Even patients who live alone can recover effectively and safely from total knee or hip replacement surgery at home rather than at an inpatient rehabilitation facility, according to a new study.
“In the past, most surgeons have been reticent to discharge patients directly home after joint replacement surgery if they live by themselves; instead, opting for such patients to enter a rehab facility,” says William J. Hozack, MD, lead author of the study, presented at the Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).
“However, we found that patients living alone were able to safely recover without any increase in the rate of complications. Even more strikingly, patients were generally happy and content being in the comfort of their own home during recovery,” adds Hozack, an orthopaedic surgeon at The Rothman Institute and professor of orthopaedic surgery at the Sidney Kimmel Medical College at Thomas Jefferson University, in a media release from the AAOS.
Among the 769 study participants (several of whom were age 75 or older) who underwent THR or TKR surgery, 138 patients lived alone and 631 lived with other people.
The patients who lived alone—especially the older patients—were more likely to stay an additional night in the hospital prior to discharge and utilize more home health services. Approximately 38% of patients living alone reported receiving limited support without weekly visits. However, nearly 80% of them had a friend or relative living within 15 miles who could provide help if needed, per the release.
According to the study results, 10.9% of patients living alone had complications, compared with 9.5% of those recovering at home with support; and there were no significant differences in functional outcomes following surgery, or in reported pain, among both groups.
In addition, patient satisfaction scores were equivalent among both groups after 90 days; and the cost savings for patients who recovered at home was estimated at $10,776 per patient, or nearly $1.5 million total.
Given these results, Hozack and his team “believe home discharge is appropriate for the vast majority of patients undergoing joint replacement, including the nearly 20 percent of patients living on their own,” the release notes.
[Source(s): American Academy of Orthopaedic Surgeons, PR Newswire]
I think this shows a lot of the things that could be hypothesized, but it’s important to illuminate them. I can see many people wanting to stay another night if they don’t have any help at home. I know I would if I was in the hospital.
Nothing is mentioned about their Muscle Strength, normalcy of gait that is reintegration of the operated leg into normal movement patterns.
Successful outcomes are best based of longer than 6 months. There is the possibility of loosening of the prosthesis due to decreased muscle strength etc. This research seems too short term to truly define sucess and a larger population is needed since replacements are done in the thousands per year.