Factors affecting rehabilitation of elective hip and knee arthroplasty and length of hospital stay

ABSTRACT

Total hip arthroplasty [THA] and total knee arthroplasty [TKA] are among the most common operative procedures[1]. Over the past 35 years, the use of these procedures has grown dramatically, providing pain relief and improving the quality of life for millions of patients. During this time, the role of rehabilitation has been emphasized as an integral part of the post-operative management of the patient. Instead of spending days in bed waiting for tissue to heal, patients now begin functional activities as early as the first postoperative day [1][2]. The purpose of this study was to predict the factors that affect the length of hospital stay. We also planned to sort out which patients admitted for total joint arthroplasty [TJA] will be discharged to home and which patients will require transfer to a rehabilitation ward at the time the surgery is planned. Sixty-four patients with mean age of 64.9 years [39 women and 25 men] have had 71 operations of elective TJA [43 TKA, 7 bilateral TKA, and 21 THA] by 4 surgeons were studied. All the patients had started early intensive rehabilitation program on the first postoperative day to attain good outcome until discharged to home functionally independent. The correlation of patient's age, sex, marital statues, body mass index, and pre-morbid illness with length of hospital stay in either orthopedic or rehabilitation ward and the need for admission to rehabilitation was studied. It was found that age was the only characteristic factor that significantly correlated to the length of stay in either the orthopedic and rehabilitation ward. The co-morbid illnesses that affect the length of hospital stay and need for inpatient rehabilitation were diabetes mellitus and obesity