• Kate L Tribe, Helen M Lapsley, Marita J Cross, Brett G Courtenay, Peter M Brooks, and Lyn M March.
• Institute of Bone and Joint Research, University of Sydney, Royal North Shore Hospital, St. Leonards, NSW 2065, Australia.
• Chronic Illn. 2005 Dec 1; 1 (4): 289-302.

ObjectivesTo analyse the differences in patient health outcomes and out-of-pocket costs following hip and knee joint replacement for osteoarthritis between patients who went home immediately after the acute care hospital stay and those who were admitted to inpatient rehabilitation care before going home.MethodsOne hundred and eighteen patients undergoing total hip or knee replacement in Sydney, Australia completed cost diaries, SF-36 and WOMAC Index, pre-operatively and for one year post-operatively.ResultsThe health status of all groups improved significantly from before surgery to 12 months post-surgery. No significant difference in health status at 12 months post-surgery was seen between home and rehabilitation patients for either hip or knee replacement. Both hip replacement home and rehabilitation patients and knee replacement home patients reported lower out-of-pocket expenditure from before surgery to 1 year post-surgery.DiscussionThe majority of total joint replacement patients can be discharged directly home and achieve excellent outcomes at 12 months post-surgery. We would recommend more focused randomized studies to explore the most suitable patient selection for rehabilitation.

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