Can Patients Who Live Alone Be Sent Home Safely After Joint Replacement?
According to a recent study published by The Journal of Bone & Joint Surgery in partnership with Wolters Kluwer, most patients who live alone can safely be discharged home from the hospital to recover after knee or hip replacement surgery.
This encouraging finding questions the firmly held belief that patients who live on their own should first be sent to an inpatient rehabilitation facility after undergoing joint replacement surgery. “Patients living alone had a safe and manageable recovery when discharged directly home after total joint arthroplasty,” write Andrew N. Fleischman, MD, and colleagues from The Rothman Institute, Thomas Jefferson University, Philadelphia.
The study focused on 769 patients of a similar age demographic who were sent directly home after one-sided total hip or knee replacement; 138 of these patients were living alone for the first two weeks after surgery. The researchers compared complication rates and other important outcomes for patients who lived alone versus those who lived with others.
The researchers did find that patients who lived alone were more likely to spend more than one night in the hospital, had higher rates of in-home nursing care and physical therapy. But otherwise, the outcomes were very similar for patients living alone compared to those who lived with others. In both groups, the post-discharge complication rate was around eight percent. The two groups also had similar rates of “unplanned clinical events,” such as emergency department or urgent care visits. Pain relief and satisfaction scores during recovery were very alike as well.
Perhaps some of the most exciting results: up to six months after surgery, there were no significant differences in scores for joint functioning and quality of life and nearly 90 percent of patients living alone said they would choose to be discharged home directly after surgery again.
Although some patients who live alone can benefit from home health services or even an extra day in the hospital, discharge directly home may be a much more economical and comfortable choice than routinely sending them for inpatient rehabilitation – while also avoiding the believed associated risks.
Dr. Stickney, a Kirkland orthopedic surgeon, is an expert in exercise and health, joint replacement surgery, sports medicine and more. Contact Dr. Stickney and return to your healthy, pain-free lifestyle!