Inpatient Rehab After Total Knee Arthroplasty Proves Ineffective
Twelve participants in the inpatient group had post discharge complications after TKA.
HealthDay News — The use of inpatient rehabilitation in addition to home-based rehabilitation does not improve mobility at 26 weeks after total knee arthroplasty, according to a study published in the Journal of the American Medical Association.
Mark A. Buhagiar, from Braeside Hospital in Prairiewood, Australia, and colleagues conducted a 2-group, parallel, randomized clinical trial involving patients with osteoarthritis undergoing primary total knee arthroplasty. The authors randomized 81 patients to receive 10 days of hospital inpatient rehabilitation followed by an 8-week clinician-monitored home-based program, 84 to receive the home-based program alone, and 87 to be in an observational group, which received the home-based program.
The researchers observed no significant difference in the 6-minute walk test between the inpatient rehabilitation and either of the home program groups at 26 weeks after surgery (mean difference, −1.01; 95% confidence interval [CI], −25.56 to 23.55) or in patient-reported pain and function or quality of life (knee score mean difference, 2.06; 95% CI, −0.59 to 4.71; EuroQol Group 5-Dimension Self-Report Questionnaire visual analogue scale mean difference, 1.41; 95% CI, −6.42 to 3.60). For the inpatient group the number of post-discharge complications was 12 vs 9 among the home group; no adverse events were reported as a result of trial participation.
"These findings do not support inpatient rehabilitation for this group of patients," the researchers wrote.
Buhagiar MA, Naylor JM, Harris IA, et al. Effect of inpatient rehabilitation vs a monitored home-based program on mobility in patients with total knee arthroplasty. [published online March 14, 2017]. J Am Med Assoc. doi:10.1001/jama.2017.1224