Knee Replacement Rehabilitation Care Pathways

Description

Previous research has shown that use of rehabilitation (including physical therapy) and the recovery of function after knee replacement surgery may differ depending on patients' race, sex, income or insurance, and geographic location. In this study, the investigators will develop and test a new care pathway for knee replacement rehabilitation that is designed to maximize functional recovery for all patients and reduce differences between different groups of patients. Findings from this project will lead to improved rehabilitation quality after knee replacement surgery.

Interventions

• TKA Journey - patient education (Behavioral)
  The investigators' team are co-developing new patient education materials with patients and physical therapists, to be presented at the pre-operative "total joint class" that patients awaiting knee and hip replacement attend prior to their surgery. These new materials replace previous slides that were presented about rehabilitation post-knee replacement.
• Optimized Rehab Scheduling (Other)
  For all patients in the 'intervention' cohort, the home health physical therapist will receive instruction to assist the patient with scheduling their first outpatient physical therapy session, to avoid unnecessary gaps in care between home health discharge and outpatient physical therapy evaluation.
• Usual Rehab (Behavioral)
  Participants in the usual rehab group will continue to follow the current standard-of-care rehabilitation pathway for patients post-TKA.
• Physical Therapist reminders (Behavioral)
  Along with implementation of the new patient education materials, outpatient physical therapists will receive reminder materials regarding the preferred elements of the current standard-of-care "prehabilitation" visit --- a single outpatient physical therapy visit that patients awaiting total knee replacement are instructed to attend prior to their surgery. Instructions exist regarding the content of these visits, but physical therapists in the system have not received updated materials or reminders regarding the content of the visits in quite some time. This will serve as a reminder of "best practices" and re-education to the prehabilitation process.

Eligibility criteria

Conditions

Locations

• University of Pittsburgh — Pittsburgh, Pennsylvania, United States