating the controls. The doctor will determine when it's safe to get back behind the wheel.
- Work—Determining when to return to work will depend on the physical nature of work or tasks. People who do excessive amounts of manual labor, daily repetitive tasks, or tasks requiring squatting, standing for long periods of time, or climbing steep stairs or ladders may want to consult with an occupational therapist. Some activities may lead to the damage of your artificial joint over time due to wear and tear. The more vigorous the task, the higher the risk of damaging the implant. Discuss your plans with your doctor. Farm work is different than most other occupations. It is important that the doctor knows the type of work involved and the type of conditions the patient will encounter.
Acknowledgments
This fact sheet was reviewed by Karen Mancl, PhD, Professor, Food, Agricultural and Biological Engineering, The Ohio State University; and Pat Luchkowsky, Director of Public Affairs, Easter Seals of Ohio.
References
- Hip and Knee Replacement Overview.
bonesmart.org - Joint Replacement Surgery. April 2009. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
niams.nih.gov/Health_Info/Joint_Replacement/default.asp - Reither, Jeremy. How long does it take to recover from total hip replacement surgery? June 2009.
- Total Hip Replacement. American Academy of Orthopaedic Surgeons.
orthoinfo.aaos.org/topic.cfm?topic=a00377 - Total Knee Replacement. American Academy of Orthopaedic Surgeons.
orthoinfo.aaos.org/topic.cfm?topic=A00389
About AgrAbility-Based Fact Sheets
These fact sheets were developed to promote success in agriculture for Ohio's farmers and farm families coping with a disability or long-term health condition. AgrAbility offers information and referral materials such as this fact sheet, along with on-site assessment, technical assistance, and awareness in preventing secondary injuries. Fact sheets were developed with funding from NIFA, project number OHON0006.