Arthrose et appareil locomoteur
Le 14/10/2021 de 14:30 à 16:00
Facteurs corrélés à la durée de séjour en service de rééducation ostéoarticulaire après arthroplastie totale de hanche ou de genou : une étude rétrospective
Christophe Dang (Paris, France), Alexandre Martini (Paris, France), Tanya Hanna (Paris, France), Lily On (Paris, France), Zoé Laclergue (Paris, France), Ilo Razakarivony (Paris, France), Nicolas Bayle (Paris, France), Marjolaine Baude (Paris, France), Jean-Michel Gracies (Paris, France), Charlotte Pauwels (Paris, France)
Objective : In France, an increase in numbers of total hip arthroplasty (THA) and total knee arthroplasty (TKA) has been predicted for the future. In 2018, half the patients were hospitalized in orthopedic rehabilitation post-surgery. Some factors may influence the length of stay (LOS) in rehabilitation, intrinsic to the patients or environmental, pre-, per- or post-operative.
Material / Patients and Methods : Adult patients post-THA or post-TKA surgery hospitalized in our center from January 2018 to December 2020 were included (variables collected from the medical records). Pearson’s correlations or a univariable analysis of variance were first performed depending on the variable type. Variables yielding a p<0.2 were included in a multivariable model. Correlation between any variable and the LOS was validated for those with p<0.05.
Results : 96 patients post-THA and 73 patients post-TKA were identified. The median LOS was 29[21;42] days for THA and 28[24;36] days for TKA patients. Regarding THA patients: body mass index (β=0,180 CI[0,009;0,351] p=0.039), maximal passive hip flexion upon admission in rehabilitation (β=-0,188 CI[-0,376;-0,001] p=0.049), no psychiatric background (β=-0,160 CI[-0,316;-0,003] p=0.046), prior surgery for inflammatory arthritis (β=0,706 CI[0,409;1,003] p<0.0001) and the absence of a postoperative complication (β=-0,239 CI[-0,407;-0,070] p=0.006) were correlated with LOS. No factors were identified for TKA.
Discussion - Conclusion : The study highlitghted direct correlation between some factors and the LOS post-THA surgery. Crucial findings for pre-operative care: comorbidities should be optimally treated before a THA surgery. However, a longer LOS may not be deleterious for patients if hospital rehabilitation is beneficial. A prospective study is required to assess the difference between THA inpatients and outpatients.
Keywords : length of stay ; total hip arthroplasty ; total knee arthroplasty ; orthopedic rehabilitation ; rehabilitation ; post-surgery
Disclosure of interest : Aucun lien d'intérêt