Home may be the best place to recover after total joint replacement surgery

March 14, 2017

Despite higher costs, many doctors recommend and some patients prefer, recovery at an in-patient rehabilitation facility following total hip (THR) or total knee replacement (TKR) surgery. And yet a new study to be presented Thursday, March 16, at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS), found that even patients who live alone can recover effectively and safely at home.

"In the past, most surgeons have been reticent to discharge patients directly home after joint replacement surgery if they live by themselves; instead, opting for such patients to enter a rehab facility," said lead author William J. Hozack, MD, an orthopaedic surgeon at The Rothman Institute and professor of orthopaedic surgery at the Sidney Kimmel Medical College at Thomas Jefferson University. "However, we found that patients living alone were able to safely recover without any increase in the rate of complications. Even more strikingly, patients were generally happy and content being in the comfort of their own home during recovery."

The study, "Even if You Live Alone, There's No Place Like Home after Total Joint Arthroplasty," (LINK) involved 769 patients undergoing primary THR or TKR. Of these, 138 patients lived alone and 631 lived with other people. In both groups, patients age 75 and older were well represented. The patients who lived alone were more likely to stay an additional night in the hospital prior to discharge and utilize more home health services, especially older patients. Limited support without weekly visits was reported by 37.2 percent of patients living alone, although nearly 80 percent had a friend or relative living within 15 miles who could provide help if needed.

Among the results of the study: Given the cost savings of in-home recovery, the emotional benefits of patients recovering in familiar surroundings, and no measurable difference in pain, complications or functional outcomes, "we believe home discharge is appropriate for the vast majority of patients undergoing joint replacement, including the nearly 20 percent of patients living on their own," said Dr. Hozack.

In addition, the July 2016 U.S. Department of Health & Human Services (HHS) Office of Inspector General report, "Adverse Events in Rehabilitation Hospitals: National Incidence Among Medicare Beneficiaries," highlighted "a surprisingly high rate of adverse events at rehab hospitals across the U.S.," said Dr. Hozack.
-end-


American Academy of Orthopaedic Surgeons

Related Orthopaedic Surgeons Articles from Brightsurf:

Women orthopaedic surgeons report high rates of sexual harassment
More than two-thirds of women orthopaedic surgeons report experiencing sexual harassment during their residency training, according to a survey study in Clinical Orthopaedics and Related Research® (CORR®), a publication of The Association of Bone and Joint Surgeons®.

Falling Medicare reimbursement rates for orthopaedic trauma
The amount Medicare reimburses for orthopaedic trauma surgery has fallen by nearly one-third over the past two decades, reports a study in the Journal of Orthopaedic Trauma.

COVID-19 evidence and strategies for orthopaedic surgeons
How should orthopaedic surgeons respond to the COVID-19 pandemic? A review in The Journal of Bone & Joint Surgery analyzes evidence and strategies for managing the novel SARS-CoV-2 virus - including critical lessons from past pandemics.

Nationwide study shows disparities in outpatient care for common orthopaedic problems
Racial/ethnic minorities, people with lower incomes, and other groups are less likely to receive office-based care for common musculoskeletal conditions, reports a nationwide study in Clinical Orthopaedics and Related Research® (CORR®), a publication of The Association of Bone and Joint Surgeons®.

Female surgeons earned 24% less per hour while operating compared to male surgeons: study
Female surgeons earned 24 per cent less per hour while operating compared to male surgeons, finds a new study led by St.

Factors orthopaedic surgeons should consider when prescribing opioids
Orthopaedic surgeons are the third-highest physician prescribers of opioids, writing more than 6 million prescriptions a year.

End-of-career transitions for older surgeons
A special communication article focuses on end-of-career transitions for older surgeons.

Certain factors linked with higher risk of infection after orthopaedic surgery
In an International Wound Journal study of 4,818 older patients undergoing elective orthopaedic surgeries, five risk factors were linked with an increased risk of developing surgical site infections, including diabetes, morbid obesity, tobacco smoking, prolonged surgical duration, and lower serum albumin levels prior to surgery.

Study supports safety of overlapping surgery for outpatient orthopaedic procedures
At least for brief periods, overlapping surgery is safe for patients undergoing outpatient or 'same-day' orthopaedic surgery procedures, reports a study in the Dec.

Multicenter study supports safety of overlapping orthopaedic surgery
For patients undergoing orthopaedic surgery, the use of 'overlapping' procedures -- where the attending surgeon is simultaneously involved in two different surgeries in different operating rooms -- does not lead to an increased risk of complications, reports a study in the Nov.

Read More: Orthopaedic Surgeons News and Orthopaedic Surgeons Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.