Outpatient in the Home Physical Therapy: A New Postoperative Rehabilitative Setting for Total Joint Replacements.

Abstract

Total joint arthroplasty (TJA) procedures are being performed at higher rates at ambulatory surgery centers (ASCs) and outpatient hospitals as surgeries continue to progress with minimally invasive approaches. Reducing surgical costs without compromising safety and clinical outcomes are a few driving factors for utilizing ASCs. Similarly, there may be avenues to reduce the rehabilitative costs of traditional home healthcare. Research continues to support the need for early therapeutic interventions after TJA. Historically, patients undergoing total joint replacements have been discharged to a skilled nursing facility or home healthcare. With the frequency of TJAs performed as outpatient procedures, there is an opportunity to change the dynamic of postoperative rehab. Advancements in surgery and anesthesia have led to optimization for TJA patients. As a result of advancements, implants are lasting longer so patients are considering replacements at younger ages. These factors present an opportunity to close a gap in the market, creating an outpatient home physical therapy program. During the initial phases of planning for total joint surgery, physical therapy in the home is initiated and scheduled prior to surgery. This mitigates variables that may affect delays in the rehabilitative process which can drive negative patient outcomes, dissatisfaction, and hospital readmittance.