Article

The objective of this retrospective study was to evaluate the association of early
ambulation with length of stay, costs, and outcomes in inpatients undergoing
total knee arthroplasty.
DESIGN: This is a retrospective study of 1504 patients
who underwent total knee arthroplasty between August 2009 and January 2011 in a
tertiary teaching hospital. All patients commenced physiotherapy interventions on
postoperative day 1. The patients were categorized into an early ambulation group
(began ambulating on postoperative day 1; n = 803) or a late ambulation group
(began ambulating on postoperative day 2; n = 701). Multivariable regression and
propensity score analyses were used to reduce selection biases. RESULTS: Early
ambulation was associated with a statistically significant reduction in the
adjusted average length of stay (-0.44 day; P < 0.001) and adjusted average total
hospitalization costs (Singapore, -$385; United States, -$315; P < 0.001). Both
groups did not differ significantly in the 90-day readmission rate; however,
early ambulation was associated with higher odds of achieving at least 90 degrees
of knee flexion (adjusted odds ratio, 1.33; P < 0.01) and requiring a walking aid
with a smaller base of support (adjusted proportional odds ratio, 1.36; P < 0.001). CONCLUSIONS:
As little as a 1-day difference in the day of first
ambulation was associated with a shorter length of stay, lower hospitalization
costs, and improved knee function. The results of this study provide the first empirical support for the usefulness of early ambulation after total knee arthroplasty.
- Ambulation précoce

Langue : ANGLAIS