knee replacement guidelines

[madlovejen]

Hi

Has anyone written guidelines for the referral of total knee replacement patients to outpatient appointment?

Many thanks

Jen

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[Hussam]

when and when ??

jin,

ingeneral patients are referref for outpatient PT to review progress or to start advanced exercises ... in TKR you must emphasis on reganing quadriceps control, the pt starts to walk with two cruches, partial-weight bearing for 6 weeks, during the time you can transfer to sticks if possible! full bearing depending on the pail level, swelling, muscle power and ROM.

close -chain quadriceps over spongy ball, progressing to open chain.

http://orthoinfo.aaos.org/booklet/vi...pcategory=Knee

[madlovejen]

sorry you have misunderstood what i am asking

I am looking at the effectiveness of our referral from orthopaedics to our outpatient department. I am looking for anyone who have written guidelines on what to include in this referral for TKR/ who have an effective referral they are willing to share with me so that I can develop our current practice.

Many Thanks

[jwilso]

At the hospital that i work in we aim to discharge pts post TKR within 5 days. To make this a safe discharge patients should have 90 degrees of knee flexion and be able to SLR. they are usually on 1 or 2 sticks and would also practice stairs/steps if required.

i do a post-op knee clinic to review them 2 weeks postop. again we check ROM,SLR and gait. providing that they are still 0-90, can SLR and our managing their home exs then we do not arrange any more physio. if they are not acheiving these goals then i either give them another week and review them again or arrange out-pt physio.

in effect this means that i have to do a knee clinic every week but i give the pts 15 minute appointments and so with a typical clinic of about 4 pts this only takes 1 hour. this reduces the number of referrals to out-pts.

the patients that are discharged from the knee clinic then see their Orthopaedic consultant at 6 weeks post-op.

Hope this sort of info is what you are after.

Cheers,

john