Does Accelerated Physical Therapy After Elective Primary Hip and Knee Arthroplasty Facilitate Early Discharge?

Overview

Accelerated physical therapy (PT) protocols are a potential mechanism for achieving early mobilization and safe discharge from hospital after elective primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). We compared 2 groups of patients who underwent elective unilateral THA or TKA-those who started PT the same day (Day 0) and those who started PT the next day (Non-Day 0). The difference in mean (SD) hospital length of stay between the Day 0 and Non-Day 0 groups was not statistically significant for THA patients, 2.26 (0.11) days vs 2.50 (0.15) days (P = .270), or TKA patients, 2.28 (0.66) days vs 2.35 (0.75) days (P > .05). A higher proportion of THA patients in the Day 0 group (16%) vs the Non-Day 0 group (6%) achieved discharge goals on postoperative day 1 (P = .04). This effect was not present for TKA patients. Day-of-surgery PT helped THA patients (but not TKA patients) achieve discharge goals on postoperative day 1.