When Karen Lootens Chantry had her arthritic right hip replaced five years ago, at 67, she heeded her surgeon’s advice to recuperate at a well-regarded rehabilitation center. But rehab didn’t go so smoothly, recalls the clinical psychologist, who is now 72 and still practicing.
“They encouraged me to be too gung-ho” about rehab exercises, leaving Chantry’s leg and hip painfully bruised, she says. After her surgery was revised in a second operation, she opted to recover at her home in Winthrop Harbor, Ill., north of Chicago, with the help of a visiting nurse, a physical therapist and her husband, John. Being home, surrounded by her own things and following her own schedule, “made a huge difference,” Chantry says.
So when she needed a knee replacement two years later, she knew exactly what she wanted to do: head straight home for two weeks of rehab before six weeks of outpatient therapy. The combination proved just right, she says. “I recuperated very, very quickly,” recalls Chantry.
Rethinking Rehab After Knee or Hip Replacement Surgery
More than a million Americans will undergo knee or hip replacements this year, according to the National Institutes of Health. Most of them will be 45 or older and suffering painful joint damage from osteoarthritis. In the past, many were routinely directed to inpatient facilities to rebuild their strength and reduce pain after the operation — especially if they were of Medicare age and lived alone.
But a wave of influential studies over the last five years has demonstrated that home rehab can be just as effective, less costly and even less risky for many patients. Now, with Medicare’s recent emphasis on “value-based care,” the tide has shifted and most knee or hip replacement patients are homeward bound.
“Our consensus is to encourage people to go home,” says Dr. Douglas Padgett, chief of the Adult Reconstruction and Joint Replacement Service at New York’s Hospital for Special Surgery (HSS). He estimates that 95 percent of his patients return home in a day or two.
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