Knee Surg Relat Res.  2018 Sep;30(3):215-224. 10.5792/ksrr.17.060.

Does Discharge Destination Matter after Total Knee Arthroplasty? A Single-Institution Korean Experience

Affiliations
  • 1Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, MP, India.
  • 2Department of Orthopaedic Surgery, Joint Reconstruction Center, Seoul National University Bundang Hospital, Seongnam, Korea. osktk@snubh.org
  • 3Department of Orthopaedic Surgery, Seoul National University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
To compare extended care facility (ECF) and home as discharge destination after total knee arthroplasty (TKA) at a single high-volume tertiary center in South Korea.
MATERIALS AND METHODS
We retrospectively analyzed 1,120 primary TKAs (614 patients) performed between January 2012 and December 2013. A telephonic survey was conducted to determine discharge destination. The data reviewed included demographic and surgical data, functional outcome at 2 years and complications within 3 months.
RESULTS
ECF and home received 316 patients (51%) and 298 patients (49%), respectively. The ECF group had more bilateral TKA patients than the home group (272 vs. 234; p=0.014) and more patients with additional hospital stay (44 vs. 22; p=0.009). A higher tendency of complications was seen at home (n=8, 2.7%) than the ECF (n=2, 0.6%) (p=0.057). No significant differences were found in any functional outcome measure. Home patients had better patient satisfaction than ECF patients (81.9% vs. 54.3%; p < 0.001).
CONCLUSIONS
Patients who returned home after discharge had similar functional outcome at 2 years after surgery and higher patient satisfaction than those in the ECF in spite of the higher tendency of complications. Patients need adequate counseling and education regarding advantages and limitations of the two discharge destinations.

Keyword

Knee; Arthroplasty; Discharge; Home; Extended care facility

MeSH Terms

Arthroplasty
Arthroplasty, Replacement, Knee*
Counseling
Education
Humans
Knee
Korea
Length of Stay
Outcome Assessment (Health Care)
Patient Satisfaction
Retrospective Studies
Skilled Nursing Facilities
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