Preliminary Review of Revised Primary Total Knee Arthroplasty Rehabilitation Programme: Occupational Therapy Perspective

Abstract

Introduction: The rehabilitation programme after primary total knee arthroplasty (TKA) has been revised to 1 week for unilateral TKA and 2 weeks for bilateral one-stage TKA since May 2013. Occupational therapists are interested to have a preliminary review of the revised programme. Materials and Methods: Consecutive patients who were transferred to MacLehose Medical Rehabilitation Centre for primary TKA rehabilitation from May to July 2013 were recruited for the study. Those who only met the pre-defined discharge criteria after rehabilitation were discharged. The short length of stay group (SLOS) included patients discharged within the expected LOS, while the long LOS group (LLOS) included those who stayed beyond. Patients’ demographics, social support, functional scores, and self-perceived difficulties at home between the groups were compared by independent t test. Results: A total of 32 (18 with SLOS and 14 with LLOS) patients were included in this review. Those in the LLOS were statistically significantly older than SLOS (74.4 vs. 68.4 years; t = –2.07; p < 0.05). In all, 83.3% and 92.9% of patients required daytime carer support in SLOS and LLOS, respectively. There was no statistical difference in the admission and discharge Functional Independence Measure scores between the groups. In LLOS, 21.4% reported difficulties in simulated bathroom and toilet environment, whereas that was 0% in SLOS. Discussion and Conclusion: In the revised rehabilitation programme, the older patients required longer LOS. Early occupational intervention may be helpful to them for early integration to community after TKA.