title: Sunday physiotherapy reduces inpatient stay in knee arthroplasty: a retrospective cohort study.
abstract: OBJECTIVE
  To evaluate, in patients treated with knee arthroplasty, whether providing Sunday (7d/wk) physiotherapy intervention could decrease length of stay (LOS) without affecting discharge knee functional outcomes.
  
  
  METHODS
  Retrospective cohort study.
  
  
  METHODS
  A tertiary hospital.
  
  
  METHODS
  Patients (N=229) who underwent total or unicompartmental knee arthroplasty.
  
  
  METHODS
  In October 2009, we implemented a Sunday physiotherapy intervention program for patients undergoing knee arthroplasty on Friday or Saturday. Prior to this initiative, physiotherapy intervention was provided from Monday to Saturday. LOS and discharge knee outcomes were compared between patients seen during the 4-month intervention period (n=73) and patients seen in the 4 months prior to the intervention (n=82). To control for secular trends, LOS during the intervention period was compared with LOS during the same 4 months in the prior year (n=74).
  
  
  METHODS
  LOS and discharge knee functional outcomes comprising (1) passive knee flexion range of motion, (2) the proportion of patients who were able to perform an unassisted straight-leg raise, and (3) the proportion of patients who ambulated safely with the use of a single walking stick or quadstick.
  
  
  RESULTS
  During the Sunday physiotherapy intervention period, median LOS significantly reduced (5-4d). Controlling for secular trends in LOS revealed similar results. The number needed to treat for 1 additional patient to achieve a LOS 4 days or shorter with Sunday physiotherapy intervention was between 3 and 4. There were no significant changes in knee functional outcomes.
  
  
  CONCLUSIONS
  Sunday physiotherapy intervention was associated with a modest reduction in LOS and a faster short-term knee recovery.
authors.affiliation: Department of Physiotherapy, Singapore General Hospital, Singapore. puayonghao@gmail.com
authors.forename: Yong-Hao
authors.initials: YH
authors.lastname: Pua
authors.forename: Peck-Hoon
authors.initials: PH
authors.lastname: Ong
authors.forename: Hwei-Chi
authors.initials: HC
authors.lastname: Chong
authors.forename: Ngai-Nung
authors.initials: NN
authors.lastname: Lo
mesh_terms: D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology; D007902:Length of Stay / Q000706:statistics & numerical data*; D010814:Physical Therapy Department, Hospital / Q000458:organization & administration*; D026741:Physical Therapy Modalities; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012846:Singapore; D013997:Time Factors