Inpatient Programs

Pioneering Rehabilitation

Single Joint Replacement Program

Program Description
The mission of Burke Rehabilitation Hospital's Single Joint Replacement Program is to provide the most comprehensive and effective rehabilitation to maximize recovery from physical impairments caused by unilateral total knee and unilateral total hip replacements. Led by the physician, the multidisciplinary team works collaboratively with the individual and the family and/or caregiver to facilitate achievement of the best possible post-operative recovery. Intensive rehabilitation improves mobility and promotes greater independence completing daily activities. Personalized care and individual therapy sessions help patients recover more quickly and experience less pain. Most of our patients return home within one week, walking independently with a single cane.

The rehabilitation team consists of the orthopedic individual, his or her family and/or caregivers, and medical, nursing and other rehabilitation personnel who, by virtue of their education and experience, are qualified to work with the orthopedic individuals. The medical and rehabilitation professionals on the team are responsible for assessing the orthopedic individual’s medical, and rehabilitation needs, establishing individualized goals in consultation with the individual and/or family/caregiver, designing and implementing a treatment program, assessing its outcome, communicating with the team and preparing the individual and family for the next phase in the rehabilitation process.  

Scope of Services
The Single Joint Replacement Team is committed to ensuring that each individual’s needs are addressed by:

  • Providing rehabilitation through an interdisciplinary approach that emphasizes communication, collaboration and cooperation
  • Providing the highest quality, patient focused rehabilitation
  • Providing counseling to the individual and family and/or caregiver on alternative possibilities for life participation when necessary
  • Preparing the individual, family and/or caregiver to make the transition to the next stage of the rehabilitation process

Cultural and religious needs are respected for each patient by the entire team. Accommodations to the patient’s schedule, dietary needs and requests, and the provision of appropriate equipment are provided to enhance the patient’s experience and support full participation in the rehabilitation program. All staff members participate in annual cultural diversity and sensitivity training.

Within the scope of the Single Joint Replacement Orthopedic Program, patient evaluation and care planning are designed around traditional medical disablement models. These models assess three levels of dysfunction which stem from the patient’s admitting diagnosis (pathology). 

Impairments: Weakening, damage, or deterioration of function within a specific component of the cardiopulmonary and/or musculoskeletal system resulting from injury or disease. 

Examples: decrease in exercise tolerance, decrease in balance, limitations   in         pulmonary hygiene, decreased cardiac output, decreased ventilatory capacity, decrease in strength, decrease in active and/or passive ROM.

 Activity Limitations: The inability to perform a specific task (i.e. dressing or stair climbing) as a consequence of the aforementioned impairments.

Examples: Difficulty with ambulation, stair negotiation, dressing, grooming, or self-care.

Participation Restrictions: The cumulative effect of impairments and activity limitations on the ability of a person to participate in life roles. 

 Examples:  Inability to perform duties as a parent, caregiver, employee, or participant in social and leisure activities.

The Single Joint Replacement program serves patient populations from young adult through geriatric. Diagnoses of patients served include unilateral total knee replacement and unilateral total hip replacement. Beginning on the day of admission and continuing throughout the individual’s stay, the team works collaboratively to identify and address the needs of each patient. The multidisciplinary assessment of the orthopedic individuals is conducted by the medical and rehabilitation professionals on the individual’s team, including the physician, nurse, social worker/case manager, occupational therapist, physical therapist, and dietary personnel. Other professionals, such as the clinical neuropsychologist, speech-language therapist, recreation therapist and orthotist, become part of the team as warranted. These professionals share the information obtained from the assessment via verbal communication and chart documentation so that each team member can understand the orthopedic individual’s strengths, impairments, and limitations to activity, restrictions in participation, and the environmental and personal contextual factors that may influence treatment outcomes and plans for discharge.

Based on the results of the assessment, goals are determined with the individual and/or family/caregiver(s) and a treatment plan is implemented. The goal of the intensive rehabilitation program at Burke is to help each patient return to as active and productive a life as possible despite physical disability. Team consultation and collaboration occur throughout the treatment program. The individual’s progress is discussed formally once per week at a team meeting. Family members and/or caregiver(s) are encouraged to attend and participate in treatment sessions and patient care as appropriate. Within a safe, secure and structured environment, each individual receives intensive therapy five to six times a week for a minimum of three hours. Rehabilitation nursing and access to a physician are available twenty-four hours a day, seven days a week.

Team Description
The philosophy of the Single Joint Replacement Orthopedic Program is that the program’s mission can best be accomplished by providing rehabilitative care through an interdisciplinary team approach. The team consists of the following:

Additional services available to meet the needs of each individual patient include:

Examples of technology used: 

  • Nu-Step
  • Kinetron
  • Treadmill
  • Monark

Medical Management
The multi-disciplinary team is led by Dr. Ellen Gitler, MD who has extensive experience caring for orthopedic patients. As the leader of the team, Dr. Gitler is responsible for directing the medical care of the individual and monitoring the overall team process and outcome.  At Burke, a physician is available 24 hours a day, seven days a week. Medical consultations (Podiatry, Urology, Plastics, ENT, Dermatology, etc.) are available to address all patient needs while at Burke.

Educational Objectives
Patient and Family/Caregiver: 
Ongoing education of the orthopedic individual and the family and/or caregiver is essential in order to maximize recovery from the physical impairments caused by surgery and effectively prepare the individual and family and/or caregiver for the transition to the next stage in the rehabilitation process.

Orthopedic individuals will receive ongoing education from each discipline throughout his/her stay in order to maximize achievement of each individual’s goals. Family members and/or caregivers are encouraged to attend and participate in treatment sessions and patient care activities as appropriate. Providing education and training for the family and/or caregivers is an essential component of the patient’s rehabilitation stay and provides an opportunity to successfully transition the patient to the next phase of rehabilitation.

Team members:
In an effort to promote ongoing education and learning, an interdisciplinary in-service program is provided for the members of the Single Joint Replacement Orthopedic Program. Each discipline is responsible for presenting a topic relevant to orthopedic rehabilitation. In-services are scheduled on a rotating basis once a month. Team members attend professional conferences, continuing education courses and seminars throughout the year to supplement what is learned and experienced in the clinic. Participation in research initiatives and presentations of poster/platform presentations at seminars and conferences is encouraged.

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