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    New in the Literature: Effect of Postoperative Physical Therapy on LOS (J Arthroplasty. 2012 Mar 2. [Epub ahead of print])

    To study the isolated effect of physical therapy on total joint arthroplasty hospital length of stay (LOS), researchers from the University of Pittsburgh conducted a prospective cohort study on 136 patients with primary total joint arthroplasties (58 hips, 78 knees). LOS was determined by the operative start time until the time of discharge. On postoperative day (POD) 0, 60 patients remained in bed, 51 moved to a chair, and 25 received physical therapy (22 ambulated, 3 moved to a chair). LOS differed for patients receiving physical therapy on POD 0 (2.8 ± 0.8 days) compared with POD 1 (3.7 ± 1.8 days). There was no difference in physical therapy treatment based on nausea/vomiting, pain levels, or discharge location. Isolated physical therapy intervention on POD 0 shortened hospital LOS, regardless of the intervention performed.

    This article was published online March 2 in The Journal of Arthroplasty.


    Comments

    Thanks for some current information about length of stay for total joint arthroplasty for hospitals.
    Posted by Heidi Harris -> ?IQZDF on 3/23/2012 2:05 PM
    I see this trend in our orthopaedic hospital. Patients that get up POD#0 progress as if it were POD#2 on POD#1.
    Posted by wendy lance on 3/23/2012 10:39 PM
    I have stood on this soap box for years. Thanks for the documentation.
    Posted by Court Burkham on 3/24/2012 8:11 AM
    I feel vindicated! I was repromanded while on one of my clinicals for standing a patient on POD#1 34 yrs. ago. How times have changed. Thank you U of Pitt.
    Posted by Don Smith on 4/3/2012 7:41 PM
    I agree, however I am running into a major safety issue. If I attempted to stand or ambulate day 0 I run into total quad nerve block.
    Posted by Chuck porter on 4/3/2012 11:24 PM
    In response to Chuck Porter's comment, do you have Safe Patient Handling equipment at your facility? There are excellent solutions to this problem
    Posted by Margaret Arnold on 4/5/2012 10:25 AM
    In response to Margaret Arnold: what equipment do you find essential? I want my staff to be safe when working with tall/ heavy patients who we tend to see often.
    Posted by Paul Hoover on 4/5/2012 7:25 PM
    We initially experienced poor quad control with "Q-pump" IV nerve blocks on total knees. We went to 2 people assist with first day standing/ambulation and/or knee immobilizer for 1-2 days on involved leg. We asked other facilities within our national system - they had the same issue - and did the same response. Anaesthesia has improved their med control with fewer problems know. Our typical LOS is 3 days for total hips and knees. We get 'em up POD#1 2X/day. 90% amb X 200' by discharge.
    Posted by Lynn Johnson on 4/5/2012 11:25 PM
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