Compared to home-based program, in-patient rehab following knee replacement does not improve mobility

March 14, 2017

Among patients with osteoarthritis undergoing total knee replacement and who have not experienced a significant early complication, the use of inpatient rehabilitation compared with a monitored home-based program did not improve mobility at 26 weeks after surgery, according to a study appearing in the March 14 issue of JAMA.

From 1980 to 2010, the prevalence of total knee replacement in the United States increased 11-fold. Formal rehabilitation programs, including inpatient programs, are often assumed to optimize recovery. Inpatient programs, however, have not been compared with any outpatient or home-based programs. Justine M. Naylor, Ph.D., of the University of New South Wales, Liverpool, Australia and colleagues randomly assigned patients with osteoarthritis undergoing total knee arthroplasty (replacement) to receive 10 days of hospital inpatient rehabilitation followed by an 8-week clinician-monitored home-based program (n = 81) or the home-based program alone (n = 84). There were 87 patients in an observational group, which included only the home-based program.

Among the measures analyzed, there was no significant difference in the 6-minute walk test between the inpatient rehabilitation and either of the two home program groups, nor in patient-reported pain and function, or quality of life. The number of postdischarge complications for the inpatient group was 12 vs nine among the home group, and there were no adverse events reported that were a result of trial participation.

"These findings do not support inpatient rehabilitation for this group of patients," the authors write.
-end-
(doi:10.1001/jama.2017.1224; the study is available pre-embargo at the For the Media website)

Editor's Note: Please see the article for additional information, including other authors, author contributions and affiliations, financial disclosures, funding and support, etc.

The JAMA Network Journals

Related Surgery Articles from Brightsurf:

Decision conflict before cancer surgery correlates with lower activity after surgery
Nearly one-third of cancer patients who decide to undergo surgery for their condition may have second thoughts, and this decision conflict may lead to less favorable treatment outcomes in both the near- and long-term, according to a team of investigators at Massachusetts General Hospital and Ariadne Labs.

Examining association between weight loss before bariatric surgery, risk of death after surgery
Researchers looked at whether a patient's body weight and weight loss before bariatric surgery were associated with risk of death within 30 days after surgery using data from nearly 500,000 patients in the US and Canada.

Guidelines for thyroid surgery published in Annals of Surgery
The first set of comprehensive, evidence-based clinical guidelines for surgical treatment of thyroid disease -- developed by an expert panel assembled by the American Association of Endocrine Surgeons (AAES) -- was published today by Annals of Surgery.

Colorectal surgery patients use fewer opioids, report less pain with enhanced recovery after surgery
Colorectal surgery patients who were a part of an enhanced recovery after surgery (ERAS) program had less pain, while using nearly half as many opioids, according to research being presented at the ANESTHESIOLOGY® 2019 annual meeting.

Video assisted lung surgery reduces complications and hospital stays compared to open surgery
Video-assisted thoracic surgery is associated with lower in-hospital complications and shorter length of stay compared with open surgery among British patients who were diagnosed at an early stage of lung cancer, according to research presented today the IASLC 2019 World Conference on Lung Cancer, hosted by the International Association for the Study of Lung Cancer.

Most deaths related to noncardiac surgery occur after surgery and after discharge from hospital
It's not the operating room that is risky for patients undergoing noncardiac surgery; it's the recovery period.

Study looks at opioid use after knee surgery
A small study looked at whether reducing the number of opioid tablets prescribed after knee surgery would reduce postoperative use and if preoperative opioid-use education would reduce it even more.

Surgery patients are getting older every year
A new BJS (British Journal of Surgery) analysis reveals that people undergoing surgery in England are getting older at a faster rate than the general population.

Children requiring thyroid surgery have better outcomes at high-volume surgery centers
New research recently published in the Journal of Pediatric Surgery found that post-operative success rates of pediatric thyroid patients, particularly children who require a thyroidectomy, correlate with the institution's patient volume.

Do negative public attitudes toward weight loss surgery stop some patients from having surgery?
Most patients who qualify for weight loss surgery don't have the procedure despite its safety and effectiveness.

Read More: Surgery News and Surgery 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.