Which is a better place to recover from knee or hip replacement surgery—at home or at a rehab facility?
Home Is Where Recovery Is
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Secondary
Three studies have come down firmly on the side of home.
As reported by Michael Roizen, M.D., and Mehmet Oz, M.D., a study conducted at Thomas Jefferson University School of Medicine of joint replacement patients who went directly home after total joint replacement had a lower risk of post-surgery complications and hospital readmission than those who went to an in-patient rehab facility.
Another study, cited by Roizen and Oz, done by New York’s Hospital for Special Surgery, showed that patients admitted to a care facility after hip replacement had a higher risk of wound complications, respiratory problems and hospital readmissions than did those who just went home following their surgery.
What should be done if the patient lives alone? Yet another study found that patients recovered as quickly at home and with as few complications whether they had a live-in caretaker or not. Roizen and Oz recommended arranging for visits from a visiting nurse, a friend or bringing in a paid attendant for a few days.
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Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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