title: Rapid mobilization decreases length-of-stay in joint replacement patients.
abstract: BACKGROUND
  Physiotherapy after total joint replacement enhances postoperative recovery. Implementing a pathway to include earlier postoperative mobilization can reduce the hospital length-of-stay as well as cost.
  
  
  OBJECTIVE
  Does a rapid rehabilitation program con- sisting of physical therapy on the day of surgery affect the hospital length-of-stay on patients undergoing either total hip or total knee replacements? Is there a difference in the effectiveness of rapid rehabilitation between patients under- going Total Hip and Total Knee Replacements? Can these patients tolerate day of surgery physical therapy sessions?
  
  
  METHODS
  Nine-hundred hip and knee arthro- plasty patients were divided into two groups for analysis. Group 1 participated in a rapid rehabilitation physical therapy program that began with physical therapists in the recovery room. Group 2 received a standard physical therapy protocol starting the day after surgery. Progression with rehabilitation was followed, and length of hospital stay between the two groups was compared.
  
  
  RESULTS
  Total length-of-stay was 3.9 days for the rapid rehabilitation group and was 4.4 days (p < 0.001) for the standard therapy group. We found the rapid rehabilitation group had a significantly shorter length-of-stay than patients who began therapy on postoperative day one. In addition to decreased length-of-stay, rapid rehabilitation also resulted in direct savings considering fewer hospital resources were utilized over the decreased time in-house.
  
  
  CONCLUSIONS
  Rapid mobilization of total joint replacement patients in the recovery room can be accomplished safely and reduces the overall length of hospital stay for over 70 % of patients.
authors.forename: Gregory
authors.initials: G
authors.lastname: Tayrose
authors.forename: Debbie
authors.initials: D
authors.lastname: Newman
authors.forename: James
authors.initials: J
authors.lastname: Slover
authors.forename: Fredrick
authors.initials: F
authors.lastname: Jaffe
authors.forename: Tracey
authors.initials: T
authors.lastname: Hunter
authors.forename: James
authors.initials: J
authors.lastname: Bosco
mesh_terms: D000368:Aged; D019644:Arthroplasty, Replacement, Hip / Q000534:rehabilitation*; D019645:Arthroplasty, Replacement, Knee / Q000534:rehabilitation*; D001696:Biomechanical Phenomena; D004434:Early Ambulation / Q000379:methods*; D005260:Female; D006621:Hip Joint / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D007719:Knee Joint / Q000503:physiopathology / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D020127:Recovery of Function; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome