Full Course Description
Therapeutic Strategies for Degenerative Joint Disease: Overcoming Pain and Improving Function
Diagnostic Criteria for Degenerative Joint Disease (DJD)
- American Medical Association (AMA) Guidelines
- Arthritis foundation’s guidelines
- Medical history
- DJD v. Rheumatoid Arthritis v. Gout
- Other Arthritic conditions
The Pathophysiology of DJD in:
- Weight-bearing joints
- Non-weight bearing joints
- The spine
- Silver Sneakers
- Ergonomic work and home environments
- Positional awareness
Techniques to Maintain Mobility
- Motion is lotion
- Muscle balance
- Joint stability
- Diet and supplements
- Super foods
- Over the counter supplements
- Total joint arthroplasty
- Total hip
- Total knee
- Total shoulder
- MCP replacement
Physical Therapy Management
- Introduction of assistive devices
- Pre-op exercise program
- Smoking cessation
- Weight reduction
- Motivational interviewing techniques
Total Joint Regimens
- Acute care post-op
- Post-op teaching
- Gait instruction specific to intervention
- Exercise programs
- Critical pathways
- Program Goals
- Design of exercise regimen
- Scar care management
- Outcome measure
- Gait Progression
- Household v. community ambulation
- Addressing the “What can I do?”
- Mature adult
- Middle-aged adult
- 1+ year to complete recovery
- Activity guideline
- Quality of life
- Cost benefits of activities
- Summarize the commonly-experienced condition of degenerative joint disease.
- Explain focused history taking techniques and examination methods to create diagnostic skills for evaluation of upper and lower extremity degenerative joints.
- Evaluate the decision-making processes regarding conservative and surgical treatment options for patients with degenerative joints.
- Obtain methods to effectively educate patients regarding: the arthritic process, treatment options, recovery steps, and long-term expectations.
- Describe recovery and rehabilitation stages to counsel and consult patients.
- Determine the strategies to share with patients to optimally prevent or delay arthritic changes.
An Intensive Training Lab on Total Joint Replacements
Determinants for Joint Replacement
- Muscle imbalance
- Acute injuries
- Chronic conditions
- Systemic conditions
Pre-operative Selection Determinants
- Postural deformity
- Diagnostic imaging
- Function and pain level
- Conservative therapies
- Physical co-morbidities
- Relative bone density
- Post-op considerations: Acute rehab? Skilled nursing? Home? Which is the right choice in terms of accessibility, assistance, activity restrictions, and length of time?
Surgical Procedures with Video Presentations
- Total shoulder arthroplasty (TSA)
- Reverse TSA
- Total elbow arthroplasty
- Total hip arthroplasty (THA), conventional posterior and lateral approaches
- Anterior THA and THA revision
- Total knee replacement (TKA), conventional and subvastus
- Total ankle replacement
- The future of joint replacement:
- Video radio graph assisted total elbow arthroplasty
- Computerized and robotic assisted hip, knee and ankle replacement
Acute Post-op Recovery Interventions
- Pain management, opioid tolerance and opioid induced constipation (OIC)
- Wound care/Infection prevention demonstration of PICO dressing
- VTE prophylaxis
- Hands on demonstration
- Point-of-care PT/INR
- The latest recommendations on TED hose
- Cold recirculator units and cold compression devices
Treatment Sessions for the Acute through the Subacute Recovery Phase
- Physical/Occupational therapy
- Movement restrictions
- Demonstration of proper positioning
- Hands on practice
- UE: Donning and doffing of UE immobilizers
- Shoulder, distal UE exercises, and active proximal scapular exercise, cervical stretching techniques
- Hip: Immediate post-op exercises and progressions for the conventional/anterior approach hips, including transfer considerations
- Knee: Immediate post-op exercises and progressions for the conventional/subvastus approach, forms of stretching
Out-patient and Beyond: Strategies for Optimal Function and Joint Longevity
- Hands on activities
- Shoulder: Manual techniques to build proximal scapular stabilization, progression to rotator cuff strengthening
- Hip: Progression of core pelvic strengthening, proximal trunk stability, proprioceptive, balance, coordination activities, return of normal gait mechanics
- Knee: Progression of flexibility exercises, patellar mobilization, importance of proper footwear, proprioceptive, balance, coordination activities, return of normal gait mechanics
- Participate in hands-on application of acute and sub-acute intervention strategies for the total shoulder, hip, and knee patient.
- Evaluate the key indications for timing of joint replacement surgery, including post-op recovery considerations.
- Practice application of cold therapies, UE immobilizers, and point-of-care PT/INR.
- Evaluate post-operative pain, wound care, and anticoagulant options.
- Compare surgical approaches and procedures through video presentations to determine appropriate post-op restrictions.
- Explain the indications to reverse a TSA.
- Distinguish between the various surgical approaches currently available for THA.
- Differentiate between traditional surgical approaches and the subvastus approach for TKA.
- Analyze the advantages of computerized and robotic assisted replacement surgeries.
- Practice hands-on application of advanced out-patient intervention strategies for the total shoulder, hip, and knee patient.