[Effectiveness of rehabilitation measures from the orthopedic viewpoint]

The investigations reported here were prompted by the rapid increase in the amount of rehabilitation treatment performed in recent years and the high costs it incurs. The patients considered had all undergone orthopedic treatment. Rehabilitation treatment lasted between 4 and 6 weeks. On the basis of certain criteria (alleviation of pain, improvement of function) it was attempted to show what degree of success can be achieved with rehabilitation measures following disc operations, total hip and knee-joint replacements and degenerative changes of the spine. In view of their high cost rehabilitation measures would not be justifiable if equally satisfactory results could be achieved by less costly methods. However, a complex therapeutic program generally cannot be carried out adequately on an outpatient basis. While surveys of effectiveness conducted by numerous authors have shown that considerable savings are possible in terms of general and insurance costs (Gercke 1977), accurate indication and careful assessment of the necessity for a cure are essential. The authors' investigations in 4 rehabilitation groups revealed that in a high percentage of the patients not only subjective alleviation of pain but also genuine, measurable functional improvements were achieved. Rehabilitation is one of the most important elements of pension insurance schemes: the dictum here is that "rehabilitation has priority over pensions". Nevertheless, the low chance of success assumed by pension applicants during rehabilitation should be taken into account. These patients, who are only interested in the success of their pension applications, regard the chances of success as practically non-existent.(ABSTRACT TRUNCATED AT 250 WORDS)