Same-day discharge after early mobilisation and increased frequency of physiotherapy following hip and knee arthroplasty

South African Journal of Physiotherapy

Field Value
Title Same-day discharge after early mobilisation and increased frequency of physiotherapy following hip and knee arthroplasty
Creator Prinsloo, Retha-Mari Keller, Monique M.
Subject Physiotherapy length of stay; early mobilisation; physiotherapy; arthroplasty; replacement; hip; knee
Description Background: Advanced rehabilitation pathway (ARP) after hip and knee arthroplasties is popular globally and is gaining ground in South Africa (SA). A multidisciplinary team in Rustenburg, SA, has implemented an ARP with the first same-day discharge (SDD) from hospital. The lack of evidence of physiotherapy protocols within an ARP determined our study.Objectives: Determine and compare hospital length of stay (LOS) (hours), patient satisfaction (Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)), patient safety (30-day re-admission) and cost between the two cohorts.Method: A quantitative prospective patient (treatment) group receiving early mobilisation with increased frequency of physiotherapy on post-operative day zero (POD0) was compared to a conservatively managed retrospective historical (control) group following post-operative elective hip and knee arthroplasties.Results: Results for the prospective group which were significantly improved relative to the retrospective group included decreased LOS (median 7.650, p  0.001), less pain at 6 weeks (mean 16.20, standard deviation [SD] = 2.673, p  0.001), less stiffness (mean 5.82, SD = 1.214, p = 0.007), higher function (mean 54.87, SD = 8.544, p  0.001), lower hospital cost (mean R43 340, p  0.001) and physiotherapy cost (mean R1069, p  0.001), and total costs compared to the retrospective group (mean R117 062, p  0.001).Conclusion: Safe and cost-effective SDD is possible in an ARP with earlier mobilisation and increased frequency of physiotherapy on POD0.Clinical implications: Achieving safe SDD after hip and knee arthroplasty surgeries saved costs and improved patient satisfaction, with a decrease in LOS being beneficial for medical funders and stakeholders including government aiming to implement National Health Insurance (NHI) in the future.
Publisher AOSIS
Contributor Retha-Mari Prinsloo, Monique Marie Keller, Ms Tonya Esterhuizen
Date 2022-05-31
Type info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion — Cohort study
Format text/html application/epub+zip text/xml application/pdf
Identifier 10.4102/sajp.v78i1.1755
Source South African Journal of Physiotherapy; Vol 78, No 1 (2022); 9 pages 2410-8219 0379-6175
Language eng
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Coverage Rustenburg South Africa Twenty-first century Adults; Male and Female; South African
Rights Copyright (c) 2022 Retha-Mari Prinsloo, Monique M. Keller