Orthopaedic Specialty Programs: Joint Replacement

Osteoporosis, degenerative joint disease, osteoarthritis and many other knee and hip ailments often lead to the need for joint replacement surgery. Rehabilitation focuses not only on regaining function of the replaced joint, but rebuilding the weakened muscles, maintaining mobility in the surrounding joints and improving the patient's physical condition to aid in the recovery process. Patients with joint replacement are placed on a rehabilitation program usually following a short stay in an acute care hospital.

Patients with joint replacement require intensive nursing care. The patient's surgical incision, pain medication management, bowel and bladder function, and cardiopulmonary and neurological status are all monitored daily. Patients are also educated on joint precautions and given a home program to reinforce the incorporation of newly learned skills into their daily routine.

An occupational therapist will assess the patient's dressing, grooming, toileting and bathing skills, and upper extremity strength and endurance to determine if this service is needed. A physical therapist will work with the patient on mobility while in bed, transfers, joint range of motion and walking with adaptive equipment. The patient may also participate in aquatic therapy, where, with the support of water, it is easier for the patient to move and exercise. As the patient progresses, he will work on climbing up and down stairs, getting in and out of the car and maneuvering in a bathroom. When appropriate, the patient will work with an occupational therapist for home management and kitchen skills.

At the end of the patient's stay, the treatment team will meet to discuss the patient's progress. The patient's family is invited to attend this meeting. By the time of discharge, the patient should be clear of any medical need, be proficient with a home program and be able to function more independently with the assistance of an adaptive device (walker, reacher, etc.). The patient is then advised to follow up treatment with his orthopaedic surgeon.