Inpatient Rehab After Total Knee Arthroplasty Proves Ineffective

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.

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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