A Narrative Review of the Physical Therapist’s Clinical Reasoning, Diagnosis, and Coordination of Care in a Patient Following Total Knee Arthroplasty: A Case Study With Two-Year Follow-Up

BACKGROUND: Efforts to promote physical therapists as first-contact providers in the US health system have grown in recent years. This requires delivering accessible, comprehensive, and continuous care, including coordination of referrals to meet patient needs. CASE DESCRIPTION: A 70-year-old female presented with persistent knee and thigh pain following a left total knee arthroplasty with a diagnosis of iliotibial band syndrome and quadriceps weakness. Examination lead to a clinical diagnosis of hip osteoarthritis. With a lack of significant response to conservative management, the physical therapist referred her for hip radiography and diagnostic injection, with injection yielding 90% improvement in pain. OUTCOME AND FOLLOW-UP: The patient underwent total hip arthroplasty and was seen for postoperative rehab. Early in post-surgical care the patient was able to resume limited activities, and her PSFS remained high through two-year follow-up. DISCUSSION: This case demonstrates the role that the physical therapist can have in primary evaluation and coordination of care for orthopaedic conditions.