Association between rehabilitation timing and major complications of total knee arthroplatsy.

Abstract

To investigate the association between rehabilitation timing and the occurrence of post-total knee arthroplasty complications and related medical service utilization. Data from Taiwan's National Health Insurance Research Database from 2003-2006 were used to perform a retrospective study on patients who received their initial total knee arthroplasty during 2004-2005 (a total of 21,143 subjects). All subjects were divided into 1 of 3 groups based on the timing of their rehabilitation after total knee arthroplasty, namely, the within 2 weeks group, the after 2 weeks group or the no-rehabilitation group. We found that patients in the no-rehabilitation group and the after 2 weeks group had higher incidences of prosthetic infection (odds ratio (OR) =1.29, p=0.0409; OR=1.66, p=0.0012) and deep venous thrombosis (OR=1.51, p=0.0099; OR=2.07; p=0.0007) than in the within-2-weeks group. In addition, compared with the within-2-weeks group, the after 2 weeks group had higher total medical expenses (exponentiated regression coefficient: Exp. (β) =1.07, p=0.0211), and the no-rehabilitation group had lower total medical expenses (Exp. (β) =0.01, p<0.0001). The results of this study indicated that, because the incidence rates of complications and medical service utilization among total knee arthroplasty patients in the within 2 weeks group were lower than in the after 2 weeks group, the timing of rehabilitation may be 1 factor affecting post-TKA complications and promoting high levels of medical service utilization. These findings could be useful for clinicians and health policymakers attempting to improve total knee arthroplasty services.