Physical Therapy Continuing Education: Rehah Post Fai Surgery

Physical Therapy Continuing Education recently interviewed a Hip Surgery Rehab Expert about his process for rehabbing people post FAI Hip surgery.

Here are some of his answers:

Hip Surgery Rehab Expert:That being said he asked the patients to stay at least four to five days following the surgery, come twice a day, really get hands on as far as whats involved with the rehab, have a thorough understanding of that rehab process. The more times that patient can hear and have the rehab performed on them the more theyre gonna remember once they leave.

We couldnt always rely on if the patient was going back somewhere where there was a therapist available or they didnt have the means to go to therapy following this, so we also tried to make the rehab process as much possible for the patient to perform on their own with just some follow-up care as needed.

So, our main hip surgeon, when he came out here he had for the most part the same population and so he adopted that philosophy. He asked that the patients stay at least four to five days, to get in twice a day while theyre out here and we go through their specific program with them.

They get treated twice a day and then once they leave here they have the information to contact us via email, phone call to continue up with either their therapist or once they leave here their therapist or they themselves can follow-up with us.

Because our hips surgeon's practice is just exploding we did bring on an athletic trainer who has allowed us to communicate more openly with these patients and the therapists once they leave here. So, we have one full staff person dedicated purely to communicating with the patients and the therapists once they leave.

Interviewer: Excellent. And then follow-up. Do people actually come back to Vail for reassessment or how does that side of things work?

Hip Surgery Rehab Expert:Yes. What well do is theyll stay here four to five days, and what we found is that a lot of patients will stay a little bit longer. Weve seen more and more people dedicating two weeks out here. Obviously its Vail and theres some expense with spending the days out here and the nights out here, so we understand that, but some patients have made the they put the effort into finding one of the best physicians in the world doing the surgery in the rehab facility they figure they might as well spend a little extra money and stay out here. So, they are staying anywhere from four days to two weeks, three weeks up to some patients staying their whole rehab process.

That being said, even if they leave after four or five days we have them come back at probably about six to eight weeks which is right around the time when theyre starting to get more into their functional activities. Kind of going from phase two into phase three of their rehab. Thats around the time that we ask them to come back, around that six to eight week mark and/or they will come back at around 12 weeks.

Physical Therapy Continuing Education: Rehab Post Acl Surgery

Many of the Physical Therapy continuing education courses I have attended are taught by other Physical Therapists. Since many of the patients we see on a regular basis are post surgical, I'm surprised more courses don't have input from orthopedic surgeons.

We recently interviewed a prominent orthopedic surgeon to get his input on rehabilitation following an Anterior Cruciate Ligament (ACL) reconstruction surgery.

Here are some excerpts from the interview.

PhysicalTherapyContinuingEducation.Org: What are some of the key outcomes you are looking for when a patient comes back to see you after the surgery?

ACL Surgeon: So, I think important things are early on, again, gaining that extension, decreasing the swelling, getting that motion going, and then getting them on a bike and really working with them. And then the other thing is not trying to do things too fast. Ive seen some patients that have come back from therapists and said, Well, they tried to have me do this jumping or running or hopping or things like that before they were ready, and again, that was not necessarily in my protocol. Sometimes the patients doing so well that the therapist thinks that they may be able to do advanced things sooner, and that may not be the case.

So, communication I think is important, and both with the issues that are going on that are not good, or issues that are good that they may want to communicate and say, Johnny looks great and is doing real well. What do you think about doing this? And I really appreciate that kind of feedback and I appreciate the time that is taken that somebody like you will take with the athlete, and the expertise that you take in really getting this patient back.

If I do a good surgery and everything goes great but we dont have good rehabilitation then its all for not. At the same time I give a huge amount of credit to the physical therapists and the athletic trainers that work with these athletes because theyre really helping the athletes along, and getting them to where they need to be, and if we didnt have them then they wouldnt be able to get back. So, I think its really a joint effort and a combined effort that we can all take pride in when the athlete does get back on the field.

PhysicalTherapyContinuingEducation.Org: Excellent. Any exciting work on the horizon that youre aware of in regards to ACL reconstruction?

ACL Surgeon: It continues to advance. Theres some work with some of my colleagues that I used to work with at Vanderbilt in Tennessee that theyve been looking at growth factors and ways to potentially help to optimize healing of the ACL and looking at different scalpels that we may be using. Some off the shelf ACL type tissue that may be grown in the lab. That may be a ways off, but I think thats very interesting.

Additionally, I think the rehabilitation continues to evolve and advance, so I think thats exciting as well. We continue to gain a better understanding of what were doing and how to get people back and been very happy with the results.

Some of the work too, and Ive done some of the double bundle type procedures, I think theres a role for those, maybe not as a primary ACL type of surgery, but using two tunnels for the ACL and revision surgery may be very helpful and Ill be very pleased with that. So, theres some work done there that weve all got a great understanding of the anatomy of the ACL and again, I think understanding where to place the ACL is really important and that has come under great understanding with the concept of the two tunnel or double bundle techniques as well.

So, I think its all evolving and we are getting better at fixing these. Were getting better at doing the rehabilitation and providing better outcomes for our patients, and thats really what its about.