APTA's first self-produced clinical practice guideline combines careful review of evidence with expert consensus on best practice to create the first-ever CPG on total knee arthroplasty specifically for the physical therapy profession.
In this review:
- Physical Therapist Management of Total Knee Arthroplasty
(PTJ, June 2020)
The Message
In addition to evaluating some of the most common interventions for rehabilitation after total knee arthroplasty, the new clinical practice guideline also makes recommendations around the factors PTs should take into account when determining a patient's prognosis, group versus individual therapy, timing of PT management, and discharge planning. Among the results: preoperative exercise, cryotherapy, and motor function training are among the interventions with the strongest support, while use of a continuous passive motion device for mobilization is the approach to avoid.
The CPG
An APTA volunteer guideline development group consisting of PTs from different APTA sections, an orthopedic surgeon, a nurse, and a consumer developed the guideline through analysis of 192 research articles (whittled down from 1,258 English-language articles reviewed from 1995 to 2018) and extensive discussions on the relative strength of each recommendation. In the end, the group identified 17 recommendations with varying levels of strength.
APTA members Diane Jette, PT, DPT, DSc, FAPTA; Stephen Hunter, PT, DPT; Bud Langham, PT, MBA; David Logerstedt, PT, PhD; Noreen Poirier, PT, DPT; Jennifer Ritter, PT; David Scalzitti, PT, PhD; Jennifer Stevens-Lapsley, PT, MPT, PhD; James Tompkins, PT, DPT; and Joseph Zeni Jr., PT, PhD, were among the authors of the guideline.