Outcomes After Inpatient Rehabilitation of Primary and Revision Total Hip Arthroplasty

Abstract

Vincent KR, Vincent HK, Lee LW, Weng J, Alfano AP. Outcomes after inpatient rehabilitation of primary and revision total hip arthroplasty. Objective To compare the outcomes of patients who have gone to inpatient rehabilitation after primary total hip arthroplasty (THA) and revision THA. Design Retrospective, comparative study. Setting Fifty-bed freestanding, university-affiliated rehabilitation hospital. Participants Two hundred fifty-five male and female primary THA patients and 147 male and female revision THA patients. Intervention Interdisciplinary inpatient rehabilitation. Main Outcome Measures Length of stay (LOS), FIM instrument score and FIM motor score components, hospital charges, and discharge disposition location. Results FIM scores improved from admission to discharge by 29.7 and 27.9 points for the primary THA and revision THA groups, respectively ( P<.05). LOS was shorter for primary THA patients compared with revision THA patients (10.0d vs 11.5d, P<.05). FIM efficiency (ΔFIM/LOS) was greater for primary THA compared with revision THA (3.4 and 2.7 points/day, P<.05). Total rehabilitation hospital charges were $11,421 and $13,707 for the primary and revision THA groups, respectively, with the mechanical and infection revision THAs incurring the greatest charges ($14,596 and $15,386, respectively; P<.001). Compared with primary THA, revision THA patients were twice as likely to be discharged to locations other than home. Conclusions FIM score improvement was lower and LOS and hospital charges were greater in revision THA than in primary THA after rehabilitation. Infection revision THA patients gained less functional independence and were discharged home less often than mechanical or pain revision THA patients; finally, infection and mechanical revision THA accrued the highest hospital charges.