Immediate Physical Therapy following Total Joint Arthroplasty: Barriers and Impact on Short-Term Outcomes
Joint Authors
Seyler, Thorsten M.
Warwick, Hunter
George, Andrew
Howell, Claire
Green, Cynthia
Jiranek, William A.
Source
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-04-08
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
Recent evidence suggests benefit to receiving physical therapy (PT) the same day as total joint arthroplasty (TJA), but relatively little is known about barriers to providing PT in this constrained time period.
We address the following questions: (1) Are there demographic or perioperative variables associated with receiving delayed PT following TJA? (2) Does receiving immediate PT following TJA affect short-term outcomes such as length of stay, discharge disposition, or 30-day readmission? Methods.
Primary TJA procedures at a single center were retrospectively reviewed.
Immediate PT was defined as within eight hours of surgery.
Demographic and perioperative variables were compared between patients who received immediate PT and those who did not.
We identified an appropriately matched control group of patients who received immediate PT.
Postoperative length of stay, discharge disposition, and 30-day readmissions were compared between matched groups.
Results.
In total, 2051 primary TJA procedures were reviewed.
Of these, 226 (11.0%) received delayed PT.
These patients had a higher rate of general anesthesia (25.2% versus 17.8%, p=0.006), later operative start time (13:26 [11:31-14:38] versus 9:36 [8:24-11:16], p<0.001), longer operative time (1.8 [1.5-2.2] versus 1.6 [1.4-1.8] hours, p=0.002), and higher overall caseload on the day of surgery (6 [4-9] versus 5 [4-8], p=0.002).
A matched group of patients who received immediate PT was identified.
There were no differences in postoperative length of stay or discharge disposition between matched immediate and delayed PT groups, but delayed PT (OR 4.54; 95% CI 1.61-12.84; p=0.004) was associated with a higher 30-day readmission rate.
Conclusion.
Barriers to receiving immediate PT following TJA included general anesthesia, later operative start time, longer operative time, and higher daily caseload.
These factors present potential targets for improving the delivery of immediate postoperative PT.
Early PT may help reduce 30-day readmissions, but additional research is necessary to further characterize this relationship.
American Psychological Association (APA)
Warwick, Hunter& George, Andrew& Howell, Claire& Green, Cynthia& Seyler, Thorsten M.& Jiranek, William A.. 2019. Immediate Physical Therapy following Total Joint Arthroplasty: Barriers and Impact on Short-Term Outcomes. Advances in Orthopedics،Vol. 2019, no. 2019, pp.1-7.
https://search.emarefa.net/detail/BIM-1121613
Modern Language Association (MLA)
Warwick, Hunter…[et al.]. Immediate Physical Therapy following Total Joint Arthroplasty: Barriers and Impact on Short-Term Outcomes. Advances in Orthopedics No. 2019 (2019), pp.1-7.
https://search.emarefa.net/detail/BIM-1121613
American Medical Association (AMA)
Warwick, Hunter& George, Andrew& Howell, Claire& Green, Cynthia& Seyler, Thorsten M.& Jiranek, William A.. Immediate Physical Therapy following Total Joint Arthroplasty: Barriers and Impact on Short-Term Outcomes. Advances in Orthopedics. 2019. Vol. 2019, no. 2019, pp.1-7.
https://search.emarefa.net/detail/BIM-1121613
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1121613