Second-Order Peer Reviews of Clinically Relevant Articles for the Physiatrist: Effect of Inpatient Rehabilitation vs a Monitored Home-Based Program on Mobility in Patients With Total Knee Arthroplasty
The number of joint replacements being performed in Canada and the United States is increasing at a rapid rate. In 2014–2015, more than 61,000 total knee arthroplasties were performed in Canada, a 20.3% increase from 5 yrs ago.1 In the United States, the number of total knee arthroplasties increased for a 10-yr period by 86% in men and by 99% in women.2 Accompanying the growing demand for total knee arthroplasties is the demand on hospitals for inpatient bed space to provide both immediate postsurgical recovery and initial physiotherapy. In a resource-constrained environment, an important question becomes how long should inpatient physiotherapy be provided to this population beyond the initial postoperative period. This review critically appraises a recent study that aims to address the question of whether hospitals can minimize length of stay without compromising total knee arthroplasty patient outcomes through a program of home-based rehabilitation rather than inpatient rehabilitation postsurgery.