scholarly journals Establishment of Qualified Integrated Care System after Total Knee Arthroplasty as a Role of Regional Rheumatoid and Degenerative Arthritis Center

2021 ◽  
Author(s):  
Eun Young Han ◽  
Sang Rim Kim ◽  
Sang Hee Im
Keyword(s):  
Total Knee Arthroplasty ◽  
Integrated Care ◽  
Knee Arthroplasty ◽  
Rehabilitation Program ◽  
Policy Support ◽  
Degenerative Arthritis ◽  
Socioeconomic Characteristics ◽  
Total Knee ◽  
Intensive Rehabilitation ◽  
Care System

Abstract Elderly population and advanced knee osteoarthritis are rapidly increasing in Korea and the socioeconomic burden of total knee arthroplasty (TKA). This study aimed to analyze the demographic, clinical and socioeconomic characteristics in patients who underwent TKA and to differentiate the factors affecting participation in inpatient- intensive rehabilitation program after TKA in oo regional rheumatoid and degenerative arthritis center established by government. This retrospective cohort study included 845 patients (735 females; 72.0 ± 5.8 years) diagnosed with primary osteoarthritis (OA) of the knee and who performed an elective unilateral primary TKA between January 2013 and June 2016. Demographic, clinical and socioeconomic characteristics including age, body mass index, obesity, length of stay, OA severity, underlying disease, education level, occupation, location of residence) were reviewed and Patients were allocated to TKA only group (home discharge) and to TKA + rehab group (participation in post-TKA rehabilitation). The variables were analyzed and compared before and after establishment of center and according to participation in intensive rehabilitation. They showed predominance of female and elderly and high prevalence of comorbidities and obesity. Also, the only factor differentiating participation in intensive rehabilitation was the location of residence. Therefore, the regional rheumatoid & degenerative arthritis center was appropriate to meet the high need for participating in intensive rehabilitation after TKA and for the qualified integrated post-TKA care system. The policy support should ensure early rehabilitation and qualified integrated care system and prepare for the increased burden of revision and the future longitudinal study should be conducted for long-term effect of the integrated post-TKA rehabilitation program on functional outcome and patients’ survivorship free from revision.

scholarly journals Establishment of a Qualified Integrated Care System After Total Knee Arthroplasty as a Role of Regional Rheumatoid and Degenerative Arthritis Centers

2021 ◽  
Author(s):  
Eun Young Han ◽  
Sang Rim Kim ◽  
Sang Hee
Keyword(s):  
Total Knee Arthroplasty ◽  
Integrated Care ◽  
Knee Arthroplasty ◽  
Policy Support ◽  
Degenerative Arthritis ◽  
Geriatric Population ◽  
Socioeconomic Characteristics ◽  
Total Knee ◽  
Intensive Rehabilitation ◽  
Care System

Abstract Background: The geriatric population and advanced knee osteoarthritis are rapidly increasing in Korea, and the socioeconomic burden of total knee arthroplasty (TKA) is increasing. This study aimed to analyze the demographic, clinical and socioeconomic characteristics of patients who underwent TKA and to differentiate the factors affecting participation in inpatient-intensive rehabilitation programs after TKA in oo regional rheumatoid and degenerative arthritis centers established by the government.Methods: This retrospective cohort study included 845 patients (735 females; 72.0±5.8 years) diagnosed with primary osteoarthritis (OA) of the knee who underwent elective unilateral primary TKA between January 2013 and June 2016. Demographic, clinical and socioeconomic characteristics, including age, body mass index, obesity, length of stay, OA severity, underlying disease, education level, occupation, and location of residence, were reviewed. Patients were allocated to the TKA-only group (home discharge) and to the TKA+ rehab group (participation in post-TKA rehabilitation). The variables were analyzed and compared before and after the establishment of the center and according to participation in intensive rehabilitation.Results: They showed a predominance of females and geriatrics and a high prevalence of comorbidities and obesity. Additionally, the only factor differentiating participation in intensive rehabilitation was the location of residence.Conclusion: The regional rheumatoid and degenerative arthritis center was appropriate to meet the high need for participating in intensive rehabilitation after TKA and for the qualified integrated post-TKA care system. Policy support should ensure early rehabilitation and a qualified integrated care system and prepare for the increased burden of revision, and future longitudinal studies should be conducted to assess the long-term effect of the integrated post-TKA rehabilitation program on functional outcomes and patient survivorship free from revision.

scholarly journals Force-plate analyses of balance following a balance exercise program during acute post-operative phase in individuals with total hip and knee arthroplasty: A randomized clinical trial

2016 ◽  
Vol 4 ◽  
pp. 205031211667509 ◽  
Author(s):  
Pankaj Jogi ◽  
Aleksandra Zecevic ◽  
Tom J Overend ◽  
Sandi J Spaulding ◽  
John F Kramer
Keyword(s):  
Total Knee Arthroplasty ◽  
Total Hip Arthroplasty ◽  
Knee Arthroplasty ◽  
Hip Arthroplasty ◽  
Force Plate ◽  
Exercise Program ◽  
Rehabilitation Program ◽  
Total Hip ◽  
Balance Exercises ◽  
Total Knee

Objectives: Typical rehabilitation programs following total hip arthroplasty and total knee arthroplasty include joint range of motion and muscle-strengthening exercises. Balance and balance exercises following total hip arthroplasty and total knee arthroplasty have not received much attention. The purpose of this study was to determine whether an intervention of balance exercises added to a typical rehabilitation program positively affects patients’ balance. Methods: A total of 63 patients were provided with outpatient physical therapy at their home. Patients were randomly assigned to either typical (n = 33) or balance (n = 30) exercise group. The typical group completed seven typical surgery-specific joint range of motion and muscle-strengthening exercises, while the balance group completed the typical exercises plus three balance exercises. After 5 weeks of administering the rehabilitation program, patients’ balance was assessed on a force plate using 95% ellipse area of the center of pressure amplitude. Results: Patients in the balance group demonstrated significant reduction in the 95% ellipse area for the anterior and posterior lean standing conditions (p < 0.01). Conclusion: Balance exercises added to the typical outpatient physical therapy program resulted in significantly greater improvements in balance for participants with total hip arthroplasty or total knee arthroplasty, compared to the typical exercise program alone. Physical therapists might consider the use of balance exercises to improve balance in individuals in the acute post-operative phase following total hip arthroplasty or total knee arthroplasty.

