Early Postoperative Physical Therapy Evaluation After Total Hip and Knee Arthroplasty Reduces Hospital Length of Stay

Purpose: To evaluate whether the timing of physical therapy (PT) after total hip arthroplasty (THA) and total knee arthroplasty (TKA) is associated with inpatient length of stay (LOS), patients with PT initiated on postoperative day (POD) 0 versus POD 1 were compared. Methods: For this evidence-based quality improvement project, a total of 260 patients were studied, with 122 patients receiving THA and 138 receiving TKA. Of the patients receiving THA, 85 received PT POD 0, and of the patients receiving TKA, 91 received PT POD 0. Data were compared with patients receiving THA and TKA who had PT on POD 1 during the same timeframe. Results: The average LOS for patients undergoing THA with PT on POD 0 versus POD 1 was 2.78 (standard deviation [SD] = 1.084) and 3.68 (SD = 2.484) days, respectively, and 2.95 (SD = 1.068) and 3.26 (SD = 0.920) days for patients undergoing TKA. Pearson χ2 analysis demonstrated a statistically significant shortened LOS for the POD 0 group (THA and TKA combined, χ2 = 16.535, P < .001). Patients in the POD 0 group were 3 times more likely to be discharged within 3 days compared with the POD 1 group (THA and TKA combined, 32% vs 11%). A greater proportion of the POD 0 group were discharged home compared with the POD 1 group (75% vs 46%). Conclusions: Our preliminary results show that providing PT evaluations on POD 0 is associated with a decreased LOS for patients following THA and TKA, which contributes to a considerable cost savings.