title: Using the Risk Assessment and Predictor Tool (RAPT) for patients after total knee replacement surgery.
abstract: OBJECTIVE
  The aim of this study was to use the Risk Assessment and Predictor Tool (RAPT) to evaluate the risk of complications in patients hospitalized after total knee replacement (TKR) surgery.
  
  
  METHODS
  The medical charts of 272 patients who had TKR surgery for knee osteoarthritis (OA) were included in the study. The presurgical RAPT score and Lequesne functional pain index score were determined based on a thorough analysis of the medical charts. Complications that had an impact on the vital prognosis or knee prosthesis outcomes were reported. Patients were compared according to the RAPT and a relative risk of complications was established.
  
  
  RESULTS
  Only 12.2% of patients hospitalized in a Physical Medicine and Rehabilitation (PM&R) center after their surgery could have been discharged home directly after their initial hospital stay for TKR surgery (score RAPT more than 9). These patients were mostly men and significantly younger. Their Lequesne score was significantly lower by an average of at least two points. Their relative risk of complications was 0.45 vs. 2.16 for patients who had a RAPT score less than 6.
  
  
  CONCLUSIONS
  Patients with a RAPT score more than 9 have a low risk of complications. They should not systematically be admitted to a PM&R unit after surgery. On the other hand, for patients with a RAPT score less than 6 a hospital stay in a PM&R care center is justified after TKR surgery.
authors.affiliation: Service MPR locomoteur, pôle de médecine physique et réadaptation, hôpital Saint-Jacques, CHU de Nantes, France. marc.dauty@chu-nantes.fr
authors.forename: M
authors.initials: M
authors.lastname: Dauty
authors.forename: X
authors.initials: X
authors.lastname: Schmitt
authors.forename: P
authors.initials: P
authors.lastname: Menu
authors.forename: B
authors.initials: B
authors.lastname: Rousseau
authors.forename: C
authors.initials: C
authors.lastname: Dubois
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation; D005260:Female; D005602:France / Q000453:epidemiology; D016304:Hospitals, Private / Q000706:statistics & numerical data; D006779:Hospitals, Public / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000601:surgery; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology; D010351:Patient Discharge; D011183:Postoperative Complications / Q000453:epidemiology* / Q000534:rehabilitation; D020127:Recovery of Function; D012047:Rehabilitation Centers / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012306:Risk; D018570:Risk Assessment / Q000379:methods*; D012720:Severity of Illness Index; D013924:Thrombophlebitis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000517:prevention & control; D014463:Ultrasonography; D014552:Urinary Tract Infections / Q000453:epidemiology