The Importance of “Complete” Rehab after a Total Knee or Total Hip Replacement

The majority of people who undergo a total joint replacement will see a physical therapist for rehabilitation following the surgery.  Despite this fact, there are some surgeons who will not refer to outpatient physical therapy after certain total joint replacements like the hip.  Even with referral to outpatient physical therapy, if sufficient strength is not reached prior to discharge, then various complications can arise.

Despite the fact that not all surgeons refer patients for outpatient therapy after a total hip replacement, physical rehabilitation following this surgery is very important.  Recovery after a total hip replacement may not take as long as a total knee replacement, but that does not make rehab any less valuable.  Outpatient therapy is necessary to regain full strength, mobility, and function.  Home therapy, where a physical therapist comes to a patient’s home and provides treatment, is helpful for STARTING the process of improving function, range, and strength; but according to the study, “Interventions Used by Physical Therapists in Home Care for People After Hip Fracture”, the majority of home therapy does not address any resistance training or higher level exercises.  In other words, full strength is not gained following a standard bout of home therapy which is likely why individuals are not regaining their full function following a hip fracture or total hip replacement. 

If an individual attends outpatient physical therapy, strengthening and regaining normal function become the top priority.  The outpatient setting is ideally equipped with weights, bands, machines, etc. geared toward gaining function and strength which are typically not found in a standard home.

While individuals who undergo a total knee replacement are often referred to outpatient therapy, not regaining full strength during the course of treatment could leave an individual prone to further damage.  The damage to which I am referring will likely affect the non-operated knee.  If the right knee had a total knee replacement but full strength was not gained, then the left knee will have to do more work to compensate for the right knee’s remaining weakness.  With sufficient physical therapy that is geared toward addressing quadriceps muscle strength and overall knee and hip function, damage to the opposite knee can be avoided.  If a person has arthritis or pain in both knees and the right is replaced, sufficient strengthening of the right knee can prolong the function of the left knee and even prevent the need for a knee replacement on the left.

These points are important to understand in terms of your rehabilitation following a total joint replacement.  With the way healthcare works, you have to be an advocate for your own healing and recovery so don’t hesitate to talk to your doctor if you are concerned that you are not receiving the rehabilitation you need.





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