Hip fracture rehab—a bit more time-consuming for people with Osteoarthritis

People who have osteoarthritis (OA) appear to require a little more time in rehabilitation after experiencing a broken hip. That’s the conclusion of researchers who examined the records of more than 13,000 people who had undergone rehabilitation while in the hospital following a hip fracture. About 2,000 of these individuals had OA—the form of arthritis that results from the breakdown of cartilage within joints, most often weight-bearing joints such as the hip. The people in both groups were predominantly women, with an average age of 80.

Assessing functionalindependence
An earlier study of people who had suffered strokes found that having OA had a negative impact on their functional recovery. This, in turn, led to prolonged stays in stroke rehab programs. Researchers in the current study set out to determine the effects of OA on recovery of function after hip fracture.

They used a standard disability rating scale to determine each person's degree of functional dependence on entering the rehabilitation program. This tool assesses functional independence in 2 areas: motor and cognitive. The motor domain includes such self-care activities as eating, grooming, bathing, and dressing; toileting; transferring from a bed or wheelchair; and walking. Assessments of cognitive function include comprehension and expression, social interaction, problem solving, and memory.

Long-term outcomes similar
All participants had similar scores at the outset, following hip fracture. But the people with OA required about a day and a half longer in rehabilitation programs. On average, they spent about 18 days as an inpatient, compared to 16½ days for those who did not have OA. The researchers speculated that OA may interfere with rehabilitation activities that are important to regaining functional independence, such as range-of-motion and strengthening exercises.

The slightly longer stay in rehab did not predict a less favorable recovery from hip fracture. Follow-up evaluations at about 3 months showed that both groups had similar functional outcomes.