Article

The number of total knee arthroplasty (TKA) procedures performed in
the United States is increasing each year, and the number of bilateral TKA
procedures has also increased during the past 2 decades. However, few studies in
the literature have investigated the rehabilitation outcomes of patients who
undergo bilateral TKA. This study was performed to provide information on the
benefits and role of inpatient rehabilitation for patients after bilateral TKA.
OBJECTIVE: To investigate the functional outcomes, complications, and transfer
rates of patients in the inpatient rehabilitation setting who undergo
simultaneous bilateral TKA. DESIGN: Retrospective cohort study. SETTING:
Freestanding inpatient rehabilitation hospital. PATIENTS: Ninety-four patients
admitted to an inpatient rehabilitation hospital after simultaneous bilateral TKA
from 2008-2013. METHODS: Retrospective chart review of demographic, clinical, and
functional data for patients admitted to inpatient rehabilitation after
simultaneous bilateral TKA. MAIN OUTCOME MEASURES: Length of stay, admission and
discharge Functional Independence Measure (FIM), and FIM efficiency. RESULTS: The
study included 27 male (28.7%) and 67 female (71.3%) patients aged 42.0-86.9
years, with a mean of 65.6 +/- 10.2 years. Mean length of time between surgery
and admission to inpatient rehabilitation was 4.5 +/- 3.3 days. Mean length of
stay in rehabilitation was 11.7 +/- 4.2 days. Mean admission and discharge FIM
scores were 87.3 +/- 11.7 and 113.4 +/- 4.8, respectively, with a mean FIM gain
of 26.1 +/- 10.5. The mean FIM efficiency was 2.33 +/- 0.84. Eight patients
required transfer to an acute care hospital. Complications leading to transfer to
acute care facilities included sepsis, cardiac arrhythmias, knee dislocation, and
suspected small bowel obstruction. Eighty-eight patients were discharged home, 4
patients were discharged to skilled nursing facilities, and 2 patients were
transferred to an acute care hospital and did not return to the inpatient
rehabilitation hospital. CONCLUSIONS: After undergoing simultaneous bilateral
TKA, patients demonstrate functional gains when admitted to inpatient
rehabilitation facilities based on FIM gains and FIM efficiency scores; 8.5% of
patients in this cohort required transfer to an acute care facility as a result
of complications during inpatient rehabilitation, and 93.6% of patients were
discharged home.
CI - Copyright (c) 2016 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS