Early commencement of physical therapy in the acute phase following elective lower limb arthroplasty produces favorable outcomes: a systematic review and meta-analysis examining allied health service models

Abstract

Early PT commencement and a weekend service may produce favorable outcomes following LL arthroplasty when baseline LOS is 4 days or more. Redistributing PT resources to commence as early as day of surgery regardless of weekday may accelerate postoperative recovery. Current, high quality research is needed to confirm these findings.

Clinical practice and post-operative rehabilitation after knee arthroscopy varies according to surgeon's expertise: a survey among Polish Arthroscopy Society members.

“…Polish experts recommended starting rehabilitation already on the day of surgery. Surgeons from all over the world have increasingly emphasized early mobilization, which may produce favorable post-operative outcomes [33,34,35]. Most surgeons (92%) reported that they always recommended their patient a rehabilitation with a physiotherapist after knee arthroscopy, which is now considered as a gold standard and its effectiveness was showed by a number of control studies [36,37,38,39].…”

Clinical practice and postoperative rehabilitation after knee arthroscopy vary according to surgeons’ expertise: a survey among Polish Arthroscopy Society members.

“…Polish experts recommended starting rehabilitation on the day of surgery. Surgeons from all over the world have increasingly emphasized early mobilization, which may produce favourable postoperative outcomes [33,34,35]. Most surgeons (92%) reported that they always recommended that their patient undergo rehabilitation with a physiotherapist after knee arthroscopy, which is now considered the gold standard, and its effectiveness has been shown by a number of control studies [36,37,38,39].…”

Rehabilitation of revision total hip replacement: A multi‐centre survey of current practice

“…Patients were likely to start physiotherapy early after surgery and be seen more than once a day. A systematic review by Haas, Sarkies, Bowles, O'Brien, and Haines () of acute primary arthroplasty rehabilitation found commencing physiotherapy on the day of surgery is beneficial and shortens LOS, for those patients and procedures with higher levels of complexity and greater scope for improvement in pain and function. This would describe the RTHR group.…”

“…The survey found the majority of RTHR patients received some OT but found no agreement about how this is provided. Haas et al () also suggest there is insufficient evidence about OT provision to draw conclusions about the effects of OT on outcomes after THR and the variability may reflect this uncertainty.…”

“…Patients were likely to start physiotherapy early after surgery and be seen more than once a day. A systematic review by Haas, Sarkies, Bowles, O'Brien, and Haines (2016) Unrestricted WB (UWB) protocols after primary THR are increasingly common (Hol, van Grinsven, Lucas, van Susante, & van Loon, 2010). These protocols are supported by evidence that UWB does not lead to worse outcomes in terms of osseous integration, implant subsidence or loosening and promotes strength and function (Hol et al, 2010).…”