Terry Rzepkowski – Advanced Treatment for Total Hip & Knee Replacement: Faster Recovery and Improved Outcomes

Outline

The Full Picture of the Total Joint Patient: Why Looking in Isolation Can be Disastrous

• How you can miss predisposing factors for DJD with a nonfunctional approach
• Examine the whole LE kinetic chain with functional test observations

Today’s Total Joint Procedure: What We Can Learn by Watching Surgical Videos

• The new reality – reducing the amount of rehab care post-op
• Post-op approaches should vary based upon procedure and component used in surgery
• 6 surgical advancements that could affect your plan of care
  • Using muscle sparring approaches
  • Computerized mapping
  • Robotics
  • Peri-operative blood loss
  • Pain control measures
  • 3D custom designed implants

Acute Post-op Recovery Interventions: How to Maintain a Robust Post-op Rehab Plan for Same-day Discharges

• New CMS guidelines for total joint patients: seeing patients right after surgery
• Confidently managing
  • Pain management, opioid tolerance, and opioid induced constipation (OIC)
  • Active and passive TED strategies
  • Wound care/infection prevention: early identification of wound versus joint infection
  • Blood thinners: various types, early warning signs of high anticoagulant levels, and identifying DVT versus cellulitis or poor edema control compliance
  • Patient education on positioning, safe transfers and mobility

Use Functional Dynamics for Optimal Returns: Hands-on Lab

• REMEMBER: Exercising joints in isolation will NOT progress your patients faster, further
• Progress the LE as a functional unit
  • Video demonstration of techniques
• Incorporate closed chain kinematics that lead to successful outcomes in reduced time
• Returning normal gait mechanics using proprioceptive, balance, and coordination activities