Exercise And Physiotherapy Delivery During The Elderly

The surgical procedure. A total knee replacement is a surgical procedure where the diseased knee joint is completely replaced by artificial materials that resemble the original knee joint. The orthopedic surgeon removed the end of the femur and the end of the tibia by using metal pieces and sawing the bone, to ensure that he removes the right amount of bone. The end of the femur bone is replaced with metal and the end of the tibia bone is replaced with plastic and metal. A plastic piece was added under the patella because the surface under the patella was damaged as well. These artificial materials, called prosthesis, have smooth surfaces so when they rub against each other, it does not cause damage and is pain-free. The purpose of this surgery is to remove the diseased portions of the joint and replace it with artificial materials to prevent further deterioration and eliminate pain, stiffness, and decreases in function that were caused by the osteoarthritis.

Physical therapy and kinesiology work in a close relationship to each other. Essentially one may think they are one in the same, however there are small differences between the two that provide different results when applied singularly. As a combined effort physical therapy and kinesiology work to heal the muscles and joints of the body, recreating movements perfectly as they were before injury or in some cases as closely as one can get to a perfect function. First one must understand where the lone is drawn between the two fields and how they balance each other to create desirable results in a patient.

OrthoOklahoma is an orthopedic medical clinic with a physical therapy branch that provides outpatient physical therapy care. The facility has a staff of three licensed physical therapists and a physical therapy assistant along with four physical therapy techs. I was able to observe all three physical therapists, Megan Ripley, Joe Ogle and Ken Roberts. At OrthoOklahoma, the most common patients are post-surgery from repairs of muscles, bones or joints. While shadowing these therapists, I observed cases of total knee replacement, total hip replacement, ACL/meniscus repair, rotator cuff repair, frozen shoulder, labrum repair, and other ailments from wear-and-tear and aging. This experience allowed me to talk to physical therapists about the ins and outs of their job, learn about different exercises and routines for treatment of injuries, and really get an idea of the work it takes to become a well-respected physical therapist.

A total knee replacement (TKA) is the most common joint surgery performed in the United States (Turner, 2011, pp. 27-32). Each year, over 650,000 Americans undergo this surgery (Wittig-Wells, 2015, pp. 45-49). It is an invasive surgery that involves an incision on top of the knee and replacing damaged parts of the knee with artificial parts that are either metal, ceramic or plastic. Someone would get a total knee replacement for damage of the joint, osteoarthritic, posttraumatic, or inflammatory arthritis. The cartilage is damaged, wears away and then you develop bony deformity and contracture of ligaments but it starts out with specific defects or wear of cartilage. The top nursing priorities for a total knee arthroplasty is to “prevent complications, promote optimal mobility, alleviate pain, and provide information about diagnosis, prognosis, and treatment needs” (Doenges, 2014, pg. 627). A possible nursing diagnosis from the patient who is undergoing a TKA might be ‘impaired physical mobility related to pain and discomfort as evidenced by reluctance to attempt movement.’ Another one could be ‘acute pain related to chronic joint disease as evidenced by reports of pain’ (Vera, 2014).

The knee is a hinge joint which is needed for movement. The joint is made by the femur and the tibia, and also contains the patella which acts as a shield for the joint. In knees with osteoarthritis, the cartilage on the ends of the bones deteriorates, causing the bones to rub against each other. X-rays can be used for the diagnosis of osteoarthritis; the images would reveal damage and other changes related to osteoarthritis. With osteoarthritis of the knees, the patient would experience progressively increasing pain, stiffness, and they would

According to Su et all (2009), knee replacement is an effective way to find relief of pain and improve mobility, but most importantly giving the patient education and skills during early recovery. In comparison, all articles focused on the need of improving mobility after surgery. Assessing the patient’s abilities and the need for physical therapy and keeping an eye out for complications. A main focus was pain relief and that recovery for each patient varies, but it is important to get them ambulating with assistive devices soon after surgery. My patient at Kindred, had continuous assessment and an interdisciplinary team that assisted in her road to

In this study, a randomized and concealed method supported by a computer was conducted prospectively for patients who showed signs of radiographic knee OA. In addition, without knowing further about the clinical status of participants, knee radiographs were assessed in the study of baseline and follow ups by an experienced surgeon. The baseline characteristics of subjects such as age and BMI were not significantly different. Criteria included were the radiographically confirmed as knee OA (a score ≥ 1 out of 4 on the K/L scale), ability to walk to the site, understand and make signature on the written consent of information form and report the data required. However, the research did not include the participants

