Benchmarking physiotherapists’ usual care for total hip and knee joint arthroplasty in Australia and New Zealand

Abstract

This study presents findings from a benchmarking survey describing reported practice in Australia and New Zealand for pre-and post-operative total joint arthroplasty management. The aim of this study was to identify differences in service delivery between both public and private healthcare sectors and geographical regions. Surveys were sent to senior physiotherapists and undertaken online. Responses were received from 125 institutions. Predicted length of stay (LOS) varied across regions with most therapists reporting an agreed LOS of ≥ 3 days (83% total hip arthroplasty; 89% total knee arthroplasty). Significantly longer LOS was reported in the private healthcare sector (p = 0.001). Patients in New Zealand and Western Australia were reported as more likely to be discharged directly home following total hip arthroplasty (p = 0.001) and total knee arthroplasty (p < 0.001) compared with other regions. The majority of physiotherapists suggested they would mobilise patients on post-operative day 0 (total hip arthroplasty 53%; total knee arthroplasty 55%), with both hospital and patient factors cited as barriers to early mobility. Heterogeneity of care across both healthcare sector and region is prevalent following elective total joint arthroplasty in Australia and New Zealand. Research opportunities regarding optimal management remain, particularly in regard to discharge destination, length of stay, and timing of first mobility.

Untitled

“…The aims of this study were to quantify physical activity undertaken in the acute setting following lower limb arthroplasty and determine the relationship between activity levels and hospital outcomes. The hospital outcomes (LOS and discharge destination) reported in this study were consistent with outcomes for usual care of THR and TKR patients across Australia and New Zealand hospitals (Hart et al, 2021). Within the acute hospital, participants engaged in low levels of physical activity following elective lower limb arthroplasty.…”

Equity of Māori access to the orthopaedic rehabilitation service of the Bay of Plenty: a cross-sectional survey

“…3,4 In spite of this emphasis, there remain considerable disparities in rehabilitation protocols locally and abroad. 5,6,7 It has been suggested internationally that access to rehabilitation is unequal between ethnic groups, although the small number of studies which examine this remain incongruent. 8,1 To date there has been one Aotearoa New Zealand study into the extent of rehabilitation access after total joint arthroplasty.…”