Post Hip and Knee Surgery Therapy Aided by LegTutor

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Image by Ammar Alothman via Flickr

Mark McGraw writing in OUTPATIENT SURGERY magazine September 29, 2011 outlines

new recommendations from the American Academy of Orthopaedic Surgeons that may help physicians prevent a potentially serious complication following knee and hip replacement procedures.

The AAOS released an updated clinical practice guideline recommending how to reduce the likelihood of blood clots after hip or knee replacement surgery. The new guideline suggest the use of preventive treatments and also advise against routinely screening patients after surgery using ultrasound imaging.

Also, Physicians should instruct patientsnot to take anticoagulants such as aspirin and clopidogrel (Plavix) before hip or knee replacement as this increases the risk of blood loss during surgery with these drugs.

The guidelines also suggest that patients discuss the timing of stopping any medication with their docotr. Patients may also want to have the surgery performed under local or regional anesthesia, such as epidural or spinal, instead of general anesthesia. Although evidence suggests that these loccal approaches do not affect the occurrence of deep vein thrombosis or pulmonary embolism, they do however limit blood loss.

Regarding care after hip or knee replacement, the guidelines recommend that patients should not have routine post-operative screening for thromboembolic disease with duplex ultrasonography. This is because, screening does not significantly reduce the rate of symptomatic DVT or PE, or, the rate of fatal pulmonary embolism.

Patients should however receive anticoagulant therapy and/or mechanical compression devices after a hip (THR) or knee replacement surgery. There is not however evidence to recommend any particular preventive strategy, or duration of these treatments. Therefore, patients should discuss the duration and type of preventive treatment with their doctor. After hip or knee replacement (THR) TKR, patients should get up and walk as soon as safely possible. This is because evidence shows that early mobilization reduces DVT rates, and is consistent with current practice.

Joshua Jacobs, MD, orthopaedic surgeon at Rush University Medical Center in Chicago says that although Hip and knee arthroplasty is a  successful procedure to restore function and minimize pain, one of the complications that concern orthopaedic surgeons is venous thromboembolic disease.

Physical rehabilitation following knee and hip orthopedic surgery patients should concentrate on getting the patient up and walking as soon as safely possible. Here the LegTutor and 3DTutor coems into play. Patients can begin leg rehabilitation in the lying sitting and standing position before weight baring.

The LegTutor has shown great success in rehabilitating hips and knees post surgery. This innovative device, joined by its ”sisters” the ArmTutor, HandTutor and 3DTutor, is a brace attached to the affected leg and is connected by sensors to a computer with a dedicated intensive exercise program. Leading U.S. and foreign hospitals including clinics are now using the devices. Tele rehabilitation (TR) allows for adult and child patients to receive therapy sessions in their own home.


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