scholarly journals Physical Therapist Management of Total Knee Arthroplasty

2020 ◽  
Vol 100 (9) ◽  
pp. 1603-1631 ◽  
Author(s):  
Diane U Jette ◽  
Stephen J Hunter ◽  
Lynn Burkett ◽  
Bud Langham ◽  
David S Logerstedt ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Guideline Development ◽  
Clinical Information ◽  
Guideline Development Group ◽  
Total Knee ◽  
American Physical ◽  
Development Group

Abstract A clinical practice guideline on total knee arthroplasty was developed by an American Physical Therapy (APTA) volunteer guideline development group that consisted of physical therapists, an orthopedic surgeon, a nurse, and a consumer. The guideline was based on systematic reviews of current scientific and clinical information and accepted approaches to management of total knee arthroplasty.

Do Individual Differences in Physical Therapists' Skills Affect Postoperative Results of Total Knee Arthroplasty?

2019 ◽  
Vol 33 (08) ◽  
pp. 832-837
Author(s):  
Tadashi Fujii ◽  
Naoyuki Nishio ◽  
Minenari Bandou ◽  
Shuji Kitano ◽  
Marehoshi Noboru ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Early Period ◽  
Exclusion Criteria ◽  
Timed Up And Go ◽  
Significant Difference ◽  
Total Knee ◽  
Climbing Stairs

AbstractWe investigated variations in postoperative outcomes of total knee arthroplasty which were dependent on the physical therapist (PT) who performed rehabilitation while keeping other parameters as uniform as possible. Seventy-nine among 690 knees were selected based on strict inclusion and exclusion criteria. Patients were randomly assigned to five PTs, who had from 2 to 21 years of experience. Range of motion (ROM) on postoperative days (PODs) 1, 3, 7, and 14 and at postoperative months 3, 6, and 12, results of timed up and go (TUG) test on POD 14, time to walking with a single cane, and time to climbing stairs, were evaluated. There were significant differences until POD 3, and no significant differences afterward in flexion. There was a significant difference on POD 1 only in extension. The TUG test showed no significant difference, but there were significant differences at the time of walking with a single cane and climbing stairs. The time taken to achieve rehabilitation, which was determined subjectively by each PT, differed among therapists, but differences in ROM were present in early period. Therefore, ROM after surgery is not affected by differences between PTs.

scholarly journals Exploring Race Differences in Satisfaction with Rehabilitation Following Total Knee Arthroplasty: a Qualitative Study

2021 ◽  
Author(s):  
Allyn M Bove ◽  
Erin R Dong ◽  
Leslie R M Hausmann ◽  
Sara R Piva ◽  
Jennifer S Brach ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Physical Therapy ◽  
Focus Group ◽  
Knee Arthroplasty ◽  
Physical Therapists ◽  
Race Differences ◽  
Theory Approach ◽  
Focus Group Study ◽  
Black And White ◽  
Total Knee

Abstract Background The purpose of this qualitative focus group study was to explore race differences in the rehabilitation experience and satisfaction with rehabilitation following total knee arthroplasty (TKA). Methods We conducted a series of qualitative focus group discussions with groups of Non-Hispanic White and Non-Hispanic Black older adults who recently underwent TKA. We used grounded theory approach, which asks the researcher to develop theory from the data that are collected. Participants discussed barriers and facilitators to accessing rehabilitation after surgery, opinions regarding their physical therapists, the amount of post-operative physical therapy received, and overall satisfaction with the post-operative rehabilitation process. Results Thirty-six individuals participated in focus groups. Three major themes emerged: (1) Participants reported overall positive views of their post-TKA rehabilitation experience. They particularly enjoyed one-on-one care, the ability to participate in “prehabilitation”, and often mentioned specific interventions they felt were most helpful in their recovery. (2) Despite this, substantial barriers to accessing physical therapy exist. These include suboptimal pain management, copayments and other out-of-pocket costs, and transportation to visits. (3) There were minor differences in the rehabilitation experiences between Black and White participants. Black participants reported longer paths toward surgery and occasional difficulty interacting with rehabilitation providers. Conclusions Individuals undergoing TKA can largely expect positive rehabilitation experiences post-operatively. However, some barriers to post-operative physical therapy exist and may differ between Black and White patients. Physical therapists should increase their awareness of these barriers and work to minimize them whenever possible.

scholarly journals Efficacy of Myofascial Trigger Point Dry Needling in the Prevention of Pain after Total Knee Arthroplasty: A Randomized, Double-Blinded, Placebo-Controlled Trial

2013 ◽  
Vol 2013 ◽  
pp. 1-8 ◽  
Author(s):  
Orlando Mayoral ◽  
Isabel Salvat ◽  
María Teresa Martín ◽  
Stella Martín ◽  
Jesús Santiago ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Physical Therapist ◽  
Trigger Point ◽  
Controlled Trial ◽  
Trigger Points ◽  
Dry Needling ◽  
Myofascial Trigger Points ◽  
Total Knee

The aim of this study was to determine whether the dry needling of myofascial trigger points (MTrPs) is superior to placebo in the prevention of pain after total knee arthroplasty. Forty subjects were randomised to a true dry needling group (T) or to a sham group (S). All were examined for MTrPs by an experienced physical therapist 4–5 hours before surgery. Immediately following anesthesiology and before surgery started, subjects in the T group were dry needled in all previously diagnosed MTrPs, while the S group received no treatment in their MTrPs. Subjects were blinded to group allocation as well as the examiner in presurgical and follow-up examinations performed 1, 3, and 6 months after arthroplasty. Subjects in the T group had less pain after intervention, with statistically significant differences in the variation rate of the visual analogue scale (VAS) measurements 1 month after intervention and in the need for immediate postsurgery analgesics. Differences were not significant at 3- and 6-month follow-up examinations. In conclusion, a single dry needling treatment of MTrP under anaesthesia reduced pain in the first month after knee arthroplasty, when pain was the most severe. Results show a superiority of dry needling versus placebo. An interesting novel placebo methodology for dry needling, with a real blinding procedure, is presented.

