Friday 27 March 2015

In-Patient Rehab Not Always Needed After New Knee

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People do just as well with in-home physical therapy, study finds


WebMD News from HealthDay

By Alan Mozes

HealthDay Reporter

THURSDAY, March 26, 2015 (HealthDay News) -- Patients who choose at-home physical therapy instead of in-patient rehabilitation after knee replacement surgery do just as well when it comes to complications, long-term pain management and movement recovery, new research indicates.

"Based on these findings, we are encouraging more patients to consider going home so they can receive their aftercare in a home environment instead of at an in-patient rehab facility," said study lead author Dr. Douglas Padgett, chief of the Adult Reconstruction and Joint Replacement Service at the Hospital for Special Surgery in New York City.

"Many patients may also feel more comfortable in a familiar home setting during their recovery," he added.

Padgett explained that the study was sparked by a growing tendency to send knee surgery patients directly home from the hospital, rather than to a rehab center.

"With our study, we wanted to make sure this would not affect patient outcomes. If hospitals are telling patients they can have all of their rehab at home, it was important to make sure they would do just as well at home," he said.

To date, only a handful of small studies have explored the issue, Padgett said. He added that the trend has been driven, in part, by a growing reluctance from private insurance companies and Medicare to cover the cost of in-patient rehab expenses.

The findings, presented this week at the American College of Orthopaedic Surgeons annual meeting in Las Vegas, should be viewed as preliminary until published in a peer-reviewed journal.

Padgett said that standard recovery time for knee replacement surgery can run anywhere from two to four months. Typically, patients assigned for in-patient rehab care stay about two weeks, receiving physical therapy roughly six days per week, sometimes followed by in-home or outpatient care after they return home.

By comparison, those sent directly home are generally visited by a home-care physical therapist three days per week for up to six weeks.

The current comparative analysis involved more than 2,400 patients who'd had knee replacement surgery between 2007 and 2011. Their average age was 66. Almost 90 percent had undergone knee replacement as a result of debilitating osteoarthritis.



source : In-Patient Rehab Not Always Needed After New Knee

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