Physical Therapists' Perspectives on Recovery in Total Joint Arthroplasty Care.

Abstract

Total joint arthroplasty (TJA) often requires coordinated care between orthopaedic surgeons and physical therapists (PTs) for optimal patient outcomes. This study aimed to examine the PT's perspective regarding recovery goals after TJA and assess PT perceptions of communication with surgical teams. A cross-sectional online survey was administered to 468 PTs nationwide. The survey assessed recovery goals for total knee arthroplasty and total hip arthroplasty, as well as PT perceptions of communication practices with surgical teams. Responses were analyzed to determine consensus, defined as ≥ 70% agreement. Subgroup analyses were conducted to examine differences based on years of practice, patient volume, and practice setting, with statistical comparisons performed using Chi-square analyses or Fisher exact tests. Physical therapists demonstrated notable demographic diversity across geographic location, years of practice, and the volume of post-TJA patients treated monthly. For postoperative total knee arthroplasty rehabilitation, there was a lack of consensus with regard to the minimum functional range of motion, the timing of manipulation under anesthesia, and the occurrence of leg lengthening during deformity correction. In total hip arthroplasty recovery, there was a lack of consensus in the timing and recommendation for shoe lifts, as well as the prioritization of early full hip range of motion. Regarding PT-surgeon communication, no consensus was observed in the perceived usefulness, comfort level, current state of communication, and preferred methods of communication, highlighting variation in the overall communication between surgeons and PTs. Subgroup analysis showed differences based on PT years in practice, patient volume, and setting. This study identified a lack of strong consensus from PTs regarding TJA recovery goals and highlights areas for improved education and dialogue. The findings underscore the critical need for enhanced interdisciplinary communication and education to optimize patient care in TJA, especially in certain PT groups such as those in early practice or with a lower volume of TJA patients.