Immediate Postoperative Rehabilitation

Current approaches in postoperative management of knee and hip arthroplasty are changing from passive, resource consuming, inefficient care episodes to active, value driven, efficient care models. Extended stays in acute hospitals and discharge to post-acute rehabilitation thereafter are transitioning to short-stay or same-day discharges and recovery from home. Restoring function earlier allows quicker patient engagement and indirectly reduces cost burdens. Changes in reimbursement models are shifting based on value and quality outcomes per dollar of resource used. Several preoperative, perioperative, and postoperative factors are driving the progress toward these changes. After arthroplasty, restoration of function is important in the same-day or short-stay protocols. Transformative thinking in anesthesia, perioperative management, physical therapy, and care coordination play pivotal roles in enhancing function. This chapter will examine the relevance of these areas during the immediate postoperative period.