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Home-based rehabilitation correlated with higher physical function after TKA
Results of this study showed that compared with discharge to an inpatient facility, discharge to home-based rehabilitation after total knee arthroplasty correlated with higher physical function at 3 months postoperatively.
Researchers conducted a retrospective analysis of previously collected prospective data for 708 patients who underwent a total of 738 unilateral total knee arthroplasties (TKA). Investigators included variables on demographics, BMI, discharge disposition, length of stay, range of motion (ROM) and patient-reported outcome measure responses from the Veterans RAND-12-item questionnaire. Responses from the VR-12 were used to quantify physical component scores (PCS) and mental component scores.
The Charlson Comorbidity Index score was calculated at time of admission. Investigators also collected data, including complications, hospital readmission within 30 days of surgery, manipulation under anesthesia and reoperation on the index joint with 90 days of the initial surgery. To predict outcomes of primary unilateral TKA, investigators used multivariate predictive models.
According to researchers, 3-month PCS improvement correlated with home-based rehabilitation. They found difference in ROM at 3 months between groups.
Findings indicated predictors for discharge to an inpatient facility were female sex, surgeon, age 65 years or older, at least one comorbidity, preoperative PCS between 20 and 30, and morbid obesity. Investigators noted preoperative lower ROM was a strong predictor for lower postoperative ROM. Lower improvement in PCS was predicted by inpatient discharge and higher preoperative patient component scores. ‒ by Monica Jaramillo
Disclosure: The researchers report no relevant financial disclosures.
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Rissman CM, et al. J Arthroplasty. 2016;doi:10.1016/j.arth.2015.09.002.