Exploring variation in patient access of post-discharge physiotherapy following total hip and knee arthroplasty under a choice based system in the UK: an observational cohort study

BMJ Open
David F HamiltonColin R Howie

Abstract

To assess a targeted 'therapy as required' model of post-discharge outpatient physiotherapy provision. Specifically, we investigated what proportion of patients accessed post-discharge physiotherapy following total hip arthroplasty (THA) and total knee arthroplasty (TKA), whether accessing therapy was associated with post-arthroplasty patient reported outcomes and whether it was possible to predict which patients would access post-discharge physiotherapy from pre-operative data. Prospective, observational, longitudinal cohort study. Single National Health Service orthopaedic teaching hospital in the UK. 1395 patients undergoing total hip arthroplasty and 1374 patients undergoing total knee arthroplasty. Self-reported access of post-discharge physiotherapy, the Oxford Hip or Knee Score, EuroQol 5-dimension questionnaire and post-operative surgical episode satisfaction metric. 662 (48.2%) patients with TKA and 493 (35.3%) patients with THA accessed additional post-discharge physiotherapy. Patient-reported outcomes (p<0.001) and surgical episode satisfaction (p=0.001) in both THA and TKA were higher in patients that did not participate in post-discharge physiotherapy. Regression models using pre-operative symptom burden and demogr...Continue Reading

References

Feb 14, 1998·The Journal of Bone and Joint Surgery. British Volume·J DawsonA Carr
Feb 25, 2003·Current Opinion in Rheumatology·Ewa M Roos
Feb 1, 2006·The Journal of Arthroplasty·Mark D RossiWilliam Bryan
Apr 6, 2006·Physiotherapy Research International : the Journal for Researchers and Clinicians in Physical Therapy·Justine NaylorLesley Innes
Apr 4, 2007·The Journal of Bone and Joint Surgery. American Volume·Steven KurtzMichael Halpern
May 29, 2007·The Knee·Jodie A McClellandJulian A Feller
Aug 4, 2007·The Journal of Bone and Joint Surgery. British Volume·P N BakerUNKNOWN National Joint Registry for England and Wales
Aug 6, 2009·BMC Musculoskeletal Disorders·Catherine J Minns LoweCatherine M Sackley
Aug 3, 2011·Archives of Physical Medicine and Rehabilitation·Janet K FreburgerLloyd J Edwards
Jul 24, 2012·Postgraduate Medical Journal·David HamiltonA Hamish R W Simpson
May 3, 2014·The Bone & Joint Journal·D F HamiltonC R Howie
Dec 3, 2014·Journal of Clinical Epidemiology·David J BeardAndrew J Price

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Methods Mentioned

BETA
total hip arthroplasties
total hip arthroplasty

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