Association between rehabilitation timing and major complications of total knee arthroplatsy.
OBJECTIVE
To investigate the association between rehabilitation timing and the occurrence of post-total knee arthroplasty complications and related medical service utilization.


METHODS
Data from Taiwan's National Health Insurance Research Database from 2003-2006 were used to perform a retrospective study on patients who received their initial total knee arthroplasty during 2004-2005 (a total of 21,143 subjects). All subjects were divided into 1 of 3 groups based on the timing of their rehabilitation after total knee arthroplasty, namely, the within 2 weeks group, the after 2 weeks group or the no-rehabilitation group.


RESULTS
We found that patients in the no-rehabilitation group and the after 2 weeks group had higher incidences of prosthetic infection (odds ratio (OR) =1.29, p=0.0409; OR=1.66, p=0.0012) and deep venous thrombosis (OR=1.51, p=0.0099; OR=2.07; p=0.0007) than in the within-2-weeks group. In addition, compared with the within-2-weeks group, the after 2 weeks group had higher total medical expenses (exponentiated regression coefficient: Exp. (β) =1.07, p=0.0211), and the no-rehabilitation group had lower total medical expenses (Exp. (β) =0.01, p<0.0001).


CONCLUSIONS
The results of this study indicated that, because the incidence rates of complications and medical service utilization among total knee arthroplasty patients in the within 2 weeks group were lower than in the after 2 weeks group, the timing of rehabilitation may be 1 factor affecting post-TKA complications and promoting high levels of medical service utilization. These findings could be useful for clinicians and health policymakers attempting to improve total knee arthroplasty services.
Far Eastern Memorial Hospital, Rehabilitation Department, Taipei, Taiwan.
Hui-Wen
HW
Chen
Hui-Ming
HM
Chen
Yu-Chun
YC
Wang
Po-Yu
PY
Chen
Ching-Wen
CW
Chien
D000368:Aged; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D016017:Odds Ratio; D011183:Postoperative Complications / Q000517:prevention & control*; D012189:Retrospective Studies; D012307:Risk Factors; D013223:Statistics as Topic; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D016896:Treatment Outcome; D020246:Venous Thrombosis / Q000453:epidemiology / Q000209:etiology*