Can 365-day physiotherapy service improve the outcome of patients with total knee arthroplasty?

Abstract

Introduction: Physiotherapy to patients with Total Knee Arthroplasty (TKA) has been extended to daily service since 1st Oct 2017 in Queen Mary Hospital. We sought to evaluate the 365-day physiotherapy service to these patients by analyzing the hospital length of stay (LOS) and Timed-up & go test (TUGT). Methodology: Patients with primary unilateral TKA performed between 1 Jan 2017 and 31 March 2018 who were directly discharged home from Queen Mary Hospital were reviewed. They were divided into 2 groups: before (non-365 group) and after the daily physiotherapy service started (365 group). LOS(s) and TUGT(s) were compared. Results and Analysis: There were 54 patients in non-365 group and 46 patients in 365 group. Baseline assessment of both groups was similar. The average LOS of non-365 group was 7.6 ± 1.9 days and the 365 group was 6.9 ± 1.8 days. The difference between the two groups was statistically significant (p=0.04). The TUGT upon discharge for non-365 group was 51.2 ± 32.8 seconds whereas for 365 group was 34.2± 18.5 seconds. There was statistical significant difference between two groups (p=0.005). Discussion and Conclusion: The enhancement in provision of physiotherapy service was associated with the improvement in the mobility of patient (TUGT upon discharge) and shortening of hospital LOS. This echoed with previous studies which had found that increasing therapy dose was effective in reducing LOS and improving patient outcomes. In conclusion, the service enhancement was effective in managing patients with TKA.