Inpatient Rehabilitation Outcomes in Primary and Revision Total Knee Arthroplasty Patients

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Abstract
Inpatient rehabilitation is an effective means of improving physical function and independence following total knee arthroplasty (TKA). Revision TKA (TKAR) is becoming increasingly more prevalent and it is unclear if revision TKAR patients attain similar improvements following inpatient rehabilitation compared to primary TKA (TKAP) patients. This investigation compared functional outcomes following interdisciplinary inpatient rehabilitation in 286 TKAP and 138 TKAR consecutive male and female patients. Functional Independence Measure (FIM) scores improved from admission to discharge for the TKAP (81.6 to 110.5) and TKAR (74.4 to 101.4) groups (p = 0.015). TKAP patients had shorter length of stay (LOS) compared to TKAR (9.2 and 11.3). FIM efficiency (FIM/LOS) was greater for the TKAP compared to TKAR (3.6 and 2.6). Total hospital charges were 11,399 dollars and 13,407 dollars for the TKAP and TKAR groups, respectively. TKAP patients were more likely to be discharged home compared to the TKAR patients (97.6 vs. 78.3%). Both TKAP and TKAR patients demonstrate gains in FIM scores during inpatient rehabilitation. However, the amount of FIM efficiency is lower, and LOS and hospital charges are greater when comparing TKAR and TKAP. In addition, discharge disposition may be influenced by the type of TKA, primary and revision. Prognostic study, level II-1 (retrospective study). See Guidelines for Authors for a complete description of levels of evidence.