The ideal methodology for providing postoperative physical therapy (PT) following total hip arthroplasty (THA) has long been debated. The purpose of this randomized controlled study was to examine differences in length of stay and achievement of functional milestones (FMs) between 3 groups of THA patients who received PT via different frequency and/or staff-mix protocols. A total of 150 unilateral THA patients of one surgeon were enrolled in this study and randomized into groups. Group 1 received b.i.d. PT throughout the hospital stay. Group 2 received b.i.d. sessions each day, once with a PT and once with a rehabilitation technician who practiced ambulation only. Group 3 received 1 PT session per day Monday to Friday, with an additional technician ambulation session, if time permitted, and 1 session on the weekend with either the therapist or the technician depending on the functional level and proximity to discharge. Postoperative day of achievement of assisted and unassisted FMs (transfers, ambulation with assistive devices, stair climbing) and discharge was recorded for all subjects. Analyses of variance revealed no significant difference between groups for demographics, day of achievement of any FM, percentage of patients achieving a particular FM, or discharge.
Providing b.i.d. PT sessions with a physical therapist following unilateral THA did not accelerate achievement of basic FMs or discharge, compared to b.i.d. sessions via a therapist/technician combination. There was also no statistically significant benefit to providing either type of b.i.d. protocol throughout the patient's hospitalization versus Monday to Friday only.