Effectiveness and practice variation of rehabilitation after joint replacement

Early mobilization is the gold standard for achieving functional mobility after arthroplasty. The value of additional interventions to improve range of motion during the immediate inpatient period is not proven. Home is the preferred discharge destination and yields similar outcomes compared with inpatient rehabilitation. It is possible to improve outcomes related to physical activity by implementing exercise programs carried out at home or in groups. Knee arthroplasty possibly requires more rehabilitation than hip arthroplasty to achieve optimal outcomes. To enable firm conclusions on the effectiveness of rehabilitation after joint replacement, future studies have to consider methodological issues such as outcomes evaluated and number of patients included to ensure sufficient power. (C) 2003 Lippincott Williams Wilkins.