Medical and Surgical Considerations in Orthopaedic Physical Therapy
What the candidate must know
Understand common orthopaedic surgeries and their postoperative precautions: total hip and knee arthroplasty, ACL reconstruction, rotator cuff repair, spinal fusion, and fracture fixation. Know weight-bearing status, range-of-motion limits, and protocol timelines. Recognize medical comorbidities that alter rehab: diabetes (wound healing, neuropathy), osteoporosis, cardiovascular disease, and anticoagulation. Know pharmacology basics: NSAIDs, corticosteroids, opioids, and anticoagulants, and their rehab implications.
Traps
- Applying generic protocols without checking the surgeon's specific precautions.
- Missing signs of deep vein thrombosis, infection, or hardware failure.
- Forgetting that posterior hip precautions differ from anterior approach precautions.
- Assuming anticoagulated patients can be mobilized without fall-risk consideration.
Rule of thumb
When in doubt, follow the most restrictive documented precaution and confirm with the surgeon before progressing.
Worked example
A patient two weeks post total hip arthroplasty via posterior approach: maintain posterior hip precautions (no hip flexion beyond 90°, no internal rotation, no adduction past midline) until cleared, while progressing gait and strengthening within those limits.