The population in the USA is becoming older thanks to the advances in the medical field. The quality and expectancy of life had increased. Therefore, this population now face a new challenge to improve and maintain a good health condition. Osteoarthritis is one of the pathologies with more incidence in this population. This progressive degeneration is a significant factor in the loss of functionality of the lower extremities. When it attacked the knee joint and induced advanced destruction of the bone and cartilage, the specialist decides to replace de damage part of the joint.
It is an invasive procedure, a major surgery. The rehabilitation services should address “pain, scar tissue, education, transfers, physical function, knee ROM, gait training, and safety.” (Han A., Nairn L., 2015). The PTA is going to face a different challenge and goals; between them is the education of the patient and the safety of different transfers. The clinician will put special attention in the mental state of the patient and the physical ability.
Are pivot transfers safe?
One of the diseases that cause most of the total knee replacement includes osteoarthritis, and the knee replacement has been on the rise in recent times. Over the past two decades in the United States, there has been an increase in the number of people who have undergone knee replacement. Once the operation has been conducted the right rehabilitation need to be undertaken to help in the quick recovery of the patient (Fransen et al. 2015). After the replacement, the sitting positions and bearing some weight are essential to improve the strength of the muscle and fasten the healing process. The patients are going to be evaluated by the specialist for the knee assessment.
The right procedure needs to be applied to ensure that knee replacement has been done to success. When the replacement is not done in the proper manner, then the knee may swell due to the instability in the knee (Fairchild, O’Shea & Washington, 2017). The first step includes the removal of the clothes, and the patient wears a gown. The patient is started with the intravenous (iv) on the arm and placed on the operating table. The doctor may decide to put the catheter on the patient, and hair may be clipped if it is on the surgical part. The heart rate is measured and other aspects of the patient’s body, such as the pressure. The doctor cleanses the site using the antiseptic, and the incision is made on the knee area. Finally, the doctor removes the damaged parts, and the prosthesis is formed using metallic components. There are two types of prosthesis which include the cemented and the uncemented type. When all this has been done, the kneel surgical operation has been successfully conducted.
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During the first week’s patients who have gone through total knee replacement require to undergo through stand pivot transfers from bed to wheelchair. This process helps the patient to stand, turn, or pivot and sit down on a new surface. Before attempting, it is essential to mentally prepare the activity and educate the patient about this type of transfer. Additionally, always make sure to position and secure the wheelchair parallel or at 45 degrees angle to the bed, making sure that the surface is stable and can offer enough support (The OHIO state university, 2018). A patient can do this type of transfer by themselves when it is independent, or sometimes they need help from a therapist or caregiver depending on their condition. When acting as a caregiver or a therapist, their main work is to prevent the patient from falling. When helping a patient in this process is very important to use a gait belt around the patient to get a firm surface to hold onto as you help during the transfer, make sure the client uses his strength and function during the activity and explain to the patient every step of the movement. At the end of the transfer, the therapist is going to help the patient to be in the best comfortable, stable, and secure position.
When the total knee replacement surgery is done to the older adults, the chances of walking with difficulties are high. One may be affected in the job that one does, and the job performance has to reduce as because of the complications which originate from the knee complications after the operation. In the case of the difficulties that result from the surgery of the knee, the old are most affected due to their age compared to the younger generation.
On the other side, there are other clinical complications which may occur after the total knee replacement. They include: Fracturing of the replaced knee due to a fall or an accident, pain as a result of slippage and wear on the new joint, loosening of the prosthetic components (Shiel,2019). Some complications are rare; however, in some instances, they take place for example: getting an infection on the joint, dislocation of the new joint and a blot clot can develop above or below the new knee. Once one experiences one of these clinical complications, they should seek their doctor’s attention immediately (Shiel,2019). However, due to improved practices in the total knee replacement practice, many of the clinical complications have been gotten rid of. Introduction of rehabilitation and trained therapist and caregiver to help in the stand pivot transfer has helped a lot in quick recovery and eradication of most clinical complications.
