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Physical therapy on day of surgery did not improve outcomes after TKA
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DALLAS — Patients who started physical therapy on the day they underwent total knee arthroplasty had no differences in hospital length of stay and patient satisfaction compared with patients who started physical therapy the morning after surgery, according to results presented at the American Association of Hip and Knee Surgeons Annual Meeting.
Tyler E. Calkins, BS, and colleagues randomly assigned 394 patients undergoing total knee replacement to participate in physical therapy on postoperative day 0 or postoperative day 1. Investigators looked at outcomes, including the primary outcome of hospital length of stay in hours, patient satisfaction and number of nights spent in the hospital.
Overall, 95.9% of patients completed the study. There were 183 patients in the physical therapy on postoperative day 0 group and 195 patients in the physical therapy on postoperative day 1 group. Calkins noted an intention-to-treat analysis showed no differences in hospital length of stay in hours or in the number of nights spent in the hospital between the two groups.
“When you look at the as-treated analysis here, again, there is no difference in hospital length of stay when you look at hours,” Calkins said. “However, there does appear to be a trend in the number of patients that only spent 1 night in the hospital in the postoperative day 0 group, being 63% in that cohort, compared to 51% in the postoperative day 1 group.”
However, he added the result did not reach statistical significance.
“In the additional analysis, we did a patient satisfaction [survey] over the phone within 3 days of discharge,” Calkins said. “We did not find any differences in their satisfaction rate, feelings of readiness for discharge or pain while they were in the hospital.” – by Casey Tingle
Reference:
Bohl DD, et al. Paper 4. Presented at: American Association of Hip and Knee Surgeons Annual Meeting; Nov. 1-4, 2018; Dallas.
Disclosure: Calkins reports no relevant financial disclosures.