Safe Interventions and Future Recommendations for a Patient with Knee Septic Arthritis and Chronic Obstructive Pulmonary Disease

Background/Purpose: Septic arthritis may be caused by subsequent infections of pneumonia. Individuals with chronic obstructive pulmonary disease (COPD) are at an increased risk for developing pneumonia. Patients with septic arthritis are seen by physical therapist to alleviate impairments. Negative impacts from COPD may present as a barrier to successful therapy for arthritis and require modifications to interventions. The purpose of this retrospective case report is to highlight safe interventions for a patient with septic arthritis and COPD, while also suggesting ways that behavioral modifications could have been incorporated into the episode of care. Case Description: The patient was a 65-year-old male with septic arthritis, COPD, and recurring pneumonia infections. The patient presented with decreased range of motion and strength in his lower extremities. The patient also had a decrease in aerobic endurance due to the COPD. Outcomes: After 4 weeks, the patients had improvements in knee range of motion and strength. Unfortunately, there was also a decline in aerobic endurance. The patient reached as low as 81% SaO2 during a 2-Minute Walk Test. The patient was referred to his primary care physician before continuing physical therapy. Discussion: Tobacco usage is prevalent among individuals with COPD, which may further exacerbate negative effects of the COPD and also present as a barrier to successful therapy. Given the outcomes of this case, the transtheoretical model would have been an appropriate framework to direct this patient’s care. The transtheoretical model can be utilized by healthcare professionals to incorporate smoking cessation into their treatments