Article

Objective: To investigate the association between rehabilitation timing and the
occurrence of post-total knee arthroplasty complications and related medical
service utilization. Methods: Data from Taiwan's National Health Insurance
Research Database from 2003-2006 were used to perform a retrospective study on
patients who received their initial total knee arthroplasty during 2004-2005 (a
total of 21,143 subjects). All subjects were divided into 1 of 3 groups based on
the timing of their rehabilitation after total knee arthroplasty, namely, the
within 2 weeks group, the after 2 weeks group or the no-rehabilitation group.
Results: We found that patients in the no-rehabilitation group and the after 2
weeks group had higher incidences of prosthetic infection (odds ratio (OR) =
1.29, p = 0.0409; OR = 1.66, p = 0.0012) and deep venous thrombosis (OR = 1.51, p
= 0.0099; OR = 2.07; p = 0.0007) than in the within-2-weeks group. In addition,
compared with the within-2-weeks group, the after 2 weeks group had higher total
medical expenses (exponentiated regression coefficient: Exp. (beta) = 1.07, p =
0.0211), and the no-rehabilitation group had lower total medical expenses (Exp.
(beta) = 0.01, p < 0.0001). Conclusion: The results of this study indicated that,
because the incidence rates of complications and medical service utilization
among total knee arthroplasty patients in the within 2 weeks group were lower
than in the after 2 weeks group, the timing of rehabilitation may be 1 factor
affecting post-TKA complications and promoting high levels of medical service
utilization. These findings could be useful for clinicians and health
policymakers attempting to improve total knee arthroplasty services.

Langue : ANGLAIS