ASSOCIATION OF AGE, GENDER, BODY MASS INDEX AND FUNCTIONAL STATUS OF PATIENTS DISCHARGED SAME DAY TO HOME AFTER ARTHROPLASTY

M. Apostol¹, E. Oakley², W. Santos³

¹New York Presbyterian Hospital, Physical Therapy, New York, United States, ²Andrews University, College of Rehabilitation Sciences, Michigan, United States, ³Columbia University, New York, New York, United States

Background: There has been a steady increase in the discharge of patients receiving total joint arthroplasty (TJA) to home same day of surgery. Though there are published studies describing patient’s safety and satisfaction after same day discharge (SDD), to the authors’ knowledge, no studies are available that talk about patient-reported function once they are at home.

Purpose: To explore the association between age, gender, body mass index (BMI), and functional status of patients who had total hip arthroplasty (THA) or total knee arthroplasty (TKA) with SDD.

Methods: The Institutional Regulatory Boards (IRB) of Columbia University and Andrews University approved this study. Subjects were 55 to 75 years old who had elective unilateral total hip or knee replacement at New York Presbyterian Hospital. All subjects went home on day of surgeries. Participants were contacted by phone five to six days after SDD to complete Daily Living Function sections of the Hip Disability and Osteoarthritis Outcome (HOOS) or Knee Injury and Osteoarthritis Outcome (KOOS). Subjects’ demographic data were recorded. Simple linear regression was used to analyze the association of the KOOS and HOOS scores with subjects' age, gender, and BMI.

Results: For patients who had TKA, thirty one (19 females, 12 males) out of forty one who were invited joined the study. Mean age (years) and BMI (kg/m²) are 65 and 30.2. KOOS scores ranged from 21 to 96 (mean: 56), with higher score indicating better functional performance. For patients who received THA, 17 (10 females, 7 males) out of the invited 29 participated in this study. Mean age (years) is 65 and mean BMI (kg/m²) is 26.4. HOOS scores ranged from 35.71 to 92.83 (mean: 55). This study shows that KOOS and HOOS are independent of age and BMI of patients who had TKA or THA. However, males who had TKA have higher KOOS scores compared to females. The regression coefficient β = 14.28 corresponds to the mean difference of males and females in terms of KOOS with mean KOOS of 64.75 for males and 50.47 for females.

Conclusions: Patients who received TJA with SDD had difficulty doing most common activities at home (e.g stair negotiation, picking objects from the floor). Males who received TKA score higher in the KOOS compared to women. This study has small sample size. Doing this study with a larger sample size is recommended.

Implications: This study provides information on what therapeutic activities to prioritize during therapy sessions to ensure patients’ safety post discharge. The information can also be used in developing individualized home program.This research identifies which subjects recuperate faster (e.g. males versus females). Lastly, this study provides baseline data on functional status of individuals who had TJA and had SDD.

Funding acknowledgements: None

Keywords:
Ambulatory arthroplasty rehabilitation
Outpatient joint arthroplasty
Same day discharge

Topics:
Orthopaedics
Musculoskeletal: lower limb

Did this work require ethics approval? Yes

Institution: Columbia University and Andrews University

Committee: Columbia University IRB and Andrews University IRB

Ethics number: Y01M01 and 20-0123