Functional mobility on discharge day after total knee and hip replacement surgery

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Purpose: To examine functional mobility status on discharge day after total knee and hip replacement surgery in post-acute care hospital setting. Methods: Eighty patients following total knee and hip replacement surgery were assessed with the de Morton Mobility Index (DEMMI), the Timed-Up-and-Go (TUG) and Five Times Sit to Stand Test, the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) measurements of mobility-related activity on discharge day. Demographic information comprised age, body mass index, gender, type of surgery,length of hospital stay. Since the normality of distribution of the data was not confirmed, nonparametric Mann-Whitney-U test was used for analysis. Results: Forty patients (mean age: 66.83±7.39 years) underwent total knee replacement (TKR) and 40 patients (mean age: 62.63±11.95 years) underwent total hip replacement (THR). No statistical difference was found in age, body mass index and length of hospital stay between patients (p>0.05). TKR patients had better results in mean WOMAC total score, WOMAC Physical Functioning Score and mean DEMMI total score compared to THR patients (p<0.05). TUG and Five Times Sit to Stand Test time results showed a trend of deterioration in THR patients than TKR patients. The WOMAC pain, stiffness and total scores were similar between TKR and THR patients. Discussion: Results of this study indicated that functional mobility status at discharge would be better in patients with TKR than THR. Functional mobility evaluation following lower-extremity replacement surgery before discharge should be included in acute clinical physiotherapy practice to guide to physiotherapists to design effective intervention strategies to improve mobility.