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The Effect of a Rapid Rehabilitation Program on Patients Undergoing Unilateral Total Knee Arthroplasty
Geraldine Pagnotta1, Ellen Rich, Patricia Eckardt
1Geraldine Pagnotta, MPT, MPH, Director, NYU Langone Musculoskeletal Rehabilitation Network and Programming, New York. Ellen Rich, PhD, RN, FNP, FAANP, Nurse Researcher, NYU Hospital for Joint Diseases, New York. Patricia Eckardt, PhD, RN, Associate Professor, Molloy College, Rockville Centre, NY. Patricia Lavin, MS, RN, Director of Nursing Quality, Magnet and Outcomes, NYU Hospital for Joint Diseases, New York. Rachele Burriesci, PT, DPT, GCS, Clinical Specialist and Home Based Cardiac Rehab Physical Therapist, Ann Arbor VA Healthcare System, Ann Arbor, MI.
Background:
Few studies have looked at longer term functional outcomes of rapid rehabilitation (physical therapy in the postanesthesia care unit on the day of surgery) for patients undergoing total knee arthroplasty.
Purpose:
The purpose of this interdisciplinary study (physical therapy and nursing) was to assess the effect of a rapid rehabilitation program on inpatient length of stay (LOS) and functional recovery.
Methods:
Functional outcomes were measured by the Knee Injury Osteoarthritis Outcome Score presurgically and at 4 and 12 weeks postoperatively and by progression along a physical therapy rehabilitation pathway.
Results:
Experimental group LOS was significantly shorter than the control group (p = .0261). Multilevel regression modeling showed that KOOS and physical therapy clinical pathway score trajectories did not differ significantly between groups. Patients receiving rapid rehabilitation were 2.5 (95% CI [0.958, 6.53]) times more likely to have a positive physical therapy rehabilitation trajectory than patients in the control group.
Conclusion:
Findings validated earlier study results in terms of LOS; however, further research is needed to assess the effect of rapid rehabilitation on longer term functional outcomes.