Orthopaedic patient outcomes following interdisciplinary inpatient rehabilitation

Aims: This study's primary aim was to identify factors associated with discharge disposition and length of stay (LOS) at an interdisciplinary inpatient rehabilitation unit for patients who underwent total knee arthroplasty/unilateral or bilateral knee surgery (TKA/KS) or total hip arthroplasty (THA). Methods: This was a retrospective medical chart review of 119 veterans receiving post joint replacement rehabilitation at a United States Department of Veterans Affairs Medical Center at an interdisciplinary inpatient rehabilitation unit between December 2008 and May 2010 following joint replacement surgery. Patient demographic, health/function, and outcome factors were abstracted. Findings: Approximately 96% of patients who received post joint replacement rehabilitation were discharged to a home setting. For every 1 point score increase on the Functional Independence Measurement (FIM) scale at discharge, patients were 1.29 times more likely to be discharged to home (95% CI= 1.02-1.63; P< 0.04), but this effect diminished after accounting for age. Older veterans had longer LOS. Discharge to a non-home setting following inpatient rehabilitation was associated with older age, lower functional independence at admission, and poorer functional gain between admission and discharge. Conclusions: Interdisciplinary inpatient rehabilitation is an effective transitional step from the surgical intervention to the home setting for veterans undergoing TKA/KS or THA.