Physiatrist (Physical Medicine) Questions Knee Replacement

Post joint replacement

I will be having both knee replaced soon. Would i have a better recovery working with a physiatrist versus a physical therapist?

19 Answers

Your typical physical therapist will work with you directly for at least an hour, if not more, every time you come in for an appointment...up to 3x a week.
See the PT who is experienced in post joint rehab after surgery as ordered by your orthopedist. Only if your progress stalls after 4-6 weeks, then you can be evaluated by a physiatrist for other issues that may have occurred.
Possibly. Be prepared to work through the pain.
If your physiatrist is specialized in orthopedic surgery rehabilitation is ok, equally good is a physical therapist who knows of orthopedic surgery knee replacement rehabilitation.
PT is very important post TKAs so I would not replace one for the other but a good physiatrist help as well
Last summer, I was seeing a Physical Therapist and a Physiatrist. Most people see both. They work together.
One needs good physical therapy after joint replacement even if you are seeing a Physiatrist.
I would recommend a well-trained physical therapist. Your orthopedist would have one in his team.
A physiatrist is a rehab doctor and could be the physician prescribing and overseeing your physical therapy. A physiatrist would not be the one doing physical therapy with you. Sometimes, surgeons are comfortable prescribing and overseeing physical therapy, so it would depend upon the practice and recommendation of your orthopedic surgeon.
Good Luck on your surgery. You will get the best outcome working with both. Don't forget, you get what you put in. With a good strong effort you will achieve faster results.
DEAR CONSUMER- PATIENT,
PLEASE EDUCATE ABOUT DIFFERENT PEOPLE IN MED CARE SYSTEM. REHAB MDS PHYSIATRIST ARE NOT ENOUGH IN NUMBER LIKE GPS ORTHOPEDIC DOCS OR TECH LIKE PHYS THERAPIST. EACH PROVIDER HAVE HIS OR HER OWN SYSTEM OF CARE AS PER EDUCATION EXPERIENCE. BEWARE OF WASTING MONEY ON WRONG PROVIDER.
IN USA MANY A TIMES CONSUMERS ARE CHEATED BY MANY WITH WHITE COAT AND STETHOSCOPE.
PHYSIATRISTS ARE MDS LIKE ME PLUS HAVE SPECIFIC TRAINING. PHYS THERPIST, OCCUP THER, SPEECH THER, VOCATIONAL THER, REHAB NURSES ALL TAKE CARE AS PER ORDERS BY TEAM LEADER MD REHAB EXPERT. HERE WE SEE CHIROPRACTOR CLAIMS LOT SO IS EXERCISE GURUS OR PHYS THERAPIST. AVERAGE MD GP, INTERNIST OR OTHERS, DON'T KNOW, SO JUST ORDER TREAT BY PT. HOW, WHY, AND DETAILS ARE ABSENT, SO PT IS DECIDING CARE, NO GUIDANCE BY MD OR PROVIDERS. ALSO, CORRUPTION IN POLITICIANS EXTREME AND LOTS OF MONEY TO BE MADE IN HEALTH CARE- NURSES ARE DIFFERENT SPECIALIST, PA ARE IN MANY FIELD, PT OR OT ETC ARE WORKING INDEPENDENTLY. OUR USA MED CARE QUALITY IS 30TH IN WORLD, BELOW CUBA, BUT WE SPEND NEARLY $1000 PER CAPITA. MANY GET LICENSES AND SYSTEM ENCOURAGES SUCH DECEPTIVE ADVERTISEMENT.
ST MED BD JCAHO ARE WITH BIG CARE PROVIDERS JOIN HANDS IN COVER UP OF POOR CARE POOR OUTCOME. ROOT CAUSES ARE OPEN, BUT PUBLIC MISGUIDED. WE HAVE MORE MRI, MORE REPLACEMENT SURGERIES, MORE CESARIANS, SO DOCS WIFE CAN GET MINK COAT.
BE EDUCATED CONSUMER GET THE CARE OR SURGERY ONLY IF REALLY NEEDED AND GET SECOND OPINION. WE HAVE EXPLOSION OF PAIN MANAGEMENT PROVIDERS AS IT'S A BIG, LUCRATIVE BUSINESS. MEDICARE WASTE BILLIONS OF DOLLARS PER MONTH IN SUCH UNNECESSARY CARE . DR J A SHAH, MD
I will recommend you to see a physical therapist before your total knee replacement surgery. You will need in-patient rehabilitation post operatively. Most insurance companies will need physiatrist consult before they approve you for in-patient rehabilitation. Your orthopedic surgeon usually orders physiatrist consult after your surgery .

You will be fine with your recovery!

I wish you will find benefits from physical therapy.

Dr. Li
Not an either or, both have an important function in your recovery. Start isometric quad strengthening NOW (today)!
I feel this is a very personal decision. How much do you trust your orthopedic surgeon? He works closely with the physical therapist that he will recommend. That therapist will communicate with him on your progress.

On the other hand, a physiatrist is a physician trained in the art of rehabilitation. That physician may not be closely aligned with the goals of your surgeon. You may want to check into this. However, if for some reason, your progress is slower than anticipated, you might want to talk to your surgeon about making a referral to a physiatrist.
If you have a straight forward knee replacement, you may not need a physiatrist- a physical therapist would be sufficient. If there are any complications, a physiatrist can diagnose, treat, and make suggestions to the therapist to maximize function.
Physical Therapy
I can only comment on the practice of a physical therapist. As of now, the standard of care is to see a physical therapist after a total knee replacement. The rehab process will consist of helping you regain motion, improve your strength, and get you walking normally again.

Physical therapists are experts in stengthening and recovering after a total knee replacement and this is something we work with commonly in the clinic.
Physiatrists generally work with a team that includes physical therapists anyway. Certainly that's how it works in Australia. A good physical therapist with experience in joint surgeries are great for straightforward cases with no medical complications or issues, and as long as they progress without issues. My preference would be for a treatment team, but if you are confident it should be straight forward (i.e. you are not elderly, are healthy otherwise, and physically active before the surgery), then a physical therapist should be fine. An experienced one should get you to see a physiatrist, if there are any concerns anyway.
Definitely a physiatrist, especially in the beginning for pain control. Then a physiotherapist, but make sure it's an individual who knows knees. Also, try and make sure you are not going to a clinic, which has 10 other patients at the same time. It's like a conveyor belt.