Determinants and outcomes of inpatient versus home based rehabilitation following elective hip and knee replacement

Objective. There are large variations in practice patterns and costs of reh abilitation following total joint replacement (TJR). We evaluated the deter minants of rehabilitation setting (home based vs inpatient) after TJR, and its influence on early functional outcomes. Methods. We studied a retrospective cohort of 146 primary total hip and kne e replacements. Ninety-six patients completed a mailed survey consisting of the Western Ontario and McMaster University Osteoarthritis Index (WOMAC), the Medical Outcomes Survey Short Form-36 (SF-36), and a satisfaction quest ionnaire. Results. The mean age of the cohort was 66 years, 70% were women, and osteo arthritis was the primary diagnosis in 79%. Thirty-nine percent received ho me based rehabilitation. Determinants of home based rehabilitation included preference for home based rehabilitation, male sex, and knowledge regardin g TJR. At a mean followup of 8 months post TJR, there were no significant d ifferences between the inpatient and home based rehabilitation groups with respect to the WOMAC, SF-36; and satisfaction scores. Conclusion. These results support continued use of home based rehabilitatio n.