Background: Recent evidence suggests benefit to receiving physical therapy (PT) the same day as total joint arthroplasty (TJA), but relatively little is known about barriers to providing PT in this constrained time period. We address the following questions: (1) Are there demographic or perioperative variables associated with receiving delayed PT following TJA? (2) Does receiving immediate PT following TJA affect short-term outcomes such as length of stay, discharge disposition, or 30-day readmission? . Primary TJA procedures at a single center were retrospectively reviewed. Immediate PT was defined as within eight hours of surgery. Demographic and perioperative variables were compared between patients who received immediate PT and those who did not. We identified an appropriately matched control group of patients who received immediate PT. Postoperative length of stay, discharge disposition, and 30-day readmissions were compared between matched groups.
Results: In total, 2051 primary TJA procedures were reviewed. Of these, 226 (11.0%) received delayed PT. These patients had a higher rate of general anesthesia (25.2% versus 17.8%, p=0.006), later operative start time (13:26 [11:31-14:38] versus 9:36 [8:24-11:16], p<0.001), longer operative time (1.8 [1.5-2.2] versus 1.6 [1.4-1.8] hours, p=0.002), and higher overall caseload on the day of surgery (6 [4-9] versus 5 [4-8], p=0.002). A matched group of patients who received immediate PT was identified. There were no differences in postoperative length of stay or discharge disposition between matched immediate and delayed PT groups, but delayed PT (OR 4.54; 95% CI 1.61-12.84; p=0.004) was associated with a higher 30-day readmission rate.
Conclusion: Barriers to receiving immediate PT following TJA included general anesthesia, later operative start time, longer operative time, and higher daily caseload. These factors present potential targets for improving the delivery of immediate postoperative PT. Early PT may help reduce 30-day readmissions, but additional research is necessary to further characterize this relationship.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6476141 | PMC |
| http://dx.doi.org/10.1155/2019/6051476 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Anatomic variations in origin and coursing of the transverse cervical artery: morphogenesis and relation to the high arch-shaped subclavian artery.
Anat Sci Int
January 2025
Department of Anatomy, The Nippon Dental University School of Life Dentistry at Niigata, Niigata, Japan.
This case report presents an atypical transverse cervical artery with its detailed anatomy, morphogenesis, and association with the high arch-shaped subclavian artery. The atypical arteries, related arteries, and adjacent cervical and brachial plexuses were macroscopically examined in a 98-year-old Japanese female cadaver donated to The Nippon Dental University for medical education and research. The atypical deep branch of the transverse cervical artery originated from the internal thoracic artery and passed through between the C5 and C6 roots, in close contact with the C5 and C6 junction, to reach the dorsal side of the brachial plexus.
View Article and Find Full Text PDFAge-threshold for increased risk of developing back disorders: prospective cohort with 74 000 individuals from the UK Biobank.
Eur Spine J
January 2025
Exercise Intervention for Health Research Group (EXINH-RG), Department of Physiotherapy, University of Valencia, Valencia, Spain.
Objective: To investigate the prospective associations between age and the risk of low back disorders (LBD), dorsal disorders (DD), and cervical disorders (CD), and to identify a potential age-threshold for increased risk of back disorders.
Methods: Prospective cohort from the UK Biobank comprising adults with no history of back disorders. We examined different ages and their association with the risk of back disorders derived from diagnoses of hospital registers.
"The biggest challenge is there's never a routine": a qualitative study of the time burdens of cancer care at home.
Support Care Cancer
January 2025
Division of Hematology, Oncology, and Transplantation, University of Minnesota, 516 Delaware Street SE, MMC 480, PWB 14-100, Minneapolis, MN, 55455, USA.
Purpose: As cancer care is increasingly delivered in the home, more tasks and responsibilities fall on patients and their informal care partners. These time costs can present significant mental, physical, and financial burdens, and are undercounted in current measures of time toxicity that only consider care received in formal healthcare settings.
Methods: Semi-structured qualitative interviews were conducted with patients with gastrointestinal cancer and informal care partners at a single tertiary cancer center between March and October 2023.
Musculoskeletal symptoms associated with aromatase inhibitors in the treatment of early breast cancer: A scoping review of risk factors and outcomes.
Support Care Cancer
January 2025
Fudan University School of Nursing, Shanghai, China and Fudan University Centre for Evidence-Based Nursing: A Joanna Briggs Institute Centre of Excellence, 305 Fenglin Rd, Shanghai, 200032, China.
Purpose: Aromatase inhibitor-associated musculoskeletal symptoms (AIMSS) are the most common adverse effects experienced by breast cancer patients. This scoping review aimed to systematically synthesize the predictors/risk factors and outcomes of AIMSS in patients with early-stage breast cancer.
Methods: A systematic search was conducted in PubMed, Web of Science, EMBASE, CINAHL, and the China National Knowledge Internet (CNKI) from inception to December 2024 following the scoping review framework proposed by Arksey and O'Malley (2005).
A systematic review of portable technologies for the early assessment of motor development in infants.
NPJ Digit Med
January 2025
Technology & Innovation Hub, Shirley Ryan AbilityLab, Chicago, IL, USA.
Early screening and evaluation of infant motor development are crucial for detecting motor deficits and enabling timely interventions. Traditional clinical assessments are often subjective, without fully capturing infants' "real-world" behavior. This has sparked interest in portable, low-cost technologies to objectively and precisely measure infant motion at home, with a goal of enhancing ecological validity.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!