Getting people moving after hip and knee replacement: The benefits of mobilising on the day of surgery

Mr David Jovic1, Ms Renee Wilson

1THS-north, West Launceston, Australia

Background

The LGH has seen a dramatic increase in the number of hip and knee arthroplasty surgeries since July 2016. Previously, the average length of stay (LOS) at LGH was 5.4 days. This was above the average LOS for similarly sized hospitals. Mobilisation of patients on the day of hip/knee arthroplasty had been described in the literature as a potential option in reducing length of stay in this population.

 Methods

This is a prospective observational cohort study, assessing the impact of early mobilisation on length of stay after hip/knee replacement at the LGH. Patient selection was based on Physiotherapy staff capacity on the day of operation. Mobilisation was defined as weight bearing on the new joint with the Physiotherapist. The data captured represents all patients who underwent elective hip or knee arthroplasty between May 2016 and May 2017.

 Results

244 hip/knee replacements occurred at the LGH. 26% of patients were able to be mobilised on the day of operation, with the main barrier being Physiotherapy staffing constraints. 87% of patients were mobilised by the end of the first post-operative day. Univariate analysis indicates there was a difference in terms of patient age and length of procedure between the 2 groups (p<0.05). The rate of adverse events was not statistically different (1.5% in day 0 Vs 2.2% after day 0, p=0.46). The average LOS was reduced between patients mobilised on the day of the operation, as compared to those mobilised after day 0 (4.0 Vs 5.3 days, p<0.001). Rehabilitation needs were similar in patients who were mobilised on day 0.

 Conclusion

Further statistical analysis is required. However, this data demonstrates that mobilisation on the day of arthroplasty has the potential to safely reduce length of stay. This data will aid discussions related to Physiotherapy resource utilisation in hip and knee arthroplasty.

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