1. Benick, R. A.
  2. Backus, S. I.
  3. Kroll, M. A.
  4. Ganz, S. B.
  5. MacKenzie, C. R.

Article Content

Regaining functional ambulatory status (FAS) and improving range of motion are the essential outcomes of physical therapy intervention during hospitalization after total knee arthroplasty (TKA). Typically, the primary goal is 90[degrees] of active knee flexion (KF) prior to discharge. Secondary goals include unassisted transfers, ambulation with a cane, and stair climbing. The purpose of this study was to determine the differences in date of achievement of unassisted FAS in patients who did (Group 1) and did not (Group 2) attain KF of 90[degrees] by discharge. Each postoperative day, physical therapists monitored KF with a standard goniometer and FAS with a valid functional status index. The FAS milestones monitored were transfers, ambulation, and stair climbing. Each was designated as assisted (presence of another person) or unassisted. ANOVA was used to test the differences between groups, with a significance level of P < .05. Of the 80 TKA patients, there were 52 in Group 1 and 28 in Group 2. In Group 2, KF angles were significantly lower throughout the postoperative course. Nonetheless, the postoperative day on which milestones were achieved was not different between groups. Therefore, 90[degrees] of KF in itself is not necessary to achieve unassisted FAS and need not be the primary determinant of discharge. Although the importance of KF to long-term success cannot be disregarded, unassisted FAS may be a more appropriate criterion for safe and timely discharge.