Total joint arthroplasty is the most common surgical procedure performed in the U.S. and will continue to climb rapidly. However, as surgical advances and prosthetic implants improve rapidly, the therapeutic process and protocols used with this population have remained stagnant. In an attempt to improve outcomes while reducing length of stay and therapy visits, clinicians have over utilized rigid protocols while neglecting proprioception and function yielding a reduction in long term outcomes. 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 determined not just by their referring surgeon but by current research.

This course investigates the latest surgical and minimally invasive techniques used and the benefits and risks associated with these techniques. Taking hundreds of nationally established joint protocols, presenter Trent Brown summarizes the most effective and functionally relevant treatment strategies and protocols. Numerous labs will occur to ensure application of material and immediate carry-over to the clinical setting. Mr. Brown will also discuss documentation techniques and examples to strongly justify the need for skilled services with this population in hospital, in-patient, acute, home health, and outpatient settings.

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Course Dates & Locations

    Educational Credit

    A certificate of attendance for 15 Contact Hours will be awarded to each participant. All Therapy Network Seminars are pre‐approved for CEUs in the state where the course is conducted when required for PT, OT, ATs & Assistants.

    Therapy Network, Inc. (BOC AP#: P2563) is approved by the Board of Certification, Inc. to provide continuing education to Certified Athletic Trainers. Our seminars are eligible for a maximum of 15 Category A hours/CEUs. ATs should claim only those hours actually spent in the educational program.

    AOTA Approved Provider of Continuing Education # 3073 Category 1 Domain of OT. The assignment of AOTA CEUs does not imply endorsements of specific course content, products, or clinical procedures by AOTA

    Audience

    This is an intermediate level course intended for PTs, PTAs, OTs, OTAs and ATs

    NOTE: Nothing in this course is to enable or permit the learner to apply techniques outside of the scope of practice in their individual state and discipline.

    Objectives

    • Identify the diagnostic, demographic, and lifestyle explanations related to an increase in joint arthroplasty and the increased need for therapy services following arthroplasty
    • Identify and apply current evidence behind tissue healing science and how it affects the total joint client
    • Identify the evidence justifying therapy following total joint arthroplasty and the long and short-term benefits of therapy
    • Identify the difference between standard and reverse total arthroplasty components and techniques and how it impacts rehabilitation
    • Demonstrate evidence based hip therapeutic strategies used for recovery of the most commonly used hip surgical techniques
    • Identify the difference between the various surgical components and techniques used for knee arthroplasty and the impact of treatment
    • Demonstrate the best treatment strategies for patients seen in any therapeutic setting following practice of techniques in lab

    Schedule

    • Day 1

      8:00 Registration and Continental Breakfast
      8:30 Common Themes and Research behind Shoulder, Hip and Knee Arthroplasty (TSA, THA, TKA)
      Demographics
      Age, gender, lifestyle, and socioeconomic status

      Inclusion criteria for TJA (based on AMA) and who should
      avoid TJA
      Common diagnosis, pain levels, and reduced functional
      levels

      Neurological and psychological consequences from delaying
      total joint arthroplasty
      Depression, sleep disturbances, confusion, and memory
      loss

      Healing stages
      Inflammatory, proliferative, remodeling (over icing?)
      Bone, cartilage, muscle, tendon, and nervous tissue

      Review of joint movement and osteokinematics
      Rolling, gliding, scapulohumeral rhythm, and spinning
      10:30 BREAK
      10:45 Gait (Functional Mobility) and Arthroplasty
      The Determinants of Gait vs. Phases

      -Minimizing COM Displacement pre-post arthroplasty

      -Curtate-Prolate-COM Cycloid theories

      -What the phases of gait neglect and how to address
      following arthroplasty

      -Why clients don’t fall performing “gait”

      -How Shoulder, Hip, and Knee arthroplasty all impact
      gait (pre and post-surgery)
      11:30 Total Shoulder Arthroplasty
      History leading to current procedures and prosthetics
      -Functional verses textbook ROM for “normal” function

