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Will You Need Extra Care after a Total Hip or Knee Replacement?

After mom or dad or other family members have a total joint replacement, how do you know if they are ready to go home? Should they stay in the hospital a few more days or go to a transitional unit? These are the decisions made by patients with advice from the health care team. The health care team includes doctors, nurses, social workers, family members, and physical therapists.

Wouldn't it be better if we had a way to tell if a patient is at risk for a longer stay in the hospital? Then every step could be taken to prevent problems and teach the patient needed skills. This is what a group of physical therapists in Australia have been working on. They developed a scoring method called the Risk Assessment and Prediction Tool (RAPT)
RAPT measures the risk for longer than normal care after hip or knee joint
replacement. The therapists tested it on a group of patients. Then they tested it again on another group to see if it was a valid test measure.

According to this study, RAPT is a good tool to use with patients who are going to have a knee or hip replacement. Instead of two groups of patients (going home or going to rehab), this tool shows a third group. The third group is made up of patients with an uncertain result.

Factors such as older age (over 65), gender (male), and inability to walk far without help put the patient at risk for a longer hospital stay. Having someone at home to help reduces the risk. The authors of this study conclude that discharge planning after a joint replacement shouldn't be left up to chance or to any one person on the staff. The RAPT tool is an accurate way to measure a patient's need for extra rehab.

References: Leonie B. Oldmeadow, MClin Ed, Grand Dip Physio, et al. Predicting Risk of Extended Inpatient Rehabilitation after Hip or Knee Arthroplasty. In The Journal of Arthroplasty. September 2003. Vol. 18. No. 6. Pp. 775-779.

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