Discharge to Post-Acute Care Facility After Total Knee Arthroplasty Associated with Worse Mental Health Outcomes

Strategic Insights -

Research conducted by the University of Virginia Medical Center and published in The Journal of Arthroplasty suggests that patients discharged to post-acute care facilities after total knee arthroplasty (TKA) may experience worse mental health outcomes compared to those discharged home. The study, which analyzed data from 942 patients, found that patients discharged to post-acute care facilities had significantly worse scores on both global physical health and mental health scales at all time points, with declining mental health scores at the 3-month and 6-month visits.

Key Takeaways:

  • Patients discharged to post-acute care facilities after TKA had significantly worse scores on both global physical health and mental health scales at all time points.
  • The mental health scores of nonhome discharge patients declined at the 3-month and 6-month visits, whereas home discharge patients continued to show improvement.
  • The study suggests that discharge disposition may influence patient-reported outcomes after TKA.
  • The research highlights the need for further study to determine if discharge to a post-acute care facility is causal in declining mental health scores.
  • Total knee arthroplasty patients discharged to post-acute care facilities include those with major comorbidities and are often elderly.
  • The study analyzed data from 942 patients, with 471 discharged to post-acute care facilities and 471 discharged home.
  • The Pulmonary Embolism Prevention after Hip and Knee Replacement database was used to collect patient-reported outcomes, including Knee Injury and Osteoarthritis Outcomes Score (KOOS Jr) and Patient-Reported Outcomes Measurement Information System (PROMIS) global physical health (GPH) and PROMIS global mental health (GMH).
  • Propensity score matching was used to create comparable groups of patients.

Statistics:

  • 942 patients with TKA were included in the study.
  • Patients discharged to post-acute care facilities had significantly worse scores on both PROMIS GPH and GMH scores at all time points.
  • Nonhome discharge patients had declining GMH scores at the 3-month and 6-month visits, whereas home discharge patients continued to improve.
  • The study found similar trajectories of improvement in KOOS Jr. and GPH scores between the two groups.

Sources:

  • The Journal of Arthroplasty, "Discharge to Post-Acute Care Facility After Total Knee Arthroplasty Is Associated With Worse Mental Health Outcomes," Vol. 40, No. 11 (2025): 2894-2899.
  • Mental Health Weekly Digest, "Studies from University of Virginia Medical Center Further Understanding of Pulmonary Embolism (Discharge to Post-Acute Care Facility After Total Knee Arthroplasty Is Associated With Worse Mental Health Outcomes)," October 20, 2025; p 1561.