Total Joint Program

The goal of Upstate University Hospital Regional Rehabilitation Center is to help patients reduce disability and improve independence and quality of life.

Due to the nature of joint replacement surgery, the post-operative pain, muscle weakness, decreased mobility, decreased proprioception (the perception or awareness of the position of the body) during the recovery process can limit the results of the surgery and quality of life achieved. For this reason, rehabilitation of a new joint should be completed under the direction and supervision of a trained professional such as a physical and occupational therapist. Patients should discuss the timing for when and how to have this rehabilitation with their surgeon, therapist and the healthcare practitioners involved in their care.

Upstate Community Hospital Orthopedics has a Center of Excellence designation for hip and knee replacement that offers a comprehensive rehabilitation program for individuals who have had a joint replacement. Services offered by Upstate rehabilitation include prehabilitation (therapy prior to surgery), pre-operative total joint classes, and post-operative rehabilitation from hospitalization through to the end of recovery. Patients should contact their orthopedic provider for information regarding these services if not already discussed prior to surgery.

Total joint replacement physical therapy includes a multifaceted approach with patient specific goals in mind. Therapists in all settings at Upstate's Regional Rehabilitation Center will complete an individualized assessment, and prescribe a treatment plan based on your specific needs and goals. Your therapist will help you every step of the way, providing one-on-one, evidence-based treatment sessions to help you maximize the function of your new joint.

Before your surgery: Prehabilitation (pre-operative physical therapy) begins several months to weeks prior to a patient’s joint replacement surgery and includes evaluation and treatment designed to improve a patient’s strength, range of motion, balance, and pain control prior to surgery. Also, prehabilitation helps patients plan for post-operative recovery including discussion of what type of equipment will be most helpful (such as a rolling walker, or shower chair), and how to prepare their home to maximize safety and function.

During your hospital stay:  Post-operative rehabilitation typically begins within just a few hours after surgery. Many patients will be able to go home on the same day as surgery, while others may need to stay in the hospital for 1-2 nights. Therapy is scheduled at least twice a day during hospitalization. It is important to begin therapy very soon after surgery to minimize the risk of complications and maximize the function of the new joint. Therapy during hospitalization is aimed at improving function and safety while beginning to rehabilitate the patient’s new joint.

After your hospital stay: Physical therapy after discharge from the hospital will be prescribed based on the type of surgery performed, surgeon preference, and the patient’s specific needs.

• Some patients will require a short-term rehabilitation stay in a facility if they are unable to safely return home. This is rare. Physical therapy is provided with a focus on improving the quality of movement and independence with mobility. Therapy will continue depending on the patient’s needs once discharged from the rehabilitation facility.
• Other patients will be able to return directly to home after discharge from the hospital but have a difficult time moving, and are homebound. In this case, the therapist will come to the patient’s home for 1-3 visits per week for several weeks to provide home physical therapy. Therapy will be focused on home safety, quality of movement, and independence with mobility.
• Most patients will move well enough to attend outpatient physical therapy immediately following hospitalization. Most surgeons prefer this to make use of specialized rehabilitation equipment available in clinics. Outpatient physical therapy will typically involve 1-3 visits per week for several weeks after your surgery. Therapy in this setting is focused on fine-tuning the new joint, restoring balance and alignment, and maximizing function in higher-level activities.

Interventions for therapy across settings may include:

• Activities of daily living and independent living skills
• Home safety education
• Gait training/stair training
• Strength training
• Flexibility and range of motion exercises
• Balance training
• Use of cryotherapy (ice)
• Manual therapy
• Electrical stimulation
• Neuromuscular reeducation
• Biofeedback

• Upstate Community Hospital Orthopedics informational videos (includes information regarding surgeries, total joint program 
• Physical Therapy, Occupational Therapy, Speech/Language Pathology 
• Regional Rehabilitation Locations

When seeking out information on the internet, use reputable sources such as:

• American Academy of Orthopaedic Surgeons
• American College of Sports Medicine