Pain, Functional Outcome, and Patient Satisfaction—Home-based versus Inpatient Rehabilitation After Primary Unilateral Total Hip or Knee Replacement

Abstract

Abstract
There has been an increasing trend toward discharging patients directly to home from the acute care facility with home-based rehabilitation support following total joint replacement surgery. We reviewed the existing literature on the subject to find out whether there is any difference in pain, functional outcome, and patient satisfaction between those discharged to a home-based rehabilitation program versus an inpatient rehabilitation program. We found that an inpatient rehabilitation program does not lead to inferior clinical outcomes or patient satisfaction compared with a homebased program. While we believe there still exists a need for inpatient rehabilitation services, there are currently no well-defined criteria to guide clinicians regarding which patients should be sent directly home and which to inpatient rehabilitation following hip and knee replacement surgery. Ongoing efforts to improve home care services may prove beneficial in maximizing health outcomes after surgery while also easing the burden on valuable acute care hospital resources.

Keywords
Joint replacement, hip, knee, rehabilitation

Disclosure: The authors have no conflicts of interest to declare.
Received: December 14, 2009 Accepted: February 22, 2010 Citation: US Musculoskeletal Review, 2010;5:7–10
Correspondence: Rajiv Gandhi, MD, MS, FRCSC, Toronto Western Hospital, University Health Network, 399 Bathurst Street, East Wing 1-439, Toronto, Ontario M5T 2S8, Canada. E: rajiv.Gandhi@uhn.on.ca