National evidence indicates that the comorbidities most associated with 30-day readmission following THA (total hip arthroplasty ) or TKA (total knee arthroplasty)are1,2,3:
COPD (OR: 1.51 for THA and 1.37 for TKA)
CHF and dyspnea (1.27 for both THA and TKA)
Hypertension (1.18 for THA; 1.36 for TKA)
Not surprisingly, advancing age and high BMI are also readmission risk factors.
View MonographEnhanced Recovery After Surgery plans, which include early mobility following surgery, have positive patient impacts. These plans have been shown to4,5,6:
Enhance patient recovery
Shorten hospital stay
Reduce complications and readmissions
Increase long-term survival and quality of life
Enhanced Recovery (ER) or ERAS programs typically encompass a multidisciplinary strategy involving patient education, multimodal analgesia, standardized perioperative anesthesia and local anesthetic infiltration, judicious fluid administration, and early mobilization.7
View MonographTo optimize patient recovery, aggressive mobilization of the repaired joint needs to continue post-discharge, thus monitoring patient activity in the home or long-term care facility as part of the recovery process is critical for optimal return of function. Unfortunately, a number of studies have indicated that patient compliance to prescribed post-operative movement plans tends to be poor.8,9
The use of accelerometer-based technology in this setting can help quantify patient activity level and provide objective feedback to the clinicians and the patients themselves. Such feedback can then be used to evaluate the efficacy of the patient’s goal-directed therapeutic management strategy and may also improve patient compliance.10 Furthermore, outpatient monitoring following surgery may help identify post-surgical complications earlier and reduce 30-day readmissions.11
Explore ZephyrLife™ Home Remote Monitoring Solution with Activity Tracking.
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You have her back. So she can move forward. With the ZephyrLIFE™ Home monitoring system, you still have her back. Whether she needs your support for daily management of a chronic condition or she is recovering from surgery, this streamlined wireless technology provides you continuing clinical surveillance to help her manage her health. You get the information you need, when you need it. And your patient gets peace of mind.
Evidence demonstrates patient and cost benefits of telehealth and home surveillance monitoring
1. Sutton JC, 3rd, Antoniou J, Epure LM, Huk OL, Zukor DJ, Bergeron SG. Hospital Discharge within 2 Days Following Total Hip or Knee Arthroplasty Does Not Increase Major-Complication and Readmission Rates. J Bone Joint Surg Am. 2016;98(17):1419-1428.
2. Belmont PJ, Jr., Kusnezov NA, Dunn JC, Bader JO, Kilcoyne K, Waterman BR. Predictors of Hospital Readmission After Total Shoulder Arthroplasty. Orthopedics. 2016:1-10.
3. Belmont PJ, Jr., Goodman GP, Rodriguez M, Bader JO, Waterman BR, Schoenfeld AJ. Predictors of hospital readmission following revision total knee arthroplasty. Knee Surg Sports Traumatol Arthrosc. 2015.
4. Reilly KA, Beard DJ, Barker KL, Dodd CA, Price AJ, Murray DW. Efficacy of an accelerated recovery protocol for Oxford unicompartmental knee arthroplasty--a randomised controlled trial. Knee. 2005;12(5):351-357.
5. Larsen K, Sorensen OG, Hansen TB, Thomsen PB, Soballe K. Accelerated perioperative care and rehabilitation intervention for hip and knee replacement is effective: a randomized clinical trial involving 87 patients with 3 months of follow-up. Acta Orthop. 2008;79(2):149-159.
6. McDonald DA, Siegmeth R, Deakin AH, Kinninmonth AW, Scott NB. An enhanced recovery programme for primary total knee arthroplasty in the United Kingdom--follow up at one year. Knee. 2012;19(5):525-529.
7. Khan SK, Malviya A, Muller SD, et al. Reduced short-term complications and mortality following Enhanced Recovery primary hip and knee arthroplasty: results from 6,000 consecutive procedures. Acta Orthop. 2014;85(1):26-31.
8. Groen JW, Stevens M, Kersten RF, Reininga IH, van den Akker-Scheek I. After total knee arthroplasty, many people are not active enough to maintain their health and fitness: an observational study. J Physiother. 2012;58(2):113-116.
9. Peiris CL, Taylor NF, Shields N. Patients receiving inpatient rehabilitation for lower limb orthopaedic conditions do much less physical activity than recommended in guidelines for healthy older adults: an observational study. J Physiother. 2013;59(1):39-44.
10. Boyle J, Karunanithi M, Wark T, Chan W, Colavitti C. Quantifying functional mobility progress for chronic disease management. Conf Proc IEEE Eng Med Biol Soc. 2006;1:5916-5919.
11. https://clinicaltrials.gov/ct2/show/NCT02143232.
12. National Health Service (NHS) in England and 3millionlives.co.uk/.
