Costs and effectiveness of pre‐ and post‐operative home physiotherapy for total knee replacement: randomized controlled trial

Mitchell, Caroline; Walker, James H.; Walters, Stephen J.; Morgan, Alastair; Binns, Teena; Mathers, Nigel

doi:10.1111/j.1365-2753.2005.00535.x

Cited by 89 publications

(146 citation statements)

References 15 publications

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“…There are only a few studies on cost-effectiveness of exercise in patients with arthritis (6 -10). However, except for the study by Mitchell et al (8), patients scheduled for joint replacement surgery or patients with total knee or hip replacements were excluded in these studies. Moreover, the definition of exercise differed greatly among the studies.…”

Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of intensive exercise therapy directly following hospital discharge in patients with arthritis: Results of a randomized controlled clinical trial

Bulthuis¹,

Mohammad²,

Braakman-Jansen³

et al. 2008

Arthritis & Rheumatism

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Section: Discussionmentioning

confidence: 99%

Cost‐effectiveness of intensive exercise therapy directly following hospital discharge in patients with arthritis: Results of a randomized controlled clinical trial

Bulthuis¹,

Mohammad²,

Braakman-Jansen³

et al. 2008

Arthritis & Rheumatism

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“…After screening and detailed evaluation, 48 articles describing 52 interventions met the inclusion criteria and study characteristics are summarised in Table 75. Studies reported interventions in patients before hip (n = 22), knee (n = 21), 500,503,[509][510][511][512][513][514][515][516][517][518][519][520][521][522][523][524][525] or either hip or knee replacement (n = 9). [526][527][528][529][530][531][532][533][534] Interventions focused on optimising pre-surgical health (n = 36), preparation for recovery in hospital (n = 27) and improving long-term outcomes (n = 18).…”

Section: Resultsmentioning

confidence: 99%

“…[526][527][528][529]534 Eighteen interventions were specifically exercise based, 488,494,497,502,503,509,[511][512][513][514][515]519,520,[523][524][525] nine were education based, 52,489,495,500,501,526,527,529 while nine were multifactorial with exercise and education components and, in some cases, an occupational therapy base. 487,493,496,504,507,510,517,521,528 Effect on pre-surgical physical function Physical function before surgery was measured after 21 interventions using WOMAC (physical function or total), SF-36 physical function, HHS, HOOS, HSS, Arthritis Impact Measure Score 2 (AIMS2), AKSS or locally devised scores.…”

Section: Optimising Pre-surgical Healthmentioning

confidence: 99%

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Blom

Artz

Beswick

et al. 2016

Programme Grants Appl Res

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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms PROGRAMME GRANTS FOR APPLIED RESEARCH VOLUME 4 ISSUE 12 AUGUST 2016 ISSN 2050 DOI 10.3310/pgfar04120Improving patients' experience and outcome of total joint replacement: the RESTORE programme Ashley W Blom, Neil Artz, Andrew D Beswick, Amanda Burston, Paul Dieppe, Karen T Elvers, Rachael Gooberman-Hill, Jeremy Horwood, Paul Jepson, Emma Johnson, Erik Lenguerrand, Elsa Marques, Sian Noble, Mark Pyke, Catherine Sackley, Gina Sands, Adrian Sayers, Victoria Wells and Vikki Wylde Improving patients' experience and outcome of total joint replacement: the RESTORE programme ISSN 2050-4330 (Online) This journal is a member of and subscribes to the principles of the Committee on Publication Ethics (COPE) (www.publicationethics.org/).Editorial contact: nihredit@southampton.ac.ukThe full PGfAR archive is freely available to view online at www.journalslibrary.nihr.ac.uk/pgfar. Print-on-demand copies can be purchased from the report pages of the NIHR Journals Library website: www.journalslibrary.nihr.ac.uk Criteria for inclusion in the Programme Grants for Applied Research journalReports are published in Programme Grants for Applied Research (PGfAR) if (1) they have resulted from work for the PGfAR programme, and (2) they are of a sufficiently high scientific quality as assessed by the reviewers and editors. Programme Grants for Applied Research programmeThe Programme Grants for Applied Research (PGfAR) programme, part of the National Institute for Health Research (NIHR), was set up in 2006 to produce independent research findings that will have practical application for the benefit of patients and the NHS in the relatively near future. The Programme is managed by the NIHR Central Commissioning Facility (CCF) with strategic input from the Programme Director.The programme is a national response mode funding scheme that aims to provide evidence to improve health outcomes in England through promotion of health, prevention of ill health, and optimal disease management (including safety and quality), with particular emphasis on conditions causing significant disease burden.For more information about the PGfAR programme please visit the website: http://www.nihr.ac.uk/funding/programme-grants-forapplied-research.htm This reportThe research reported in this issue of the journal was funded by PGfAR as project number RP-PG-0407-10070. The contractual start date was in December 2008. The final report began editorial review in September 2014 and was accepted for publication in August 2015. As the funder, the PGfAR programme agreed the research questions and study designs in advance with the investigators. The authors have been wholly responsible for all data collection, analysis and interpretation, and for writing up their work. The PGfAR editors and production house have tried to ensure the accurac...

