Authors (including presenting author) :
Tsang LY, Yeung KH, Chau WM, Chan YY, Ip W
Affiliation :
Physiotherapy Department, Yan Chai Hospital
Introduction :
Increased hospital length of stay (LOS) after total joint replacement has been correlated with increased complication rates including venous thromboembolism (VTE). Reducing LOS has been shown to improve functional recovery and a more rapid return to independent living. Therefore, early mobilization is recommended following total hip replacement (THR) or total knee replacement (TKR) to prevent VTE and shorten LOS. From May 2020, Early Mobilization Program (EMP) was introduced in the Total Joint Replacement Centre of Yan Chai Hospital, with the collaboration between orthopedic surgeons and physiotherapists.
Objectives :
1. to develop a patient-centered TJR early mobilization program 2. to attain earlier benefits of mobilization by transforming the practice of initiating activity of the joint replacement patient from postoperative Day 1 to the day of surgery. 3. to improve patient functional outcomes upon discharge 4.to shorten total LOS after TJR operation 5. to minimize post-op VTE complications
Methodology :
1. Primary total joint replacement patients without surgical drains who fulfilled inclusion and exclusion criteria will be selected into EMP by physiotherapists and surgeons. 2. Clinical outcomes measures were input into CMS Allied Health Discharge Summary for data analysis
Result & Outcome :
1. NPRS 2. MFAC 3. LOS 4. Developement of DVT Initial Numeric Pain Rating Score (NPRS) in patients with EMP is 2.96 and routine program is 4.85, which is significantly lower in patients with EMP (Z=-6.799, p< 0.001). Final Modified Functional Ambulatory Category is significantly better in patients with EMP(5.09) when comparing with routine program (4.79) (Z=-2.826, p=0.005).
Patients with EMP have a significantly shorter LOS (3.79 days) than those with routine program (4.44 days) (Z=-2.011, p=0.044).
Incidence of DVT complications is 0.8% in patients with EMP and 2.1% in those with routine program.
