Comparative Inpatient Rehabilitation Outcomes of Total Hip Arthroplasty Patients with and without Restrictive Hip Precautions

Abstract

Objective: To compare rehabilitation outcomes based on anterior hip arthroplasty for patients with and without post-operative surgical precautions. Methods: Sixty-eight consecutive patients’ medical records were retrospectively reviewed. Main outcome measures included total admission and total discharge functional independence measure (FIM) scores, FIM gain, FIM gain per day, and length of stay (LOS). Results: Group 1, n=31, included patients admitted to inpatient rehabilitation without post-operative surgical precautions. Group 2=37, included patients admitted to inpatient rehabilitation with post-operative surgical precautions. No statistically significant differences were observed between the groups at admission for age (Group 1 mean age=66.74 years; Group 2=67.30 years; F=0.014, p=811) and admission FIM scores (p=.866), suggesting groups were similar at admission. At discharge, both groups made similar progress related to overall FIM gain (p=. 679) and discharge FIM scores (p=.864). There was a statistically significant difference between the groups for LOS with the no-precaution group demonstrating approximately a 3-day shorter stay (Group 1=8.97 days; Group 2=11.73 days; F=0.195, p=0.012). This finding translated into improve FIM efficiency for Group 1 with statistically significant differences observed for Motor FIM gain per day for Group 1=2.83 and for Group 2=2.0 (F=17.275, p=0.007) and Total FIM gain per day with Group 1=2.90 and Group 2=2.07 (F=15.318, p=.006). Conclusion: Both groups made similar progress during inpatient rehabilitation with respect to overall FIM gain and discharge FIM scores. The no-precaution group made gains within a shorter timeframe reflecting improve efficiency with rehabilitation outcomes for the no-precaution group.