Establishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centers
Abstract Background The geriatric population and advanced knee osteoarthritis are rapidly increasing in Korea, and the socioeconomic burden of total knee arthroplasty (TKA) is increasing. This study aimed to analyze the demographic, clinical and socioeconomic characteristics of patients who underwen...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-07-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-022-03277-z |
| _version_ | 1817969638907052032 |
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| author | Eun Young Han Sang Rim Kim Kye Hee Cho Sang Hee Im |
| author_facet | Eun Young Han Sang Rim Kim Kye Hee Cho Sang Hee Im |
| author_sort | Eun Young Han |
| collection | DOAJ |
| description | Abstract Background The geriatric population and advanced knee osteoarthritis are rapidly increasing in Korea, and the socioeconomic burden of total knee arthroplasty (TKA) is increasing. This study aimed to analyze the demographic, clinical and socioeconomic characteristics of patients who underwent TKA and to differentiate the factors affecting participation in inpatient-intensive rehabilitation programs after TKA in the Jeju regional rheumatoid and degenerative arthritis center established by the government. Methods This retrospective cohort study included 845 patients (735 females; 72.0 ± 5.8 years) diagnosed with primary osteoarthritis (OA) of the knee who underwent elective unilateral primary TKA between January 2013 and June 2016. Demographic, clinical, and socioeconomic characteristics, including age, body mass index, obesity, length of stay, OA severity, underlying disease, education level, occupation, and location of residence were reviewed. Patients were allocated to the TKA-only group (home discharge) and to the TKA + rehab group (participation in post-TKA rehabilitation). The variables were analyzed and compared before and after the establishment of the center and according to participation in intensive rehabilitation. Results Patients who underwent TKA were mostly female, in the 60 s, and had a high prevalence of comorbidities and obesity. After the rehabilitation center's establishment, the intensive post-TKA participation increased profoundly from 3% to 59.2%. Participants after the center establishment had lower mean BMI and a higher proportion of K-L grade 4 compared to those before the center establishment. The location of residence was the only factor differentiating the participation in the intensive rehabilitation. Conclusion The regional rheumatoid and degenerative arthritis center was appropriate to satisfy the high unmet need for participating in the intensive rehabilitation after TKA and to execute the qualified integrated post-TKA care system. Policy support should ensure the early rehabilitation and a qualified integrated care system and prepare for the increased burden of revision. Future longitudinal studies should be conducted to assess the long-term effect of the integrated post-TKA rehabilitation program on functional outcomes and patient survivorship free from revision. |
| first_indexed | 2024-04-13T20:23:47Z |
| format | Article |
| id | doaj.art-5bc4fd72fdb840c686a828f485e4c6c0 |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-04-13T20:23:47Z |
| publishDate | 2022-07-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-5bc4fd72fdb840c686a828f485e4c6c02022-12-22T02:31:26ZengBMCBMC Geriatrics1471-23182022-07-012211910.1186/s12877-022-03277-zEstablishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centersEun Young Han0Sang Rim Kim1Kye Hee Cho2Sang Hee Im3Department of Rehabilitation Medicine, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University College of Medicine, Jeju National University HospitalDepartment of Orthopedic Surgery, Regional Rheumatoid and Degenerative Arthritis Center, Jeju National University College of Medicine, Jeju National University HospitalDepartment of Rehabilitation Medicine, CHA Ilsan Medical Center, CHA UniversityDepartment and Research Institute of Rehabilitation Medicine, Severance Hospital, Yonsei University College of MedicineAbstract Background The geriatric population and advanced knee osteoarthritis are rapidly increasing in Korea, and the socioeconomic burden of total knee arthroplasty (TKA) is increasing. This study aimed to analyze the demographic, clinical and socioeconomic characteristics of patients who underwent TKA and to differentiate the factors affecting participation in inpatient-intensive rehabilitation programs after TKA in the Jeju regional rheumatoid and degenerative arthritis center established by the government. Methods This retrospective cohort study included 845 patients (735 females; 72.0 ± 5.8 years) diagnosed with primary osteoarthritis (OA) of the knee who underwent elective unilateral primary TKA between January 2013 and June 2016. Demographic, clinical, and socioeconomic characteristics, including age, body mass index, obesity, length of stay, OA severity, underlying disease, education level, occupation, and location of residence were reviewed. Patients were allocated to the TKA-only group (home discharge) and to the TKA + rehab group (participation in post-TKA rehabilitation). The variables were analyzed and compared before and after the establishment of the center and according to participation in intensive rehabilitation. Results Patients who underwent TKA were mostly female, in the 60 s, and had a high prevalence of comorbidities and obesity. After the rehabilitation center's establishment, the intensive post-TKA participation increased profoundly from 3% to 59.2%. Participants after the center establishment had lower mean BMI and a higher proportion of K-L grade 4 compared to those before the center establishment. The location of residence was the only factor differentiating the participation in the intensive rehabilitation. Conclusion The regional rheumatoid and degenerative arthritis center was appropriate to satisfy the high unmet need for participating in the intensive rehabilitation after TKA and to execute the qualified integrated post-TKA care system. Policy support should ensure the early rehabilitation and a qualified integrated care system and prepare for the increased burden of revision. Future longitudinal studies should be conducted to assess the long-term effect of the integrated post-TKA rehabilitation program on functional outcomes and patient survivorship free from revision.https://doi.org/10.1186/s12877-022-03277-zArthroplastyKneeOsteoarthritisRehabilitationAged |
| spellingShingle | Eun Young Han Sang Rim Kim Kye Hee Cho Sang Hee Im Establishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centers BMC Geriatrics Arthroplasty Knee Osteoarthritis Rehabilitation Aged |
| title | Establishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centers |
| title_full | Establishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centers |
| title_fullStr | Establishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centers |
| title_full_unstemmed | Establishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centers |
| title_short | Establishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centers |
| title_sort | establishment of a qualified integrated care system after total knee arthroplasty as a role of regional rheumatoid and degenerative arthritis centers |
| topic | Arthroplasty Knee Osteoarthritis Rehabilitation Aged |
| url | https://doi.org/10.1186/s12877-022-03277-z |
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