Trent Brown – Joint Arthroplasty for Today’s Clinician

In addition, the recent push to reduce length of stay and therapy visits while increasing functional outcomes and activity levels makes the clinician’s job even more critical.

Trent Brown – Joint Arthroplasty for Today’s Clinician

COMMON THEMES AND RESEARCH BEHIND SHOULDER, HIP, AND KNEE ARTHROPLASTY (TSA, THA, TKA)

• Demographics
• Criteria for inclusion for TJA (based on AMA) and who should avoid TJA​
• Neurological and psychological consequences from delaying total joint arthroplasty​
• The healing stages
  • Inflammatory, proliferative, remodeling
  • Bone, cartilage, muscle, tendon and nervous tissue
• Review of joint movement and osteokinematics​

TOTAL SHOULDER ARTHROPLASTY

• The history of prosthetics and current procedures is a source of inspiration
• Functional motion vs. textbook motion for normal function and ADLs
• Procedures/components
  • Glenoid and humeral components
  • Hemiarthroplasty
  • Cemented versus cementless
  • Non-Constrained versus unconstrained
  • Reverse TSA
    • Why reverse TSA
    • TSA precautions in comparison to standard TSA
• TSA research on failure rates, functional outcomes and ROM
• General therapeutic protocol
• Approach in 3-4 phases
• Ideas for treatment/lab
  • Scapulohumeral rhythm
  • The true pendulum
  • 4 ways to get the posterior glenohumeral slide (joint mobilisation)
  • Non-weight bearing periscapular training

TOTAL HIP ARTHROPLASTY

• The history of prosthetics and current procedures is a source of inspiration
• Procedures/components
  • Femoral component (cemented versus cementless)
  • Acetabular component (plastic, metal, or ceramic)
  • Anterolateral, posterolateral, direct lateral, anterior, and superpath approaches
• Research behind THA​
• General therapeutic protocol
• Ideas for treatment/lab
  • Six determinants of gait
  • Frontal plane control (LAB), which is a lateral pelvic tilt in supine
  • Lower lateral weight shift and pelvic tilt emphasis (single leg position with resistance).
  • Straight leg raise in 4 ways

TOTAL KNEE ARTHROPLASTY

• The history of prosthetics and current procedures is a source of inspiration
• Procedures/components
  • Femoral component (cemented versus cementless)
  • Tibial component (metal platform and plastic surface) for Absorption and ROM
  • Part of the patellar (metal or in plastic)
  • Unicompartmental option
  • Preventive retaining, posterior stabilized design, fixed bearings, mobile bearings, and gender-specific
  • Incisions (parapatellar, midvastus, subvastus/quad sparing)
• Research behind TSA
• General therapeutic protocol
  • SLR and closed chain activity
  • Dynamic EOM and half-Standing with weight bearing/functional emphasis
  • The stationary bicycle is rated Gold
  • 4 directional patellar joint mobilization
  • Ideas for treatment

DOCUMENTATION

• Documentation ideas “outside the box” for The total client
• Implementing research and treatment ideas in a case study

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Description:

The most commonly performed surgical procedure in the U.S. is total joint arthroplasty. The therapeutic process and protocols for this population are still being developed each year, despite the advancements in surgical technology and prosthetic implants.

In addition, the recent push to reduce length of stay and therapy visits while increasing functional outcomes and activity levels makes the clinician’s job even more critical. With total joint procedures doubling the past decade and trending upward, today’s clinician must possess a stronger understanding of the techniques used by surgeons, the prosthetics commonly (and uncommonly) used, and evidence-Based treatment strategies are determined by the referring surgeon as well as current research.

This recording discusses the most current surgical and minimally-invasive techniques, as well as the benefits and dangers associated with them. Presenter discusses over 1,000 national protocols. Trent BrownMOT/OTR/L, BCG summarizes the most relevant and effective treatment strategies and protocols. Demonstrations, labs and presentations will take place to ensure material is applied and carry immediately.-Transfer to the clinical setting.

Mr. Brown I will also talk about documentation techniques and examples that can be used to justify the need. for This population is eligible for skilled services in hospitals.-Acute, outpatient, and patient settings.