Recovery after knee arthroplasty: home – based rehabilitation programs or hospitalization ?

Traditional beliefs are challenged once again by a recent study. Inpatient hospitalization might not be the only best option when it comes to rehabilitation programs after total knee arthroplasty (TKA).

Surveys of patients have found that up to one in three (15-30%) experience little or no improvement after surgery , while some of the people are not able to undergo the rehabilitation programs (due to age, associated diseases , etc. ) as part of inpatient treatment and are sent home with a list of exercises to do on their own. (TKA).

Although the home-based rehabilitation is supposed to be hold under the care of rehabilitation assistants in people’s homes – its primary related to physical exercises. While the complex rehabilitation care related to rehab after a knee arthroplasty implies «passive recovery» – including physiotherapy and PEMF Therapy as an effective way and holistic way in healing of musculoskeletal system disorders).

Importance:«Hospital Recovery» programs seem to be somewhat out-of-date and time-limited. Some patients need getting healing months after the surgery and hospital stay. Moreover, formal rehabilitation programs for patients after undergoing total knee arthroplasty. have not been compared with any outpatient or home-based programs.

Objective: To determine if 10 days of inpatient rehabilitation after total knee arthroplasty provided greater improvements than a monitored home-based program alone in mobility, function, and quality of life.

Design, Setting, and Participants: The study was conducted in Sydney, Australia. Of the eligible patients consecutively invited to participate, 165 were randomized either to receive inpatient hospital rehabilitation or to do home-based rehabilitation.

Main Outcomes and Measures: Mobility at 26 weeks after surgery, measured with the 6-minute walk test. Secondary outcomes included the Oxford Knee Score, which ranges from 0 (worst) to 48 (best) and has a minimal clinically important difference of 5 points; and EuroQol Group 5-Dimension Self-Report Questionnaire (EQ-5D) visual analog scale, which ranges from 0 (worst) to 100 (best), and has a minimal clinically important difference of 23 points.

Results: Among the 165 randomized participants, 68% were women, and the cohort had a mean age, 66.9 years (SD, 8.4 years). There was no significant difference in the 6-minute walk test between the inpatient rehabilitation and the home program group (mean difference, −1.01; 95% CI, −25.56 to 23.55), nor in patient-reported pain and function (knee score mean difference, 2.06; 95% CI, −0.59 to 4.71), or quality of life (EQ-5D visual analog scale mean difference, 1.41; 95% CI, −6.42 to 3.60). The number of postdischarge complications for the inpatient group was 12 vs 9 among the home group, and there were no adverse events reported that was a result of trial participation.

Conclusions and Relevanc: Among adults undergoing uncomplicated total knee arthroplasty, the use of inpatient rehabilitation compared with a monitored home-based program did not improve mobility at 26 weeks after surgery.

We consider that any recovery method should be agreed with your doctor and if he/she is not opposite to at-home rehabilitation, please check PEMF Therapy Devices by ELAMED which can help you to recover after the surgery.

Reference: https://pubmed.ncbi.nlm.nih.gov/27584144/