Association between rehabilitation timing and major complications of total knee arthroplatsy
Hui-Wen Chen , Hui-Ming Chen, Yu-Chun Wang, Po-Yu Chen, Ching-Wen Chien
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).
Conclusion: 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.
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