Department of Orthopedic Surgery, NYU Langone Health, 301 East 17th Street, New York, NY, 10003, USA.
Arch Orthop Trauma Surg. 2022 Sep;142(9):2165-2171. doi: 10.1007/s00402-021-03842-y. Epub 2021 Mar 1.
The purpose of this study is to report on the association between the number of stairs to enter home and length of stay (LOS), discharge disposition, and patient reported outcome measures (PROMs) among patients who underwent primary total joint arthroplasty (TJA).
We retrospectively reviewed patients who underwent primary total hip or knee arthroplasty between January 2016 and March 2020. Only patients with documentation of the number of stairs to enter their homes were included in the study. The two cohorts were separated into four groups: none, 1-10, 11-20, and > 20 stairs. Collected variables included demographic data, LOS, discharge disposition, and PROMs. Chi-square and ANOVA were utilized to determine significance.
Of the 1116 patients included, 510 underwent THA, and 606 underwent TKA. There was no statistical difference in LOS (THA: p = 0.308; TKA: p = 0.701) and discharge disposition (THA: p = 0.371; TKA: p = 0.484) in both cohorts regardless the number of stairs. There was no statistical difference in FJS-12 scores at 3 months (THA: p = 0.590; TKA: p = 0.206), 12 months (THA: p = 0.217; TKA: p = 0.845), and 21 months (THA: p = 0.782; TKA: p = 0.296) postoperatively for both cohorts. There was no statistical difference in HOOS, JR scores preoperatively (p = 0.278) and at 3 months postoperatively (p = 0.527) for the THA cohort, as well as KOOS, JR scores preoperatively and at 3 and 12 months postoperatively (p = 0.557; p = 0.522; p = 0.747) for the TKA cohort.
We found no statistical differences in LOS, discharge disposition, and PROMs in patients who underwent TJA, irrespective of the number of stairs negotiated to enter their home. These findings can aid surgeons to provide preoperative education and reassurance to patients who have concerns with their discharge planning due to the walk-up stairway at their residence.
本研究旨在报告进入家庭的楼梯数量与初次全关节置换术（TJA）患者的住院时间（ LOS ）、出院去向和患者报告的结果测量（ PROMs ）之间的关系。
我们回顾性分析了 2016 年 1 月至 2020 年 3 月期间接受初次全髋关节或膝关节置换术的患者。仅纳入有记录进入家庭楼梯数量的患者。两个队列分为四组：无楼梯、1-10 级楼梯、11-20 级楼梯和> 20 级楼梯。收集的变量包括人口统计学数据、 LOS 、出院去向和 PROMs 。使用卡方检验和方差分析确定显著性。
在纳入的 1116 例患者中，510 例行 THA ，606 例行 TKA 。两组 LOS （ THA ： p = 0.308 ； TKA ： p = 0.701 ）和出院去向（ THA ： p = 0.371 ； TKA ： p = 0.484 ）均无统计学差异。两组术后 3 个月（ THA ： p = 0.590 ； TKA ： p = 0.206 ）、12 个月（ THA ： p = 0.217 ； TKA ： p = 0.845 ）和 21 个月（ THA ： p = 0.782 ； TKA ： p = 0.296 ）的 FJS-12 评分均无统计学差异。 THA 队列术前（ p = 0.278 ）和术后 3 个月（ p = 0.527 ）的 HOOS 、 JR 评分以及 TKA 队列术前和术后 3 个月（ p = 0.557 ）、12 个月（ p = 0.522 ）和 24 个月（ p = 0.747 ）的 KOOS 、 JR 评分均无统计学差异。
我们发现，无论进入家庭的楼梯数量如何，接受 TJA 的患者的 LOS 、出院去向和 PROMs 均无统计学差异。这些发现可以帮助外科医生为因住所的上楼梯而对出院计划有顾虑的患者提供术前教育和保证。
