Prehabilitation Could Help Knee and Hip Replacement Patients Recover

Physical therapy prior to knee or hip replacement cut down on need for rehabilitation and reduced cost

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) With the number of total knee and hip replacements on the rise, doctors are looking for ways to reduce the amount of care needed after surgery. Prehabilitation (physical therapy before surgery) could help patients recover faster and save money.

Rehabilitation following knee or hip replacement is the standard of care. The physical therapy is designed to help patients adjust to new joints and strengthen muscles.

A new study found that physical therapy before the joint replacement surgeries reduced the need for rehab after the surgery.

Richard Snow, DO, MPH, and colleagues reviewed Medicare and Medicaid claims data from 4,733 patients who received a total knee or hip replacement.

Knee or hip replacement swaps out the natural joint with an artificial device. The surgeries are often needed to repair damage from arthritis, which is marked by pain and swelling in the joints.

The authors projected that the number of total hip replacements will grow by 174 percent to 572,000 patients every year by 2030. The same projection for total knee replacements is 3.48 million annually by 2030.

Dr. Snow and team reported that the average hospital stay following the surgeries was 3.7 days in 2008.

The claims review showed that 77 percent of patients used rehabilitation following the surgeries.

Post-surgery care decreased to 54.2 percent if that patient also went through physical therapy before surgery.

Using pre-operative care was associated with a 29 percent decrease in post-operative care. The reduction also came with a $1,215 cut in costs for skilled nursing, home health and inpatient rehab care.

The authors suggested that patient outcomes were better with prehabilitation because the patients learned to use walking devices, planned for recovery and better managed their expectations.

Their data “can be used in the development of cost-effective and value-based total joint replacement programs,” the authors wrote.

They called for more research into the best combination of pre- and post-operative care.

The study was published online Oct. 1 in the Journal of Bone and Joint Surgery.

The OhioHealth Research Institute provided travel funding for a co-author. A co-author disclosed a financial relationship with a biomedical company with a perceived interest in the study.

Review Date: 
October 7, 2014
Last Updated:
October 8, 2014