Heather K Vincent1, Kevin R Vincent, Laura W Lee, Alan P Alfano. 1. Center for Study of Complementary and Alternative Therapies and Physical Medicine and Rehabilitation, University of Virginia Health System, Charlottesville, Virginia 22908-0905, USA. hvincent@adelphia.net
Abstract
OBJECTIVES: To examine obesity effects on outcomes following inpatient rehabilitation in patients following primary total knee arthroplasty or revision total knee arthroplasty. DESIGN: Retrospective, comparative study. SETTING: Fifty-bed, university-affiliated rehabilitation hospital. PATIENTS: Obese (N = 139; body mass index >30 kg/m(2)) and non-obese (N = 146; body mass indexB <30 kg/m(2)) total knee arthroplasty patients. Participants were further stratified based on total knee arthroplasty type, primary and revision for a total of four groups. INTERVENTION: Interdisciplinary inpatient rehabilitation. MAIN MEASURES: Range of motion, length of stay, Functional Independence Measure (FIM) scores, FIM efficiency scores, total and daily hospital charges, and discharge disposition location. RESULTS: Range of motion and FIM scores improved from admission to discharge in both obese and non-obese patients regardless of total knee arthroplasty type. FIM efficiency was lower in revision than primary total knee arthroplasty (2.8 versus 3.6 patients/day; P < 0.005) but not different between obese and non-obese groups. Total hospital charges were lower for the primary than for the revision patients (P < 0.05), but were directly related with body mass index (r = 0.140, P < 0.05). Discharge disposition locations were not different among groups. CONCLUSION: Rehabilitation teams can expect comparable gains between obese and non-obese patients following total knee arthroplasty, but at a greater expense.
OBJECTIVES: To examine obesity effects on outcomes following inpatient rehabilitation in patients following primary total knee arthroplasty or revision total knee arthroplasty. DESIGN: Retrospective, comparative study. SETTING: Fifty-bed, university-affiliated rehabilitation hospital. PATIENTS: Obese (N = 139; body mass index >30 kg/m(2)) and non-obese (N = 146; body mass indexB <30 kg/m(2)) total knee arthroplastypatients. Participants were further stratified based on total knee arthroplasty type, primary and revision for a total of four groups. INTERVENTION: Interdisciplinary inpatient rehabilitation. MAIN MEASURES: Range of motion, length of stay, Functional Independence Measure (FIM) scores, FIM efficiency scores, total and daily hospital charges, and discharge disposition location. RESULTS: Range of motion and FIM scores improved from admission to discharge in both obese and non-obesepatients regardless of total knee arthroplasty type. FIM efficiency was lower in revision than primary total knee arthroplasty (2.8 versus 3.6 patients/day; P < 0.005) but not different between obese and non-obese groups. Total hospital charges were lower for the primary than for the revision patients (P < 0.05), but were directly related with body mass index (r = 0.140, P < 0.05). Discharge disposition locations were not different among groups. CONCLUSION: Rehabilitation teams can expect comparable gains between obese and non-obesepatients following total knee arthroplasty, but at a greater expense.
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