What is the interest of rehabilitation in physical medicine and functional rehabilitation ward after total knee arthroplasty? Elaboration of French clinical practice guidelines - 29/11/07
Abstract |
Objectives |
To develop clinical practice guidelines concerning the interest of post-operative rehabilitation in physical medicine and functional rehabilitation (PMR) ward after total knee arthroplasty (TKA).
Method |
The SOFMER (French Physical Medicine and Rehabilitation Society) methodology, associating a systematic literature review, collection of everyday clinical practice, and external review by a multidisciplinary expert panel, was used. Main outcomes were impairment, disability, medico-economic implications and postoperative complications.
Results |
Post-operative rehabilitation in a PMR ward after TKA is recommended for patients because of preoperative joint stiffness, and/or associated co-morbidities. The other parameters used by French physician for post-operative rehabilitation in a PMR ward after TKA are: the self-governing of the patient at home, the wishes of the patient and the opinion of the surgeon on the post-operative functional evolution of the patients. For patients in whom sustained rehabilitation is not necessary but who cannot return home, a stay in a non-specific (non-PMR) post-operative centre could be recommended. Post-operative rehabilitation in a PMR ward after TKA could reduce the length of stay in a surgical ward and increase the functional status of patients with co-morbidities. Studies with good methodological quality are needed to evaluate the cost/benefit ratio in the French health care system.
Conclusion |
This study suggests a value of rehabilitation in a PMR ward after TKA, but good methodological quality studies are needed to evaluate the cost/benefit ratio of rehabilitation in a PMR ward after TKA in the French health care system.
Le texte complet de cet article est disponible en PDF.Keywords : Osteoarthritis, Total knee arthroplasty, Practice guidelines, Rehabilitation ward, Indications
Plan
Vol 50 - N° 9
P. 729-733 - décembre 2007 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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