Rehabilitation for the Postsurgical Orthopedic Patient.

Rehabilitation for the Postsurgical Orthopedic Patient Maxey L, Magnusson J, eds. St Louis, MO 63146, Mosby, 2001, hardcover, 398 pp, illus, ISBN: 0-323-00166-1, $64.

The purpose of this book is to "provide a resource that the clinician can reference as a guideline in the rehabilitation of the post-surgical patient." The intended audience is mainly physical therapists; however, orthopedic surgeons and occupational therapists would also find this text useful in understanding the postsurgical rehabilitation of the patients with orthopedic conditions.

The text is divided into 3 parts: "Upper Extremity," "Spine," and "Lower Extremity." Within each section, some of the more common (and often preferred) surgical procedures are presented. These procedures provide a good representation of the interventions commonly seen in the practice of orthopedic physical therapists. The book places a strong emphasis on patient education throughout the book. For this reason, the text is laid out in a simple and clear way. Each chapter gives indications and considerations for surgery, a detailed look at the surgical procedure, and the surgeon's perspective on rehabilitation. Each chapter has been written by experts in their own area of specialty. There are more than 30 well-qualified contributors to this text, and they include not only physical therapists but also physicians, osteopaths, and occupational therapists.

The book also provides the therapy guidelines for determining the rehabilitation program. Areas that may be troublesome are noted with appropriate ways to address the problem. Therapy guidelines are divided into 3 sections: evaluations, phases of rehabilitation, and suggested home program. Each section provides excellent information and patient instructions. The home exercise program is given a lot of attention for patients with orthopedic conditions because the role of physical therapists as educators is crucial to the smooth progression of these patients. The author emphasizes the structure and specifics, individualization, prioritization, and conciseness of the home program.

Part 1 contains 7 chapters. The first chapter is on soft tissue healing considerations after surgery, a topic that is extremely relevant to physical therapists in this field. Knowledge of what happens to connective tissue during immobilization, trauma, remobilization, and scar remodeling is crucial in the management of this type of patient. The succeeding chapters cover the following surgical interventions: acromioplasty (chapter 2), anterior capsular reconstruction (chapter 3), rotator cuff repair and rehabilitation (chapter 4). These chapters are especially helpful in providing specific guidelines and phases of rehabilitation. Chapter 5 covers extensor brevis release and lateral epicondylectomy.

Chapter 6 covers reconstruction of the ulnar collateral ligament with ulnar nerve transposition. Chapter 7 looks at the postoperative management of carpal tunnel syndrome.

Part 2 contains strong chapters on lumbar microdiscectomy and rehabilitation (chapter 8) and lumbar spine fusion (chapter 9) that are especially helpful. The authors use numerous pictures to illustrate specific surgeries and the principles of body mechanics and exercises used to progress the patient through the phases of healing.

Part 3 contains 11 chapters that cover surgical interventions for the lower extremity, including total hip arthroplasty and total knee arthroplasty, anterior cruciate ligament reconstruction, surgeries for the ankle and Achilles tendon, meniscal surgery, and lateral release of the knee.

This text is interesting, informative, and extremely relevant for the orthopedic physical therapist who provides postsurgical rehabilitation. The text is not a cookbook but a great reference for use in postsurgical rehabilitation. The authors should be congratulated for synthesizing so much valuable information from many excellent sources with clarity. The text belongs in every orthopedic clinic and in the library of physical therapists involved in the postsurgical rehabilitation of patients. This book is a valuable, needed contribution to the physical therapy profession.

Dan Bankson, PT, MS, CSCS
Fairmont Community Hospital
Fairmont, Minn

Mr Bankson is Coordinator of Physical Therapy at Fairmont Community Hospital.