It Doesn’t Matter Where You Get Your Rehab for Total Knee Replacements - 16 Sept

. One area for protecting the healthcare dollar is to make sure rehab is as efficient as possible. The amount spent on rehab can vary from less than $2,000 to more than $15,000. The primary variable is whether a patient receives rehab as an inpatient, at home, or at an outpatient practice such as Advanced Physiotherapy. Outpatient rehab is by far the least expensive.

People may assume that more expensive rehab must be better. Researchers have repeatedly studied this question, and it turns out that setting is not terribly relevant to results. One study found that patients receiving twice-daily inpatient rehab did not fare better than patients receiving home health rehab a few times per week.(1) Two other trials studied whether patients do better with home health rehab or outpatient rehab. One study found that the results were not different,(2) while another found that outpatients achieved better results in terms of stair climbing, timed walking, leg strength, and pain.(3) The setting of your post-surgical rehab isn’t about the quality of the rehab. It’s about how much help a person needs with activities of daily living such as bathing, eating, and going into town. The more help a person needs with daily living, the more intensive setting that person needs. When you and your family are ready to take care of basic needs at home, you’ll be eligible for cost-saving, equally effective, outpatient rehab.

However, within each setting, there can be major differences. Not all outpatient practices are alike. Advanced Physiotherapy, for instance, has the Alter G, the most advanced equipment in unweighted gait training. Moreover, we know knees. With over 7,000 knees treated, Advanced Physiotherapy has a specialised lower-limb team of physiotherapists. Additionally, our patients can use our gym between appointments at no additional charge. When it comes to knee, ankle, and hip pain, remember Advanced Physiotherapy for truly advanced care.

References:

1. Buhagiar M, Naylor J, Harris I, et al. Effect of inpatient rehabilitation vs a monitored home-based program on mobility in patients with total knee arthroplasty. JAMA. 2017; 317 (10): 1037-1046.
2. Warren M, Kozik J, Cook J, Prefontaine P, Ganley K. A comparative study to determine functional and clinical outcome differences between patients receiving outpatient direct physical therapy versus home physical therapy followed by outpatient physical therapy after total knee arthroplasty. Orthopaedic Nursing. 2016 Nov 1;35(6):382-90.
3. Christensen JC, Paxton RJ, Baym C, Forster JE, Dayton MR, Hogan CA, Stevens-Lapsley JE. Benefits of direct patient discharge to outpatient physical therapy after total knee arthroplasty. Disability and Rehabilitation. 2018 Aug 30:1-7.