Effects of Early Postoperative Physical Therapy Evaluation After Total Hip and Knee Arthroplasty on Discharge Disposition

Purpose: To evaluate whether early initiation of postoperative physical therapy for patients after total hip arthroplasty (THA) and total knee arthroplasty (TKA) is associated with discharge disposition. Methods: For this retrospective project, a total of 118 patients with THA and 129 patients with TKA were included. Cases included elective single THA and TKA performed between October 2016 and September 2017. Retrospective chart data were analyzed to identify the association between physical therapy initiation on postoperative day (POD) 0 and POD 1, and discharge disposition. Results: Initiating physical therapy POD 0 was associated with discharge to home. In the combined THA/TKA analysis, patients who received physical therapy on POD 0 were significantly more likely to be discharged home, when compared with those starting physical therapy on POD 1 (72% and 53%, respectively), chi(2)(1) = 8.3 [chi(2)(1) = 8.3, P = .004]. After controlling for age, gender, and length of stay (LOS), physical therapy initiation on POD 0 increased the odds of discharge to home 2.4 times. For men, initiating physical therapy on POD 0 was associated with a 54% improvement in the proportion of patients who were discharged home (POD 0 = 79.7%, POD 1 = 51.7%), chi(2)(1) = 7.8, P = .005, Cramer's V = 0.28, P = .005. Significantly more patients aged 60 to 70 were discharged home when physical therapy was initiated on POD 0, compared with POD 1 (84.4% and 58.8%, respectively), chi(2)(1) = 7.8, P = .005, Cramer's V = 0.28. Conclusions: We found that providing physical therapy beginning on POD 0 after THA/TKA was associated with an increased proportion of patients discharged home, particularly among men between the ages of 60 and 70 years.