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Early ambulation within 24 h after joint arthroplasty: a retrospective cohort study
Dongdong Xie1,2, Guorui Cao2, Rui Chen2
1School of Nursing, Fujian University of Traditional Chinese Medicine, Fuzhou, China.
Frontiers in Medicine
|August 8, 2026
Summary
Early ambulation after knee or hip replacement surgery significantly reduces deep vein thrombosis risk and lowers costs. This practice also improves range of motion and shortens hospital stays, particularly for total knee arthroplasty patients.
Area of Science:
- Orthopedic Surgery
- Clinical Outcomes Research
- Patient Recovery
Background:
- Evaluating early ambulation's impact on recovery after primary total knee arthroplasty (TKA) and total hip arthroplasty (THA).
- Assessing clinical outcomes including deep vein thrombosis (DVT), length of stay (LOS), costs, and range of motion (ROM).
Purpose of the Study:
- To determine the association between early ambulation (within 24 hours) and postoperative outcomes in TKA and THA patients.
- To compare the effects of early ambulation on TKA versus THA outcomes.
Main Methods:
- Retrospective cohort study of 4,517 patients undergoing primary unilateral TKA or THA.
- Comparison of early (≤24h) versus late (>24h) postoperative ambulation groups.
- Statistical analyses including univariate, multivariate regression, and propensity score matching (PSM).
Main Results:
- Early ambulation significantly reduced DVT incidence in both TKA (0.2% vs 1.6%) and THA (0% vs 0.7%).
- Early ambulation correlated with shorter LOS, lower hospitalization costs, and improved ROM.
- The association between early ambulation and shorter LOS was more pronounced in TKA patients than THA patients.
Conclusions:
- Early postoperative ambulation is linked to better clinical outcomes, including reduced DVT risk and costs.
- Early ambulation demonstrates a stronger association with reduced length of stay in TKA compared to THA.
- TKA patients generally experienced longer LOS but lower costs than THA patients.