According to a New Cleveland Clinic research, domestic health services may benefit some patients after knee arthroplasty (TKA), but not all need it.
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Since the demand for TKA is increasing, the delivery of value -based posture care is becoming increasingly important. In many medical centers, patients who have TKA are released on routine domestic health services, receiving a domestic visit through health care professionals who provide assistance and monitoring during recovery. This kind of care costs, yet there are limited data about whether patients think they have benefited from care.
“The total number of couples performed in the United States is increasing, but our resources are not infinite.” Nicholas SPYZE, MDEnterprise Vice Chair of Research for Orthopedics and Rehabilitation at the Cleveland Clinic. “We need to use our limited resources wisely, they properly allocate them to patients.”
From 2016 to 2022, in more than 10,000 TKA patients at the Cleveland Clinic, people who finished domestic health services did not report better results than those engaged in self -care at home. Dr Pewzi says it shows that there are possibilities for better risk stability.
He says, “Overall, patients who have hired domestic health get the same improvement in a year that only cared for themselves.” “For us, it is assured that in the right selected patients, we can get satisfaction and improvement at the same level, regardless of the path of care.”
Dr. Pewsi and Cleveland Clinic Adult Construction Research (CCARR) team will present these results at the 2025 American Academy of Orthopedic Surgeon meeting.
Compare the results of domestic health and self -care patients
Of the total 10,084 primary TA patients, 6,963 were dismissed for domestic health services and 3,121 was discharged from home with self -care. In a year, the two groups improved a number of patients information.
For example, knee injury and osteoarthritis scores were close to 85 % a year after surgery in both domestic health and self-care groups, at least one year after surgery. The proportion was also the same for the Koos-Pen (about 93 93 %) and the Koos-Joint replacement (Koos-JR) (about 91 %). No differences between treatment groups was important in terms of statistics.
The proportion of the patient’s acceptance symbolic state (Pass) was also the same in both groups-about 66 % for Koos-PS, about 69 % for Koos-Pen and 68 % for Koos-JR.
However, self -careers expressed less satisfaction in the pass answers (or 0.87, P = .013).
Dr. Puzi says these results are not completely surprising.
“With changes in outpatient surgery and other developments, we are starting to see more patients who are young and healthy, who can perform better than self -care, outpatient physical therapy or other recovery methods.”
To determine that really requires home health services
More work will be needed to determine who will benefit from domestic health services.
“We need to guide the discharge plan and develop evidence -based standards and decision -tools to improve the discharge plan, such as patients, such as patients, to improve the preference of patients, their preference, their social support and their current activity.”
In the upcoming projects of Dr. Puzie and CCRR: the use of a sensor worth wearing to detect the activity level of patients before surgery. Studying this data can help identify factors that predict who can withdraw from the least professional support.
Their search can benefit all orthopedic surgery.
“There is a lot of difference in this field,” says Dr Puzi. “I think it’s an area of ​​improvement. We need more quality based on solid evidence.
Another step of the evolution of TKA recovery
He noted that this work explains the evolution of TKA’s recovery. About a decade ago, 30 % -40 % of people were discharged after TKA’s rehabilitation centers. Today, 90 % of the house is finished.
“Now that more patients are at home instead of the maintenance center, can we provide virtual support through technology – care?” Dr. Puzi asked. “Many centers and surgeons are applying for the multi -faceted team’s approach to this. But it is always good to have data for the decision -making guidance.
