An acute care episode of a patient following bilateral total knee arthroplasty

Abstract

More patients with bilateral joint problems are choosing to go through one surgery to replace both joints simultaneously rather than having two separate surgeries. The goals of physical therapy following the surgery are to decrease pain, maximize range of motion (ROM) and strength, improve ambulation, and improve overall function. Few studies have focused on the importance of the acute phase of rehabilitation and most concentrate instead on long-term outcomes and outpatient care. The patient was a 62-year-old male diagnosed with osteoarthritis of both knees. The day before the initial physical therapy evaluation, the patient underwent a bilateral total knee arthroplasty. By the end of his stay, active knee ROM increased to −6° to 88° on the right and −6° to 83° on the left. Passive ROM also increased to −5° to 90° on the right and −5° to 86° on the left. The patient was able to perform supine to sit transfers with supervision and sit to stand transfers with contact guard assistance and his ambulation progressed to walking 100 feet on level surfaces with a rolling walker and supervision. The positive gains of this patient suggest the potential value of high motivation combined with early aggressive physical therapy.