Orthopedic physical therapy focuses on the musculoskeletal system and any injury or disease affecting the muscles, bones, ligaments, tendons and joints. Orthopedic therapists often work with patients to focus on the treatment of arthritis and joint problems, to remedy overuse or traumatic sports-related injuries, or to develop a post-orthopedic surgical rehabilitation programs. Using state-of-the-art equipment, innovative therapy techniques, and a wide variety of treatment modalities, we're able to help patients following bone fractures, arthroscopic knee surgery, rotator cuff repairs, hip replacements, knee replacements and more.
Joint Replacement Therapy
Joint replacement surgery involves replacing an arthritic or damaged joint, generally a hip joint or a knee joint, with a metal and/or plastic prosthesis. Joint replacement therapy is an important part of the recovery process and actually often begins prior to the surgery.
Total Knee Replacements
You or perhaps a family member have been living with a painful knee. Pain and loss of motion keep you from completing simple activities of daily living. You have tried several treatments and medications without success. After a complete medical workup, your doctor recommends a total knee replacement. Most commonly, total knee replacements are performed on individuals who have severe pain or loss of motion due to degenerative or rheumatoid arthritis, fracture, or bone tumor.
According to the American Physical Therapy Association, approximately 180,000 total knee replacements are performed in the United States each year. 90% of all total knee replacements will last 10 years and 80% will last up to twenty years depending on activity and use.
Individuals who will be undergoing total knee replacement surgery are often seen by a physical therapist before surgery for instruction in exercises to build strength. The hospital stay can range from three to five days. Usually you will be seen by a physical therapist the day of or the day after surgery. You will begin exercises and learn to walk with a walker or crutches. Most patients will go directly home after their hospital stay. On occasion, some patients may need to be transferred to a rehabilitation hospital for further physical therapy. Those patients who go directly home from the hospital are often referred for further outpatient physical therapy.
You can expect to work on exercises at home and in the clinic to increase strength and range of motion of your new knee. Your therapist may need to manually stretch your knee to assure you regain full extension (straightening of the knee) and flexion (bending of the knee).
Total knee replacements can significantly reduce pain and increase range of motion. You may be able to return to most recreational activities. However, high impact activities such as jumping, jogging, or aerobics should be avoided.
Total Hip Replacements
Pain, limited ability to walk, and limited function leads many to undergo total hip replacement (THR). Some suffer for years with degenerative joint disease or osteoarthritis before deciding on THR. Others necessitate a THR because of a fall and fracture of the hip. Over 250,000 Americans each year sustain a hip fracture. Surgical repair is almost always the treatment of choice. Depending on the type and severity of fracture, surgical procedures other than THR may be more appropriate.
THR involves both the ball and socket parts of the hip joint. Typically a posterior approach is used to access the hip joint. This means that the scar on the outer, upper thigh will be slightly towards the back. More importantly, there are strict precautions you must follow for several months in order not to dislocate your new hip. Precautions for a posterior approach (these differ for other approaches) include:
- Do not flex/bend you hip past 90 degrees. In other words, do not lift your knee higher than you hip or sit in low chairs. Do not bend forward past the waist.
- Do not cross your legs while standing or sitting.
- Do not turn your foot inward (on the surgical side).
Physical therapy is initiated the day of or after surgery. Physical therapy in the hospital will concentrate on learning the above hip precautions and on waking with a walker or cane. Your weight bearing ability will depend on if the surgery was cemented or non-cemented.
Outpatient physical therapy will focus on strengthening exercises, weaning you off your cane/walker, and resuming normal household and recreational activities.
Contact us to learn more about orthopedic and joint replacement physical therapy. We'll be more than happy to answer any questions you may have or schedule an appointment with one of our physical therapists.