AAOS: Home Recovery After Joint Arthroplasty Better than Inpatient Care

HealthDay News — Patients discharged home from the hospital following hip or knee arthroplasty recover as well as, or better than, those who first go to a rehabilitation center, according to a study presented at the annual meeting of the American Academy of Orthopaedic Surgeons, held from March 14 to 18 in San Diego.

William Hozack, MD, an orthopedic surgery professor with the Rothman Institute at the Thomas Jefferson University Medical School in Philadelphia, and colleagues included 769 patients discharged home following either a total hip arthroplasty or a total knee arthroplasty in their study.¹ Of those, 138 lived alone (about 18%). Hozack’s team observed no differences by any measure. Those who had support from others at home indicated relatively higher satisfaction levels at the 2 week mark; however, by the three-month point there was no appreciable difference between the 2 groups.

Two other studies being presented at the meeting also found that recovering at home may be the better option. One study found that patients who are discharged directly home following a total knee arthroplasty face a lower risk for complications and hospital readmission than those who first go to an inpatient rehab facility. The study was led by Alexander McLawhorn, MD, an orthopedic hip and knee surgeon at the Hospital for Special Surgery in New York City.²

McLawhorn was also part of a second Hospital for Special Surgery study, led by Michael Fu, MD. That study found that hip arthroplasty patients admitted to an inpatient facility rather than being sent home faced a higher risk for respiratory, wound, and urinary complications, and a higher risk for hospital readmission and death.³

In a recent study published in the Journal of the American Medical Association, Mark A. Buhagiar, from Braeside Hospital in Prairiewood, Australia, and colleagues also found that inpatient rehab in addition to home-based rehabilitation does not improve mobility 26 weeks after total knee arthroplasty.

Reference

1. Hozack WJ, Fleischman A, Austin M, et al. Even if you live alone, there is no place like home after total joint anthroplasty. Presented at the American Academy of Orthopaedic Surgeons Annual Meeting, held from March 14 to 18 in San Diego, California.
2. McLawhorn AS, Fu MC, Schairer WW, et al. Continued impatient care after primary total kneww arthroplasty increases 30-day post-discharge complications: a propensity score-adjusted analysis [published online February 1, 2017]. J Anthroplasty. doi: 10.1016/j.arth.2017.01.039
3. Fu M, Samuel A, Sulco PK, et al. Discharge to continued impatient care after total hip athroplasty is associated with increased post-discharge morbidity: a propensity-adjusted cohort study. Presented at the American Academy of Orthopaedic Surgeons Annual Meeting, held from March 14 to 18 in San Diego, California.