Physical therapy, for strengthening purposes, and bracing the joint for stability is also an option when muscle strength is not adequate enough to support the needs of the joint. There are also many types of medications, supplements, or even cortisone injections that may be prescribed by a physician to halt or reverse the symptoms of osteoarthritis (Palo Alto Med Foundation 2014). Surgical options will depend on the severity of the disease and the mechanisms affected. Focusing on treatments for osteoarthritis of the knee, surgical options include cartilage grafts, a synovectomy, and partial or total knee replacements. These processes either remove or replace damaged tissue and cartilage in order to ease symptoms or completely negate the effects of the disease (American Academy of Ortho Surgeons

Observational prospective cohort study: An advantage of this design is a careful analysis of the trends and relationships and differences among the variables can be explored. Rationale: to determine the relationship and trends of early activity with postoperative total knee replacement.

The patient may also complain of crepitation being heard during movement due to irregularity of the joint surfaces in the knee gliding over one another. Knee osteoarthritis is characterized by structural changes in the knee seen on radiographs involving loss of articular cartilage, joint space loss, and the presence of osteophytes.3 Primary care providers is the ones who primarily manage osteoarthritis with conservative and pharmacological treatments. Conservative treatment consists of exercise, strength training, and weight loss in order to reduce pain and progression of the disease. However, many conservative treatments fail over time and pharmacological treatment is needed to reduce pain in the patient.1 This literature review will look into the knee portal techniques, corticosteroid injections, and hyaluronic acid injections for knee

The prevalence of OA is expected to increase in the coming years as risk factors, such as aging, population and obesity become more prevalent (Galvin et al., 2013). It accounts for clinical and economic burden as a result of reduced quality of life, increased use of health care resources and loss of productivity (Galvin et al., 2013). According to Laba (2013), currently there is no known cure for OA, nor are there effective interventions to slow disease progression. A physical therapist should be equipped with enough knowledge about the pathology and management of the disease, so that he can help elderly population manage the symptoms.

The most common indication for total knee replacement is osteoarthritis, or degenerative joint disease. The end stage of osteoarthritis is wearing out of cartilage (smooth, gliding bone ends) resulting in bone-to-bone contact in diseased joints. It is progressive and becomes increasingly painful as the cartilage erodes. Younger people who get knee replacements have damaged their joints by trauma (accidents that destroy joint surfaces), infection, cancer or tumor, and inflammatory conditions such as rheumatoid arthritis.

There are limitations in this study. This was a retrospective study of prospectively gathered data. The surgeries were carried out by different surgeons thence; surgical technique (conventional versus minimally invasive) and post-surgery management differ between

It is a joint disease and commonly the leading cause of pain in older adults. With osteoarthritis, joint cartilage becomes rough and worn. The damaged tissue causes the cells to release an enzyme which contributes to breakdown the cartilage. Inflammation is present in synovium, the lining of the joint. Overtime, the space in the joint becomes narrower. Patient with osteoarthritis experience joint stiffness and pain with weight bearing and movement. As the disease progresses, pain becomes extremely severe (VanMeter & Hubert, 2014 p 175). This the reason why patient had left knee arthroplasty. In left knee arthroplasty, the femoral and tibia component of the knee are replaced with an artificial material called prosthesis to relieve pain and allow a person to restore performance of activities of daily living (LeMone et.al, 2014 p 1356). According to Shmerling (2014), the patient’s risk for developing blood clots increases after surgery. Clots can form inside the blood vessels and this is where it becomes dangerous. Blood clots in the veins will hinder or block the return of blood to the vital organs of the body such as the heart. Due to the patient’s inactivity the flow of her blood becomes sluggish and causes the blood to pool commonly at the lower part of the body such as the leg and could lead to a clot. This is often called as Deep vein thrombosis. There is a tendency, that this clot could travel in the body and lodge in other

DN is a 68 year old Caucasian male who lives in Pomona, Missouri. On September 14, 2009, DN underwent a scheduled left total knee arthroplasty at Baxter County Regional Medical Center. A consultation appointment about a total knee arthroplasty was scheduled when DN had increasing pain in his knees while doing chores and working on his dairy farm. The increasing pain DN was having been due to a history of osteoarthritis and the wear-and-tear on his joints throughout his life, no specific injury was noted. Depending on the outcome of the left knee, DN was consulted on having his right knee done in the future