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March 18, 1998

Inpatient Rehabilitation After Total Joint Replacement

Author Affiliations

From the New York University–Hospital for Joint Diseases, Department of Orthopaedic Surgery, New York, NY.

JAMA. 1998;279(11):880. doi:10.1001/jama.279.11.880

In this issue of THE JOURNAL, the randomized trial of early inpatient rehabilitation after elective arthroplasty by Munin and colleagues1 provides information to improve the care of patients undergoing joint replacement surgery. The authors conclude it is both safe and effective to transfer patients to inpatient rehabilitation units as early as 3 days following surgery, and also report lower overall costs for patients in the "early transfer" group. In this study, all patients (except those who were excluded or dropped out of the study) were transferred to rehabilitation units; there was no patient group discharged home directly. The emphasis of the study is clearly on the role of inpatient rehabilitation in the continuum of care of joint replacement patients. The practice of inpatient rehabilitation has become a common component of the care of many patients with a variety of medical and surgical conditions requiring inpatient hospitalizations. The key question is why have inpatient rehabilitation programs become such an important part of health care during the past 10 years? The answer, in part, may have originated from efforts to not only benefit patient care, but also to improve facility reimbursement.