Clinical value of regular passive ROM exercise by a physical therapist after total knee arthroplasty

2009 ◽  
Vol 17 (10) ◽  
pp. 1152-1158 ◽  
Author(s):  
Tae Kyun Kim ◽  
Kwan Kyu Park ◽  
Su Won Yoon ◽  
Sung Ju Kim ◽  
Chong Bum Chang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Knee Arthroplasty ◽  
Physical Therapist ◽  
Clinical Value ◽  
Total Knee

A Novel Skin Closure Device for Total Knee Arthroplasty: Randomized Controlled Trial versus Staples

2019 ◽  
Vol 33 (11) ◽  
pp. 1116-1120 ◽  
Author(s):  
Rodney W. Benner ◽  
Jonathan P. Behrens
Keyword(s):  
Total Knee Arthroplasty ◽  
Randomized Controlled Trial ◽  
Knee Arthroplasty ◽  
Physical Therapist ◽  
Controlled Trial ◽  
Closure Device ◽  
Skin Closure ◽  
Randomized Controlled ◽  
Pain Scores ◽  
Total Knee

AbstractTwenty-five patients undergoing simultaneous, bilateral total knee arthroplasty (TKA) were randomized to receive skin closure with Zip device on one knee and staples on the other. Patients' pain and scar appearance were rated from 0 (best) to 10 (worst). Knee arc of motion was measured by a physical therapist. At 2 weeks postoperatively, pain scores were significantly better with the Zip device during device wear (p = 0.03) and during device removal (p = 0.003); arc of motion was significantly better with the Zip device (p = 0.002). At 8 weeks of follow-up, scar appearance was significantly better in the Zip device knee as rated by the patients (1.3 vs. 2.6, p = 0.04), the surgeon (1.9 vs. 3.3, p = 0.0006), and three independent plastic surgeons (3.7 vs. 4.8, p < 0.001). Results of this randomized controlled trial show that skin closure with the Zip device resulted in less pain and better scar appearance and knee arc of motion than with staples.

Trends in Periprosthetic Knee Infection and Associated Costs: A Population-Based Study Using National Data

2020 ◽  
Author(s):  
Robert Brochin ◽  
Jashvant Poeran ◽  
Khushdeep S. Vig ◽  
Aakash Keswani ◽  
Nicole Zubizarreta ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Length Of Stay ◽  
Knee Arthroplasty ◽  
Trend Test ◽  
Strong Impact ◽  
Hospitalization Costs ◽  
Teaching Status ◽  
Increasing Trend ◽  
Total Knee ◽  
Increasing Trends

AbstractGiven increasing demand for primary knee arthroplasties, revision surgery is also expected to increase, with periprosthetic joint infection (PJI) a main driver of costs. Recent data on national trends is lacking. We aimed to assess trends in PJI in total knee arthroplasty revisions and hospitalization costs. From the National Inpatient Sample (2003–2016), we extracted data on total knee arthroplasty revisions (n = 782,449). We assessed trends in PJI prevalence and (inflation-adjusted) hospitalization costs (total as well as per-day costs) for all revisions and stratified by hospital teaching status (rural/urban by teaching status), hospital bed size (≤299, 300–499, and ≥500 beds), and hospital region (Northeast, Midwest, South, and West). The Cochran–Armitage trend test (PJI prevalence) and linear regression determined significance of trends. PJI prevalence overall was 25.5% (n = 199,818) with a minor increasing trend: 25.3% (n = 7,828) in 2003 to 28.9% (n = 19,275) in 2016; p < 0.0001. Median total hospitalization costs for PJI decreased slightly ($23,247 in 2003–$20,273 in 2016; p < 0.0001) while median per-day costs slightly increased ($3,452 in 2003–$3,727 in 2016; p < 0.0001), likely as a function of decreasing length of stay. With small differences between hospitals, the lowest and highest PJI prevalences were seen in small (≤299 beds; 22.9%) and urban teaching hospitals (27.3%), respectively. In stratification analyses, an increasing trend in PJI prevalence was particularly seen in larger (≥500 beds) hospitals (24.4% in 2003–30.7% in 2016; p < 0.0001), while a decreasing trend was seen in small-sized hospitals. Overall, PJI in knee arthroplasty revisions appears to be slightly increasing. Moreover, increasing trends in large hospitals and decreasing trends in small-sized hospitals suggest a shift in patients from small to large volume hospitals. Decreasing trends in total costs, alongside increasing trends in per-day costs, suggest a strong impact of length of stay trends and a more efficient approach to PJI over the years (in terms of shorter length of stay).

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