Brossier Monika, Schwartz-Dillard Jessica, McInerney Danielle, Smith Jerome Brent, Nguyen Joseph, Murray-Weir Mary, Edwards Danielle
Hospital for Special Surgery, New York, NY, USA.
HSS J. 2024 Feb;20(1):69-74. doi: 10.1177/15563316231208423. Epub 2023 Nov 8.
Increasing numbers of patients are undergoing total joint arthroplasty as a treatment for osteoarthritis, which can be an anxiety-provoking experience. Setting expectations through a preoperative physical therapy (pre-op PT) session can alleviate some of these stressors, potentially decrease hospital length of stay (LOS), and promote home discharge.
We sought to determine whether attending a pre-op PT session is associated with decreased hospital LOS and home discharge in total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients.
A retrospective cohort study was performed of 20,822 patients who underwent THA or TKA between January 2020 and December 2023. Pre-op PT attendance and covariates, including patient demographics and clinical data, were collected and analyzed for association with LOS and discharge disposition.
Unadjusted univariate analysis revealed that THA and TKA patients who received pre-op PT had a significantly lower average LOS and were more likely to be discharged home. Our multivariate regression model showed that pre-op PT was not significantly associated with LOS in both groups but was significantly associated with home discharge among THA patients.
Our retrospective study of the effect of pre-op PT education on LOS and discharge disposition for elective THA and TKA patients found different results in univariate and multivariate analysis. Further study is needed to confirm the association found on multivariate analysis between pre-op PT and home discharge in THA patients.
越来越多的患者接受全关节置换术来治疗骨关节炎，这可能是一段令人焦虑的经历。通过术前物理治疗（术前PT）环节来设定预期，可以缓解其中一些压力源，有可能缩短住院时间（LOS），并促进出院回家。
我们试图确定参加术前PT环节是否与全髋关节置换术（THA）和全膝关节置换术（TKA）患者的住院时间缩短和出院回家有关。
对2020年1月至2023年12月期间接受THA或TKA手术的20822例患者进行了一项回顾性队列研究。收集术前PT参与情况以及包括患者人口统计学和临床数据在内的协变量，并分析其与住院时间和出院处置的相关性。
未经调整的单因素分析显示，接受术前PT的THA和TKA患者的平均住院时间显著更短，且更有可能出院回家。我们的多因素回归模型显示，术前PT在两组中与住院时间均无显著相关性，但在THA患者中与出院回家显著相关。
我们对术前PT教育对择期THA和TKA患者住院时间和出院处置影响的回顾性研究在单因素和多因素分析中得出了不同结果。需要进一步研究来证实多因素分析中发现的术前PT与THA患者出院回家之间的相关性。
