Replacement Arthroplasty: Barrois B

Barrois B, Gouin F, Ribinik P, Revel M, Rannou F, Anonymous00213. · Service de MPR, centre hospitalier de Gonesse, 25, rue Pierre-de-Theilley, BP 30071, 95503 Gonesse cedex, France. · Ann Readapt Med Phys. · Pubmed #17850912 No free full text.

Abstract: OBJECTIVES: To develop clinical practice guidelines concerning the interest of post-operative rehabilitation in a physical medicine and functional rehabilitation (PMR) ward after total hip arthroplasty (THA). METHOD: The SOFMER (French Physical Medicine and Rehabilitation Society) methodology, associating a systematic literature review, collection of everyday clinical practice, and external review by a multidisciplinary expert panel, was used. Main outcomes were impairment, disability, medico-economic implications and postoperative complications. RESULTS: Post-operative rehabilitation in a PMR ward after THA is recommended for frail patients because of their functional status, and/or associated co-morbidities, and/or post-operative complications. For patients in whom sustained rehabilitation is not necessary, but who cannot return home, a stay in a non-specific (non-PMR) post-operative center could be recommended. Post-operative rehabilitation in a PMR ward after THA could reduce the length of stay in a surgical ward and increase the functional status of patients. The total cost of the different modalities of post-operative rehabilitation after THA needs evaluation. CONCLUSION: This study suggests a value of rehabilitation in a PMR ward after THA, but good methodological quality studies are needed to evaluate the cost/benefit ratio of rehabilitation in a PMR ward after THA in the French health care system.

Barrois B, Ribinik P, Gougeon F, Rannou F, Revel M. · Service de MPR, centre hospitalier de Gonesse, 25, rue Pierre-de-Theilley, BP 30071, 95503 Gonesse cedex, France. · Ann Readapt Med Phys. · Pubmed #17959266 No free full text.

Abstract: OBJECTIVES: To develop clinical practice guidelines concerning the interest of post-operative rehabilitation in physical medicine and functional rehabilitation (PMR) ward after total knee arthroplasty (TKA). METHOD: The SOFMER (French Physical Medicine and Rehabilitation Society) methodology, associating a systematic literature review, collection of everyday clinical practice, and external review by a multidisciplinary expert panel, was used. Main outcomes were impairment, disability, medico-economic implications and postoperative complications. RESULTS: Post-operative rehabilitation in a PMR ward after TKA is recommended for patients because of preoperative joint stiffness, and/or associated co-morbidities. The other parameters used by French physician for post-operative rehabilitation in a PMR ward after TKA are: the self-governing of the patient at home, the wishes of the patient and the opinion of the surgeon on the post-operative functional evolution of the patients. For patients in whom sustained rehabilitation is not necessary but who cannot return home, a stay in a non-specific (non-PMR) post-operative centre could be recommended. Post-operative rehabilitation in a PMR ward after TKA could reduce the length of stay in a surgical ward and increase the functional status of patients with co-morbidities. Studies with good methodological quality are needed to evaluate the cost/benefit ratio in the French health care system. CONCLUSION: This study suggests a value of rehabilitation in a PMR ward after TKA, but good methodological quality studies are needed to evaluate the cost/benefit ratio of rehabilitation in a PMR ward after TKA in the French health care system.