Current Evidence-Based Rehabilitation Protocols for Total Joint Replacements: A Review of Current Research - Tapa blanda

Over the last two decades, seismic gains have been made in the field of total joint replacement surgeries and post-surgical rehabilitation. Hip, knee, shoulder and even ankle joints are being partially or completely replaced with prosthetic joints with significant gains in both pain and function being realized. Interestingly, no longer are total joint arthroplasties the “property” of the very disabled or very old. These orthopedic surgeries are now being considered for very young patients, especially those with a history of juvenile rheumatoid arthritis or joint necrosis (Polkowski, Callaghan, Mont, & Clohisy, 2012; Keeney, Eunice, Pashos, Wright, & Clohisy, 2011). The goal of this book is to give the reader a short, yet useful, evidence-supported overview of the state of total joint replacement surgeries (knee, hip, ankle and shoulder) and to “prime the pump” of clinical reasoning by providing rehabilitation protocols and suggested pathways. To be specific, the main objectives are: OBJECTIVES 1. Compare and contrast distinguishing characteristics of 3 types of arthritis, which can lead to the need for total joint replacement. 2. Briefly describe 2 roadblocks to cost containment for total joint replacements. 3. Describe 3-4 physical therapist interventions, which routinely occur during the pre-operative visit(s) for patients scheduled to undergo total joint replacements. 4. List 2 recent innovations in total knee implants and/or surgical techniques. 5. Describe 4 research-supported treatments, which can be performed during Phase I-IV of rehabilitation after a total knee replacement. 6. List 2 recent innovations in total hip implants and/or surgical techniques. 7. Describe 4 research-supported treatments, which can be performed during Phase I-IV of rehabilitation after a total hip replacement. 8. Describe 3 distinctions, which should be made when treating a total hip replacement (anterior approach) versus a total hip replacement (posterior approach). 9. List 2 recent innovations in total ankle implants and/or surgical techniques. 10. Describe 4 research-supported treatments, which can be performed during Phase I-IV of rehabilitation after a total ankle replacement. 11. List 2 recent innovations in total shoulder implants and/or surgical techniques. 12. Describe 4 research-supported treatments, which can be performed during Phase I-IV of rehabilitation after a total shoulder replacement.

Caroline Joy Co, PT, DPT, CHT, CSFA, is a licensed physical therapist and certified hand therapist whose clinical experience includes acute, subacute, home health, and outpatient settings. Her background includes Community-Based Therapy that is designed to help people with disabilities access therapy in their communities. She is the President and CEO of PTSponsor.com, an online resource for U.S. hospitals and clinics that seek to sponsor and hire foreign-trained rehabilitation therapists. She specializes in hand therapy through an integrated approach that includes education, counsel, and exercise. She is also certified in functional assessment for work hardening and work conditioning. Co is also the President of Rehabsurge, a continuing education company and a contracting agency. Her past affiliations include Long Beach Medical Center, Horizon Health and Subacute Center, and Grandell Therapy and Nursing Center. Co was a professional speaker for Summit Professional Education, Cross Country Education and Dogwood Institute. She received her transitional doctorate from A.T. Still University and her BS in Physical Therapy from University of the Philippines College of Allied Medical Professions. She is licensed in California, Nevada, and New York.