Evaluating Safety of Skipping Postoperative Physical Therapy Clearance Before Same-Day Home Discharge After Total Joint Replacement Surgery

What this Trial Is About

Researchers are evaluating whether physical therapy clearance after total joint arthroplasty TJA surgery is necessary for safe home discharge on the same day. The study focuses on patients undergoing primary total hip or knee arthroplasty who are eligible for same-day discharge. It aims to compare a new discharge protocol with standard postoperative physical therapy clearance to assess safety outcomes such as falls, emergency room visits, and readmissions. The study compares two approaches the conventional method where physical therapy evaluates and clears patients after surgery before discharge, and a novel protocol where patients receive gait and stair training from physical therapy before surgery, followed by postoperative ambulation assisted by nursing staff before discharge. This approach is designed to allow more patients, including those who have surgery late in the day, to be discharged safely without waiting for postoperative physical therapy clearance. Participants will be monitored for postoperative falls up to six weeks after surgery, as well as emergency room visits and hospital readmissions within 90 days. Patient satisfaction and reported outcome measures will also be collected at six weeks. The study is non-randomized and single-blinded, with follow-up assessments to evaluate safety and patient experience during the recovery period.

Is Physical Therapy Clearance Before Arthroplasty Home Discharge Necessary?