      Procedures/components
      -Glenoid component, humeral component
      -Hemiarthroplasty, cemented vs. cementless, constrained
      vs. non-constrained)

      Reverse TSA
      Why reverse TSA?
      Minimally invasive R TSA including subscapularis sparing


      12:00 LUNCH (ON YOUR OWN)
      1:00 General therapeutic guidelines (3 or 4 phase approach)
      -Goals, Precautions, Advancement Criteria (function vs.
      a timeline)
      1:30 LAB: TSA Treatment

      Phase 1:
      -The proper pendulum
      -Isometrics and elbow mechanics

      Phase 2:
      -4 approaches to GPG mobilization technique
      -Non-WB scapular depression
      -Natural arm swing and gait (standing/seated swingers)

      3:00 BREAK
      3:15 Phase 3 and 4

      Functional carry-over

      TSA failure rates, functional outcomes, and ROM

      Appropriate “Functional” Standardized Assessments
      4:00 Total Hip Arthroplasty
      History leading to current procedures and prosthetics

      Normal versus functional ROM

      Procedures/components
      -Femoral component (cemented versus cementless)
      -Acetabular component (plastic, metal, or ceramic)
      -Anterolateral, posterolateral, direct lateral, anterior, and
      superpath approaches

      Advantages and disadvantages to each approach
      5:30 Adjourn
    • Day 2

      8:00 LAB: General therapeutic guidelines
      Treatment

      Phase 1 – 4 (Goals, Precautions, Advancement Criteria
      (function vs. timeline)

      Supine lateral stability (bed mobility)

      Trochanter Tension
      -Glut Med emphasis (what works? Evidence-based)
      -Hip Hitch – Standing Sliders
      -Pelvic Teeter Totter

      10:00 BREAK
      10:15 LAB:
      -Hip Flexor lengthening

      -Lateral pelvic tilt in sitting leading to frontal plane
      control (bed mobility)

      -Seated Rotation

      -Lateral weight shift - pelvic tilt emphasis (single leg
      stance with resistance)

      -Static Chops
      Clinical Evidence behind THA and appropriate activities
      12:00 LUNCH (ON YOUR OWN)
      1:00 Total Knee Arthroplasty
      History leading to current procedures and prosthetics
      - “Normal” range versus functional range

      Procedures/components
      -Femoral component (cemented versus cementless)
      -Tibial component (metal platform with plastic surface for
      ROM and absorption)
      -Patellar component (metal or plastic)
      -Cruciate retaining, posterior stabilized design, fixed
      bearing, mobile bearing, and gender specific,
      unicompartmental option
      -Incisions (parapatellar, midvastus, subvastus/quad
      sparing)
      -Computer Aided Orthopedic Surgery (CAOS) why isn’t
      being utilized?

      1:45 LAB: General therapeutic guidelines
      Treatment

      -Phase 1 – 4 (Goals, Precautions, Advancement Criteria
      (function vs. timeline)
      -Quad sit-up (NDT approach) (WB and functional
      emphasis)
      -4 directional Patellar Joint Mob
      -AP/PA Tibiofemoral Joint Mob
      2:30 BREAK
      2:45 LAB
      Gold standard of the stationary bicycle

      Knee Flexion 8* at Midstance

      Gastroclock and Soleuostretch

      Dynamic PNF Mobile Chops
      4:15 Clinical Evidence behind TKA
      4:30 Documentation
      Documentation ideas “outside the box” for the total joint
      client
      -Long-term care, acute, HH, outpatient, and transitional
      clients

      -Case study implementing research and treatment ideas
      5:00 Course Evaluation and Adjourn

    Cancellation Policy

    Registration fee less a $75 administrative charge is refundable if cancellation received 14 days prior to program date. No refunds will be given after that time. Therapy Network, Inc. reserves the right to cancel a seminar and will refund in full the registration fee only. TNI is NOT responsible for registrants nonrefundable airfare, accommodations or fees.