Follow-up of patients after hip and knee replacement at the LGH in 2017

Mr David Jovic,1 Mrs Margot Lowther,1 Mr Thomas Senyard1

1.THS-north West Launceston Tasmania

Introduction

In financial year 2014-15, the LGH Orthopaedic Department completed a total of 186 hip and knee replacements. Between February and August 2017, 172 hip and knee replacements have been completed at the LGH. Prior to 2017, patients were seen in 1:1 clinical environment, dependant on their discharge location. The primary aim of this study was to ascertain whether Arthroplasty Group Rehabilitation (AGR) provided timely, goal orientated rehabilitation that met patients needs and satisfaction

Methods

Data has been collected for all patients who undertook hip or knee replacement for osteoarthritis from February 2017. Preoperative data was collected including Oxford Hip/Knee Score (OHKS), TUGT and RAPT. Data was collected around discharge destination and subacute rehabilitation requirements. AGR collected pre and post exercise/education group data, including patient specific functional scale, OHKS and EQ5D, as well as a post group satisfaction survey.

Results

45/172 patients were discharged to AGR (27%). On average they were followed up at 10 days postop. Forty patients were discharged back to the districts. 20 patients were discharged to subacute rehab (13%).  83% of patients achieved their goals, defined as PSFS >8/10, after attending 6 weeks of group practice. OHKS score improved by 35% on average over the 6 weeks. Patients satisfaction with AGR was very high. However, satisfaction with education of patients at discharge from the acute hospital was seen as poor.

Conclusion

AGR is a feasible option for the follow up of patients post hip or knee arthroplasty. AGR appears to provide a timely, patient centred and evidence based option for this population. The process has also provided important feedback for Physiotherapists on the Orthopaedic Ward in relation to planning follow-up care.

 

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