Rehabilitation PathwayKnee Replacement Rehabilitation Care Pathways

We will gather data on patients to form a historical control group (those whose knee replacement surgery and rehab was completed prior to implementation of the new rehab pathway). This pathway typically involves discharge to home on post-operative day 0 or 1, followed by 5 visits of home health physical therapy, followed by outpatient physical therapy at a frequency and duration deemed appropriate by the care team.

We will form the interventional cohort by gathering data on patients whose knee replacement surgery and rehab occur after implementation of the new pathway. The progression from inpatient to home health to outpatient physical therapy will remain the same, but with the addition of the interventions described below.

The investigators' team are co-developing new patient education materials with patients and physical therapists, to be presented at the pre-operative "total joint class" that patients awaiting knee and hip replacement attend prior to their surgery. These new materials replace previous slides that were presented about rehabilitation post-knee replacement.

For all patients in the 'intervention' cohort, the home health physical therapist will receive instruction to assist the patient with scheduling their first outpatient physical therapy session, to avoid unnecessary gaps in care between home health discharge and outpatient physical therapy evaluation.

Participants in the usual rehab group will continue to follow the current standard-of-care rehabilitation pathway for patients post-TKA.

Along with implementation of the new patient education materials, outpatient physical therapists will receive reminder materials regarding the preferred elements of the current standard-of-care "prehabilitation" visit --- a single outpatient physical therapy visit that patients awaiting total knee replacement are instructed to attend prior to their surgery. Instructions exist regarding the content of these visits, but physical therapists in the system have not received updated materials or reminders regarding the content of the visits in quite some time. This will serve as a reminder of "best practices" and re-education to the prehabilitation process.