Tuesday, September 12, 2017

After Knee surgery, should you rehabilitate at home or the hospital?

I have had my knee replaced and I may have to have my second knee replaced because I have osteoarthritis, so I was interested in the results of this study done by Donghai Li, Zhouyuan Yang, Pengde Kang, Xiaowei Xie. which was published by the  American journal of physical and medical rehabilitation in  August 2016 Aug.

The researchers asked the question “How does home-based rehabilitation compare to hospital-based rehabilitation in terms of quality of life and physical performance after hospital discharge following knee replacement surgery for osteoarthritis?”

This is a great question because I did my rehabilitation at home but the hospital based rehab was an option that was presented to me. For a number of reasons, I chose not to use this option and did my rehabilitation at home.

Many of us who undergo knee replacement surgery to treat pain and joint dysfunction resulting from osteoarthritis. However, upon discharge, we have a number of options and a choice of numerous rehabilitation programs. What I was not aware of was that there was little evidence or no evidence supporting their effectiveness.

Currently, patients are discharged to home after knee replacement surgery and receive outpatient rehabilitation routinely at the hospital. However, one idea catching interest is home-based rehabilitation which allows patients to receive physiotherapy and rehabilitation in their homes.

This study aimed to compare home-based with hospital-based rehabilitation after knee replacement surgery for osteoarthritis patients, in terms of quality of life and physical performance improvements.

How the review was done
A detailed search of four electronic databases was conducted for studies published from 1974 to February 2016. Studies that compared the effects and costs of home-based rehabilitation to hospital-based rehabilitation after knee replacement surgery for osteoarthritis patients were included.

A total of 168 studies were identified in searches, and seven were included in the review after assessments for eligibility.

This review was funded with support from the National Natural Science Fund of China.

What the researchers found
This review found that home-based rehabilitation is similar to hospital-based rehabilitation in terms of physical performance at 12 and 52 weeks post-surgery.

The review also found that the hospital-based group had less pain than the home-based group. However, the range of motion of knee flexion in the home-based group was better than the hospital-based group.

This review found that the costs of the two rehabilitation programs were similar. 

Conclusion
This review found that the use of home-based rehabilitation is comparable to hospital-based rehabilitation, in terms of quality of life and physical performance of patients such as knee range of motion. The study concludes that rehabilitation at home can be recommended as an alternative. However, these results should be used with caution as further research with more participants is required.

Having completed my rehabilitation at home, I am in favour of the home alternative, but that is based on personal experience, not research.


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