National Physical Therapy Month: The Future of Hip and Knee Replacement

We are outnumbered. By 2025 there will be 650,000 Total Hip Replacements and 1.2 million Total Knee Replacements annually in the United States. Cost controls, patient volumes, and limited therapists: patient ratios require efficiency and planning. Just this week I had the first session with a man 2 weeks post total knee replacement who stated, “My Medicare Advantage plan will cover 6 visits so let’s make the best of them.” Fast-tracking”, outpatient surgery options, anesthesia advances, minimally invasive procedures, and pre-operative planning are maximizing patient activity after surgery. We can’t match those advances with “this is what I always did for total joints….” Patients have raised their expectations of what they can do after surgery – we should too. Surgery puts in new hardware – you are the software engineer.

Enhanced recovery programs require a multidisciplinary team of dedicated professionals, principally involving preoperative education, multimodal pain control, and accelerated rehabilitation; this will be boosted if combined with minimally invasive surgery. The current economic climate and restricted healthcare budget further necessitate brief hospitalization while minimizing costs. These NON-OPERATIVE INTERVENTIONS are the way forward to achieve such requirements. (Ibrahim, 2013)

Be “Brilliant at the Basics”. Total Joint Rehabilitation may not be flashy and make you a Social Media icon but it is the bread and butter we need to be best at. Set yourself apart and be the therapist every patient tells their friends to see – because they will tell them something about you – make it great!

Pre-operative Planning and Exercise

• Therapists are optimally positioned for education and exercise advice
• Establish therapeutic rapport early
• Increased revenue outside of postoperative dollar and visit limits

Immediate Post-Operative care

• Same day and 24 hours discharges – are you and the patient ready?
• Advances in anesthesia speed recovery and return home
• Minimize edema, maximize strength return, gain ROM quickly and safely
• Optimize exercise volume and combine Manual Therapy for best outcomes

Return to Function

• Patient-specific and “mobile” component designs can meet activity goals
• Dislocation (hip) precautions may be a thing of the past
• Strength training is way more than leg raises and 3 sets of 10

Above is a simple exercise I use for high volume ROM and combined knee and hip motion without pain for pre-op and immediate post-operative care. The patient in the video is 48 hours post op and moving great!

If you want to learn more, join my Live Interactive Webinar on October 27th, Total Knee/Hip Arthroplasty: The First 72 Hours, or for my NEW 3-Hour Live Workshops coming soon in 2023 – see you then!

Explore continuing education courses from Jason below:

An Evidence-Based Approach to Treating the Lumbopelvic Complex

Clinical Practice Guidelines for Low Back Pain (LBP)

Simplifying Assessment and Treatment of the Sacroiliac Joint & Hip Dysfunction

Total Knee/Hip Arthroplasty: The First 72 Hours

Visit summit-education.com for more information.