Pre-operative One-on-One Physical Therapy Education Improves Postoperative Function and Patient Satisfaction After Total Joint Arthroplasty

Hospital for Special Surgery, New York126 enrolled

Overview

The purpose of this study was to evaluate the efficacy of a one-time, preoperative physical therapy protocol on postoperative (1) discharge disposition, (2) pain, function and stiffness and (3) patient satisfaction.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

SUPPORTIVE_CARE

Masking

NONE

Enrollment

126

Conditions

Arthroplasty

Interventions

Preoperative Physical Therapy SessionBEHAVIORAL

This was a one-on-one preoperative physical therapy session on preoperative education. These patients were also given access to a surgery specific web-based microsite

Group Preoperative Education Session (per the standard of care)BEHAVIORAL

Eligibility

Sex: ALLMin age: 18 YearsMax age: 90 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Subjects will be required to meet the following inclusion criteria in order to participate: * Unilateral Primary Knee OA or Hip OA * Patients at least 18 years old up to 85. * Undergoing surgery with one of the following study surgeons * Able to independently ambulate ≥ half a block with or without assistive device * Able to independently perform non-reciprocal stairs with or without assistive device/rails * Patients that plan to D/C home post TKA / THA * Patients that speak English only. Exclusion Criteria: * Rheumatoid arthritis * Psoriatic arthritis * Juvenile rheumatoid arthritis * Knee or Hip revisions * Patients under 18 years of age * Patients unwilling or unable to complete PRO instrument or study questionnaires at the specified study time points pre-operatively or post-operatively * Bilateral TKA and THA * Uni-condylar knee arthroplasty or Hip resurfacing * Patellar reconstruction * Patient on disability, workman's compensation * Patients unwilling to participate in PEdPTWP and/or Patient education class and booklet. * Patients that plan to D/C to rehabilitation center post TKA and THA * Patients that do not speak English * Patients that do not have access to computer

Outcomes

Primary Outcomes

Number of In-patient Physical Therapy visits required to meet hospital discharge criteria PT

This included a review of the hospital database for hospital discharge time. At this institution PT discharge is defined as the ability to (1) independently transfer, (2) independently ambulate approximately 150 feet and (3) independently negotiate stairs (4) independent with home exercise program and activities of daily living. All of this data was recorded from hospital records

Time frame: Through Study Completion, an average of 3 days

Secondary Outcomes

Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC)

This standard patient reported outcome was filled out preoperatively or at six weeks postoperatively

Time frame: This standard patient reported outcome was filled out preoperatively or at six weeks postoperatively

Patient Satisfaction Scores

Patient satisfaction was measured by a series of patient administered questionnaires at various stages of the study. All satisfaction questions, with the exception of the utilization of the microsites \[Yes/No\], were asked via a visual analogue scale to disagree or agree with given statements \[0-5, where 0 was strongly disagree, 3 was neutral and 5 was strongly agree\]. Patients unable to complete any forms at the time of the appointment completed the form over the phone with a co-investigator.

Time frame: from two weeks prior to surgery until 6 weeks after surgery

Time to meet Physical Therapy discharge criteria

At this institution PT discharge is defined as the ability to (1) independently transfer, (2) independently ambulate approximately 150 feet and (3) independently negotiate stairs (4) independent with home exercise program and activities of daily living.

Time frame: Time from Surgery to meeting PT discharge criteria, an average of 3 days

Hospital Length of Stay

Data from ClinicalTrials.gov

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