Clinical Application of TCM-Characteristic Rehabilitation Program after Total Knee Arthroplasty

2021 ◽  
Author(s):  
Xin-Xia Gao ◽  
Xiong Xiao ◽  
Ying Chen ◽  
Li Yang ◽  
Yun-Xia Zhang ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Treatment Group ◽  
Knee Arthroplasty ◽  
Rehabilitation Program ◽  
Control Group ◽  
Pain Scores ◽  
Total Knee ◽  
Random Number Table ◽  
The Difference

<B>Objective:</B> To evaluate the effect of traditional Chinese medicine (TCM)-characteristic rehabilitation program on levels of pain and swelling after total knee arthroplasty. <B>Methods:</B> A total of 72 in-patients who recovered from total knee arthroplasty in our department were selected as the study subjects. They were divided into two groups according to a random number table: the control group (n = 36) with routine nursing and the treatment group (n = 36) with TCM rehabilitation nursing. The pain scores and joint swelling were statistically analyzed. <B>Results:</B> The pain scores in the treatment group were lower than those in the control group, and the difference was statistically significant (P < 0.05).<B>Conclusion:</B> The implementation of a TCM rehabilitation program for patients after total knee arthroplasty can effectively and quickly reduce the pain and swelling of the affected limb, promote the local blood circulation, and promote the quality of life of patients after rehabilitation.

scholarly journals Total Knee Arthroplasty for the Oldest Old

Geriatrics ◽  
2021 ◽  
Vol 6 (3) ◽  
pp. 75
Author(s):  
Carmen da Casa ◽  
Helena Fidalgo ◽  
Javier Nieto ◽  
Enrique Cano-Lallave ◽  
Juan F. Blanco
Keyword(s):  
Total Knee Arthroplasty ◽  
Emergency Room ◽  
Knee Arthroplasty ◽  
Hospital Readmission ◽  
Oldest Old ◽  
Age Groups ◽  
Length Of Hospital Stay ◽  
Rehabilitation Program ◽  
Emergency Room Visits ◽  
Total Knee

The present study describes and compares the early functional results after total knee arthroplasty (TKA) of the oldest-old population (aged over 84 years) and a randomly matched younger septuagenarian cohort so treated. We aimed to evaluate the early functional outcomes after patients’ rehabilitation and the yearly requirements for hospital readmission and emergency room visits after TKA. We noted a similar length of hospital stay for octogenarian and septuagenarian patients, and we determined that both groups of patients were improving ROM (both flexion and extension) after the rehabilitation program (p < 0.05, in all cases), but there were no significant differences between octogenarian and septuagenarian improvement of the knee function (p > 0.05, in all cases). Patients from both age groups behaved similarly in terms of mobility before starting rehabilitation and after completion of the rehabilitation program. We noted that older octogenarian patients showed a higher one-year hospital readmission rate than younger septuagenarian patients, but similar early emergency room visits for both age groups. The findings of this study allow us to conclude that advanced age in itself should not be a contraindication for TKA.

scholarly journals The economic impact of periprosthetic infection in total knee arthroplasty

2021 ◽  
Vol 64 (2) ◽  
Author(s):  
Mina W. Morcos ◽  
Paul Kooner ◽  
Jackie Marsh ◽  
James Howard ◽  
Brent Lanting ◽  
...  
Keyword(s):  
Health Care ◽  
Total Knee Arthroplasty ◽  
Economic Impact ◽  
Health Care System ◽  
Knee Arthroplasty ◽  
Joint Infection ◽  
Accurate Estimate ◽  
Total Knee ◽  
Revision Tka ◽  
Care System

Background: Currently, the gold standard treatment for periprosthetic joint infection (PJI) after total knee arthroplasty (TKA) is 2-stage revision, but few studies have looked at the economic impact of PJI on the health care system. The objective of this study was to obtain an accurate estimate of the institutional cost associated with the management of PJI in TKA and to assess the economic impact of PJI after TKA compared to uncomplicated primary TKA. Methods: We identified consecutive patients in our institutional database who had undergone 2-stage revision TKA for PJI between 2010 and 2014 and matched them on age and body mass index with patients who had undergone uncomplicated primary TKA over the same period. We calculated all costs associated with the 2 procedures and compared mean costs, length of stay, clinical visits and readmission rates between the 2 groups. Results: There were 73 patients (mean age 68.8 [range 48–91] yr) in the revision TKA cohort and 73 patients (mean age 65.9 [range 50–86] yr) in the primary TKA cohort. Two-stage revision surgery was associated with a significantly longer hospital stay (mean 22.7 d v. 3.84 d, p <s; 0.001), more outpatient clinic visits (mean 8 v. 3, p < 0.001), more readmissions (29 v. 0, p < 0.001) and higher overall cost (mean $35 429.97 v. $6809.94, p < 0.001) than primary TKA. Conclusion: Treatment for PJI after TKA has an enormous economic impact on the health care system. Our data suggest a fivefold increase in expenditure in the management of this complication compared to uncomplicated primary TKA.

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