Artz Neil, Dixon Sam, Wylde Vikki, Beswick Andrew, Blom Ashley, Gooberman-Hill Rachael
Musculoskeletal Research Unit, University of Bristol, Bristol, UK.
Musculoskeletal Care. 2013 Mar;11(1):31-8. doi: 10.1002/msc.1027. Epub 2012 Jul 9.
Total hip replacement (THR) and total knee replacement (TKR) are two common elective orthopaedic procedures, and the provision of physiotherapy for patients after discharge is variable, with evidence for best practice remaining uncertain.
To determine the standard physiotherapy service offered to patients following discharge after THR and TKR.
A telephone survey was carried with clinicians at 24 high-volume NHS orthopaedic centres in England and Wales. Information was gathered on standard physiotherapy provision and categorized into; no routine physiotherapy, outpatient physiotherapy (including one-to-one and group), home-based physiotherapy or other physiotherapy (including telephone consultation and drop-in services).
No centres surveyed referred patients to outpatient physiotherapy as a routine pathway of care following THR. Eleven centres provided group physiotherapy to patients after discharge following TKR compared with five centres providing one-to-one outpatient physiotherapy.
The provision of physiotherapy following discharge after TKR is a more common practice than after THR, where ongoing physiotherapy is provided depending upon clinical need. Group exercises are the favoured destination for patients following TKR in high-volume centres.
全髋关节置换术（THR）和全膝关节置换术（TKR）是两种常见的择期骨科手术，出院后为患者提供物理治疗的情况各不相同，最佳实践的证据仍不明确。
确定THR和TKR术后出院患者接受的标准物理治疗服务。
对英格兰和威尔士24家高容量国民保健服务（NHS）骨科中心的临床医生进行了电话调查。收集了有关标准物理治疗服务的信息，并将其分类为：无常规物理治疗、门诊物理治疗（包括一对一和小组治疗）、居家物理治疗或其他物理治疗（包括电话咨询和即到即服务）。
接受调查的中心中，没有一家将患者作为THR术后常规护理途径转诊至门诊物理治疗。11家中心在TKR术后出院为患者提供小组物理治疗，而5家中心提供一对一门诊物理治疗。
TKR术后出院后提供物理治疗比THR术后更为常见，THR术后根据临床需要提供持续的物理治疗。在高容量中心，小组锻炼是TKR术后患者的首选。
