NDLI: Pre- and postoperative physiotherapy using a digital application decreases length of stay without reducing patient outcomes following total knee arthroplasty

Content Provider	Springer Nature : BioMed Central
Author	Hardwick-Morris, Max Carlton, Simon Twiggs, Joshua Miles, Brad Liu, David
Abstract	Introduction Total Knee Arthroplasty (TKA) for both patients and the surgical team is a journey spanning many months, rather than purely a hospital episode of care. To improve patient outcomes and reduce costs in TKA, greater emphasis should be placed on the pre- and postoperative periods as, historically, innovation has focused on the intraoperative execution of the surgery. The purpose of this study was to determine if a pre- and postoperative physiotherapy program delivered via a digital application could reduce hospital length of stay (LOS) without compromising patient outcomes. Methods A retrospective series of 294 patients who underwent TKA from a single-surgeon in a single-centre was examined. This included 232 patients who underwent a pre- and postoperative physiotherapist-led program delivered via a digital application and 62 patients who underwent a conventional pre- and postoperative protocol. 2:1 nearest neighbour propensity score matching was performed to establish covariate balance between the cohorts. Data collected included pre- and postoperative Knee Injury and Osteoarthritis Outcome Score (KOOS), KOOS for Joint Replacement (KOOS, JR), and acute, rehabilitation, and total LOS. Results No significant difference in KOOS or KOOS, JR scores was observed at 12-month follow-up. A significantly reduced rehabilitation (P = 0.014) and total LOS (P = 0.015) was observed in the patients who received the digital physiotherapy program. Conclusions There may be significant economic benefits to a pre- and postoperative physiotherapy program delivered via a digital application. Our results suggest that a digital physiotherapist-led patient program may reduce the need for inpatient rehabilitation services without compromising patient outcomes.
Related Links	https://arthroplasty.biomedcentral.com/counter/pdf/10.1186/s42836-022-00133-8.pdf
Ending Page	13
Page Count	13
Starting Page	1
File Format	HTM / HTML
ISSN	25247948
DOI	10.1186/s42836-022-00133-8
Journal	Arthroplasty
Issue Number	1
Volume Number	4
Language	English
Publisher	BioMed Central
Publisher Date	2022-08-02
Access Restriction	Open
Subject Keyword	Orthopedics Rehabilitation Total knee arthroplasty (TKA) Digital application Patient outcomes Length of stay
Content Type	Text
Resource Type	Article
Subject	Orthopedics and Sports Medicine Surgery
Journal Impact Factor	2.3/2023
5-Year Journal Impact Factor	2.3/2023

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