20.2: Joint Arthroplasty: Advances in Surgical Management and Rehabilitation
State of Ohio Approval #: 10S0843, Hours granted: 30, Effective dates: 5/1/10-5-1/11; NV Board of PT Examiners Approved for 1.5 CE Units, Unit type: Clinical, Approval through: 7/31/11; PA State Board of PT Approval #: PTCE001212, Date of course: 5/1/10-5/1/11, Number of credits: 30 (30 gen, 0 DA); State of CA approval: (CPTA #10-361), 3.0 CEUs, dates: 6/27/10-12-31/10.

Course Description

This monograph series provides a unique opportunity for the participant to learn the essential components governing the evaluation and rehabilitation of the patient who presents with joint pathology that may warrant joint arthroplasty for the hip, knee, shoulder, spine, or ankle. Both conservative and operative considerations are discussed in detail including minimally invasive procedures.

Upon completion of this course the participant will be able to do the following:

1. Understand the anatomical and biomechanical functions of joint structures that are suitable for arthroplasty including hip, knee, shoulder, ankle, and spinal column.
2. Implement common approaches to conservative care for the patient who may be a candidate for joint arthroplasty.
3. Understand the rationale behind preoperative decision making for joint arthroplasty made by the physical therapist and surgeon.
4. Understand the essentials of evaluation and develop preoperative and postoperative plans of care within the constraints of tissue healing for joints considered for arthroplasty
5. Identify the prognostic indicators and contraindications for joint arthroplasty.
6. Differentiate among the various surgical approaches for knee arthroplasty including, sub- and mid-vastus approach, quadriceps snip, minimally invasive, unicompartmental arthroplasty, and revision knee arthroplasty.
7. Identify appropriate modifications of rehabilitative interventions based upon the surgical procedures and techniques employed for joint arthroplasty.
8. Describe the intra-operative and postsurgical complications following joint arthroplasty and their potential impact on the rehabilitative plan of care and recovery.
9. Understand the various minimally invasive surgical techniques for total hip and knee arthroplasty including the assets, liabilities, risks, complications, and educational needs of patients who are most suitable candidates for this type of surgery.
10. Develop a postoperative rehabilitation program following joint arthroplasty including acute care management, home health therapy, and outpatient therapy with progression to return to optimal function.
11. Describe the surgical procedures associated with cervical and lumbar artificial disk replacement and the effects those surgical procedures have on postoperative plans of care.
12. List the advantages and disadvantages of total ankle arthroplasty versus ankle arthrodesis.
13. Describe the types of total ankle replacements currently being used and the advantages and complications of each.
14. Learn about future developments in implantable materials and designs for hip and knee, and surgical techniques, such as surgical navigation and robotic procedures that influence minimally invasive surgical procedures and consequently accelerated clinical recoveries.
15. Discuss the unique features of the physical therapy regime that are needed as part of the rapid recovery unit following minimally invasive surgery.
16. Describe Self-report Measures and Functional Outcome Measures following joint arthroplasty procedures.

• Hip Arthroplasty- Diane M. Heislein, PT, DPT, MS, OCS
• Surgical Management and Rehabilitation of Knee Arthroplasty- Michael Bade, PT, MPT, FAAOMPT; Karla A. Bell, PT, DPT, OCS; Jennifer Stevens-Lapsley, PT, MPT, PhD; and Tara Jo Manal, PT, DPT, OCS, SCS
• Minimally Invasive Total Hip and Knee Arthroplasty: Rationale, Techniques, and Forthcoming Developments-Dana C. Mears, MD, PhD
• Total Disk Arthroplasty: Advances in Surgical Management and Rehabilitation-Carrie W. Hoppes, PT, DPT, OCS, ATC, CSCS, and James T. Mills III, PT, MS, ECS, OCS (Subject Matter Expert: Norman Gill, PT, DSc, OCS, FAAOMPT)
• Ankle Arthroplasty-Stephanie Albin, PT, DPT, FAAOMPT, OCS, and Thomas G. McPoil, PT, PhD, ATC, FAPTA
• Shoulder Arthroplasty- Todd R. Hooks, PT, SCS, MOMT, ATC, MTC, CSCS; Andrew Hsiao, MD; and James R. Andrews, MD

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