While rounding this morning on a patient who had a knee replacement yesterday, an ancient proverb was quoted: “Even a journey 10,000 miles long begins with a single step.” Total joint replacement is one of the most successful operations ever performed in medicine, but it is a significant undertaking for a patient. The recovery from total joint replacement is done after years of progressively debilitating pain, which has forced lifestyle changes and activity limitations.
That first step for patients after joint replacement is taken under the supervision of physical therapists (PT) the day after surgery. Dr. Thornhill reminded our group recently that during his surgical training, patients were placed on bed rest and the average length of stay in the hospital was 17 days. Now, the average length of stay is approximately 2 days. A major contributor to this change is the work done by physical therapists. While the surgeon is tasked with surgical planning and execution the day of an operation, PT is tasked with educating a patient on how to walk for a lifetime. By mobilizing patients sooner and safely, complications are decreased and patient outcomes improve.
This was readily apparent today at HGPS, where PT helped a patient ambulate up and down stairs just 24 hours after having both knees replaced yesterday. This particular patient reported that her expected post-operative pain was manageable, and she was motivated by the absence of arthritic pain and the prospect of having pain-free ambulation is the coming months. The Op Walk mission would not be possible without the physical therapists that work tirelessly to help patients achieve their activity goals.
The post-operative clinic is a testament to the work done by PT. This clinic sees patient who were operating on during Op Walk missions in years past. Today, a young man who previously could not walk because of end-stage pathology in his hips was seen after both hips were replaced last year. He is a wonderful example of just how far one can come under the guidance of physical therapy after an operation.
Dan Tobert, orthopaedic surgery resident