A protocolized home rehabilitation program had better outcomes than the usual care following total knee replacement: a prospective cohort study
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Abstract
Objective: to compare functionality and quality of life, and some indicators of patient satisfaction, between two postoperative rehabilitation care following total knee replacement: 1) Protocolized care provided by the Italian Hospital Rehabilitation Unit for patients who live in CABA; 2) Usual care provided by the outsourced rehabilitation system.
Materials and methods: prospective cohort of patients who underwent total knee replacement at the Italian Hospital were evaluated using ques- tionnaires of functionality and quality of life at 45 days.
Results: 81 patients were included in the protocolized care group and 28 in the usual care group. Statistically significant differences were observed in all the variables evaluated, highlighting clinical relevance that only 2.43% of the patients treated by the URED continued using the walker at 45 days vs 35.71% of those who had been treated with the usual care (p = 0.004); as well as the lower proportion of patients with flexion deficit (2.47 vs. 46%, respectively; p < 0.001) and extension (18.52 vs. 75%; p < 0.001) at the same time.
Conclusion: a home protocolarized rehabilitation program supervised by a physical therapist proved to be effective for a quicker progression to an independent walk with lower risks of flexion or extension deficits at 45 days.
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Khan F, Ng L, Gonzalez S, Hale T, et al. Multidisciplinary Rehabilitation Programmes Following Joint Replacement at the Hip and Knee in Chronic Arthropathy. Cochrane Database Syst Rev. 2008 Apr 16;(2).
López-Liria R, Vega-Ramírez F, Catalán-Matamoros D, et al. La rehabilitación y fisioterapia domiciliaria en las prótesis de rodilla. Anales Sis San Navarra. 2012; 35(1):99-113.
Iyengar KP, Nadkarni JB, Ivanovic N, et al.. Targeted Early Rehabilitation at Home after Total Hip and Knee Joint Replacement: Does It Work?. Disabil Rehabil. 2007 Mar 30;29(6):495-502.
Majumdar S, Luccisano M, Evans C. Perceptions of Physiotherapy Best Practice in Total Knee Arthroplasty in Hospital Outpatient Settings. Physiother Can. 2011 Spring;63(2):234-41.
Westby MD, Kennedy D, Jones D, et al. Post-Acute Physiotherapy for Primary Total Knee Arthroplasty. Cochrane Database of Systematic Reviews 2008, Issue 2. Art. No.: CD007099.
Mahomed NN, Davis AM, Hawker G, et al. Inpatient Compared with Home-Based Rehabilitation Following Primary Unilateral Total Hip or Knee Replacement: A Randomized Controlled Trial. J Bone Joint Surg Am. 2008 Aug;90(8):1673-80.
Lopez Liria R., Padilla Gongora D., Catalan Matamoros D. Home-Based versus Hospital-Based Rehabilitation Program after Total Knee Replacement. BioMed Research International Volume 2015, 9 pages
Escobar A., Quintana J, Bilbao A. et al. Validation of the Spanish Version of the WOMAC Questionnaire for Patients with Hip or Knee Osteoarthritis . Clin Rheumatol 21, 466–471 (2002) doi:10.1007/s100670200117
Augustovski F, Irazola V, Velazquez A, et al. Argentine valuation of the EQ-5D health states. Value Health. 2009 Jun;12(4):587-96.
Coretti S, Ruggeri M, McNamee P. The minimum clinically important difference for EQ-5D index: a critical review. Expert Rev Pharmacoecon Outcomes Res. 2014 Apr;14(2):221-33.
Larsen K, Hansen TB, Søballe K. Hip Arthroplasty patients benefit from accelerated perioperative care and rehabilitation: a quasi-experimental study of 98 patients. Acta Orthop 2008;79(5): 624-30.
Walters SJ, Brazier JE. Comparison of the minimally important difference for two health state utility measures: EQ-5D and SF-6D. Qual Life Res 2005;14(6):1523-32.
Buhagiar MA, Naylor JM, Harris IA y cols. Effect of inpatient rehabilitation vs. a monitored home-based program on mobility in patients with total knee arthroplasty, the HIHO randomized clinical trial. JAMA. 2017;317(10):1037-46.
Onggo JR, Onggo JD, De Steiger R, Hau R. The Efficacy and Safety of Inpatient Rehabilitation Compared With Home Discharge After Hip or Knee Arthroplasty: A Meta-Analysis and Systematic Review. J Arthroplasty. 2019;34(8):1823-1830.
Buhagiar MA, Naylor JM, Harris IA, Xuan W, Adie S, Lewin A. Assessment of Outcomes of Inpatient or Clinic-Based vs Home-Based Rehabilitation After Total Knee Arthroplasty: A Systematic Review and Meta-analysis. JAMA Netw Open. 2019;2(4):e192810. Published 2019 Apr 5.