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“…In a recent Danish trial, an accelerated perioperative care and rehabilitation intervention after TKA turned out to be as effective as but less costly than standard care (12). So far, only a few other studies, representing guidance and physiotherapy, have reported the cost-effectiveness of rehabilitation programs in connection with total knee replacement surgery (13)(14)(15)(16).…”

Section: Introductionmentioning

confidence: 99%

Economic evaluation of multidisciplinary rehabilitation after primary total knee arthroplasty based on a randomized controlled trial

Kauppila

Sintonen

Aronen

et al. 2011

Arthritis Care & Research

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Objective. To conduct an economic evaluation of a multidisciplinary, biopsychosocial outpatient rehabilitation program implemented 2-4 months after total knee arthroplasty (TKA), compared with conventional orthopedic care. Methods. After surgery, 86 patients were randomized to a multidisciplinary rehabilitation group (n ‫؍‬ 44) or a conventional orthopedic care group (n ‫؍‬ 42). Alongside the randomized controlled trial, we estimated the costs of rehabilitation, health care resource use, and community support. Information about resource use was collected by means of a questionnaire together with data from hospital records. The primary outcome (effectiveness) measure was change in self-reported functional capacity and the secondary measure was quality-adjusted life years (QALYs) gained during the 12-month followup. Cost-effectiveness was assessed from between-group differences in costs, change in functional capacity, and QALYs gained. Results. Both protocols of providing rehabilitation services turned out to be equally effective, but the conventional orthopedic care protocol was unequivocally cost saving: the saving was €1,830 per patient (95% confidence interval ؊548, 3,623) using the available direct cost data. Conclusion. Multidisciplinary rehabilitation for unselected osteoarthritis patients in the subacute period of recovery after TKA is not a cost-effective use of health care resources. Similar rehabilitation protocols cannot be recommended for clinical pathways of TKA in the future.

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Costs and effectiveness of pre‐ and post‐operative home physiotherapy for total knee replacement: randomized controlled trial

Abstract: Although home physiotherapy was as effective and as acceptable to patients as hospital outpatient physiotherapy for unilateral TKR, it was more expensive. Additional pre-operative home physiotherapy did not improve patient-perceived health outcomes.

Cited by 89 publications

References 15 publications

Cost‐effectiveness of intensive exercise therapy directly following hospital discharge in patients with arthritis: Results of a randomized controlled clinical trial

Cost‐effectiveness of intensive exercise therapy directly following hospital discharge in patients with arthritis: Results of a randomized controlled clinical trial

Improving patients’ experience and outcome of total joint replacement: the RESTORE programme

Economic evaluation of multidisciplinary rehabilitation after primary total knee arthroplasty based on a randomized controlled trial

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