A new study shows that physical therapy before hip or knee replacement surgery can help reduce the need for postoperative care.
It is usual for patients to undertake physical therapy as part of their rehabilitation after total hip replacement (THR) or total knee replacement (TKR) surgery. But the new research shows that preoperative physical therapy – or “prehabilitation” – is also beneficial.
Researchers in the United States examined historical Medicare claims data to identify preoperative physical therapy and postoperative care usage patterns for 4,733 THR and TKR patients. Postoperative care, also known as post-acute care, was defined as the use of a skilled nursing facility, home health agency or inpatient rehabilitation centre within 90 days of being discharged from hospital.
Overall, 77% of patients used such care services after surgery. The study results showed that the use of post-acute care was lower among those who received preoperative physical therapy. Only 54.2% of those who had preoperative physical therapy needed post-acute care services, compared to 79.7% of the non-preoperative physical therapy group.
After adjusting for demographic characteristics and comorbidities (other conditions), there was a 29% reduction in post-acute care use for patients receiving preoperative physical therapy.
“This study demonstrated an important opportunity to pre-empt postoperative outcome variances by implementing preoperative physical therapy along with management of comorbidities before and during surgery,” commented orthopaedic surgeon Ray Wasielewski, MD, co-author of the study.
The findings of the study have been published in the Journal of Bone & Joint Surgery (JBJS).