New York City—March 24, 2015
A study by researchers at Hospital for Special Surgery (HSS) finds that patients who go home after knee replacement and receive physical therapy at home do as well as those who go to an in-patient rehabilitation facility.
“There’s a common belief that people should go to a rehab facility after joint replacement,” said Douglas E. Padgett, MD, the lead investigator and chief of the Adult Reconstruction and Joint Replacement Service at HSS. “Our study found that patients can be safely discharged to their home following knee replacement, dispelling the notion that rehabilitation at an inpatient facility is essential for a successful recovery.”
The study, which will be presented the annual meeting of the American College of Orthopaedic Surgeons in Las Vegas on March 24, analyzed data for more than 2,400 patients enrolled in Hospital for Special Surgery’s Knee Replacement Registry from 2007 to 2011. Researchers found no difference in complication rates within six months of knee replacement, whether patients went home or to an inpatient rehab facility after leaving the hospital. Both groups also had similar outcomes in terms of pain and function two years after surgery.
Stephen Lyman, PhD, co-chief investigator and director of the Healthcare Research Institute at HSS, underscores the importance of the study design. He notes that a statistical technique called “propensity score matching” ensured that the research focused on patients with similar characteristics when comparing those who went home versus those who went to inpatient rehab after surgery…
…The vast majority of patients in the study (89 percent) had undergone knee replacement for painful osteoarthritis. The mean age of the patients in this study was 66 years. Fifty-seven percent of the patients were female and 43 percent were male…
…Despite the study findings, when deciding on discharge destination, Dr. Padgett notes that a patient’s social situation often comes into play and needs to be taken into account. “The present study found no difference in complication rate or functional improvements in patients who lived alone compared to patients who lived with others,” he said. “However, in many instances, an older adult who lives alone and has no immediate help may require discharge to an inpatient facility based upon social needs.”