Key result
A single preoperative physical therapy visit significantly increased the proportion of patients leaving inpatient care on post-operative day 1 compared to no preoperative therapy (37.1% vs 27.0%, p≤0.001).
Why the study?
As total knee arthroplasty utilization and its financial impact have grown, the study aimed to quantify the economic impact of a standardized preoperative physical therapy visit.
Does a preoperative physical therapy visit reduce length of stay and improve discharge disposition in adult patients undergoing total knee arthroplasty?
Cohort (n=1,043)
No
Does a preoperative physical therapy visit reduce length of stay and improve discharge disposition in adult patients undergoing total knee arthroplasty?
A single preoperative physical therapy visit significantly reduces hospital length of stay and improves discharge disposition to home following total knee arthroplasty, potentially reducing healthcare costs.
May support preoperative PT for earlier TKA discharge; hypothesis-generating and should not yet change practice.
Objective: Total knee arthroplasty is an effective surgical approach used to treat arthritis and knee trauma. Its utilization has grown, as has the accompanying financial impact, resulting in an equal need to advance physical therapy practice. One emerging approach improving patient outcomes and reducing cost is the inclusion of a preoperative physical therapy visit. The aim of this study was to quantify the economic impact of a standardized preoperative physical therapy visit in the healthcare setting. Design: This study is a retrospective review of 1,043 adult patients who underwent total knee arthroplasty. Methods: Patients who underwent total knee arthro-plasty were divided into those who received a prehab compared with those who did not. Results: Preoperative physical therapy resulted in a marked decrease in length of stay, with 37.1% of preoperative physical therapy patients leaving inpatient care on post-operative day 1 compared to 27.0% of the no preoperative physical therapy controls (p???0.001). Preoperative physical therapy also improved discharge disposition, with 41.6% of preoperative physical therapy patients returning home and utilizing outpatient services compared to 23.2% of controls (p???0.001). No effect on duration of care was observed. Conclusion: These data suggest that a single preoperative physical therapy visit improves key outcomes, both clinically and financially, following total knee arthroplasty.
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Garrison et al. (2019) conducted a cohort in Total knee arthroplasty (n=1,043). Preoperative physical therapy (prehab) vs. No preoperative physical therapy was evaluated on Leaving inpatient care on post-operative day 1 (p=≤0.001). A single preoperative physical therapy visit significantly increased the proportion of patients leaving inpatient care on post-operative day 1 compared to no preoperative therapy (37.1% vs 27.0%, p≤0.001).
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