Achieving Milestones in Post-acute Rehabilitation

Rapid recovery protocols in hip and knee arthroplasty are seeing transformative shifts in preoperative management, rehabilitation, and care coordination. Previous hospital extended stays after arthroplasty are being shortened to short-stay or same-day discharges from hospitals or outpatient surgical centers. The premise that a well patient elects a joint replacement as opposed to a sick patient raises questions for discharge to subacute centers catering to those with several comorbidities. Discharging patients to safe, comfortable, and familiar environments with vigorous therapy protocols may aid milestone achievement faster than environments with increased risks of infection, weak therapy protocols, and variable commitments to excellence. Risks especially for the high-risk patients with comorbidities continue into their next discharge setting raising a question, “Are all patients safe to be discharged home?” This chapter will discuss milestone achievement through arthroplasty care stages looking at rehabilitation, muscle recovery, discharge settings, and care coordination.