& REHAB
TRAINING CLIENTS
POST-JOINT REPLACEMENT
With our ageing population, and the increase in older people
working out, you are more likely than ever to find yourself
training clients with joint replacements.
WORDS: PHEBE COREY
ccording to the Australian
Orthopaedic Association’s 2015
annual report, the number of
both hip and knee replacements are
increasing each year, with 43,183 hip
replacements
and
54,277
knee
replacements reported to the registry in
2014. Despite them being performed more
often, they remain a major surgery requiring
appropriate rehabilitation. Understanding
the
post-op
recommendations
and
precautions is vital for you and your client to
return to training both safely and confidently.
A
Reasons for joint replacements
In general terms, the purpose of a joint
replacement is to remove diseased or
broken parts of the joint and replace
them with artificial parts. The goals of
replacement surgery are therefore to:
• decrease pain
• improve joint range of movement
• improve overall function.
The most common reason for this is
osteoarthritis, and surgery are usually
elective when conservative treatments are
no longer effective.
Another major reason a joint
replacement is required, in particular of
the hip joint, is due to a fracture, most
commonly a broken femoral neck. The
most common risk factor for sustaining
a hip fracture is osteoporosis, and this
should be flagged early on in your client’s
training history and kept in mind during
their return to training post-op.
The different types of
replacements
There are three main types of replacement
for both the hip and the knee; total, partial
and revision.
Hip
• Total hip replacement involves
replacing the femoral head (ball of the
hip joint) as well as the acetabulum
(socket of the hip joint).
• Partial hip replacement, in which only
the femoral head is replaced, most
commonly due to a fracture, as
mentioned above. In some instances
these fractures are managed with
dynamic screws, however the decision
will depend on the severity, patient’s
age and surgeon’s opinion.
• Revision surgery for reasons including
loosening of the parts, dislocation,
fracture or infection.
Knee
• Total knee replacement involves
replacing the complete joint surface of
the femur and tibia.
• Partial replacement of the femoral and
tibial joint surface on either the inner or
outer side (most commonly the inner/
medial side due to biomechanical loading)
• Revision surgeries are performed for
similar reasons to the hip.
The role of a physio
While still an inpatient, the physio’s role is to
NETWORK SPRING 2016 | 11