1. Patients receiving preoperative PT showed a 29% reduction in post- acute care use cost reduction of $1,215 (n = 4733)

Associations between preoperative physical therapy and post-acute care utilization patterns and cost in total joint replacement.

2. Patients given multimedia education had statistically significantly shorter hospital stays (t = 2.54, P < 0.05), higher self-efficacy (t = 7.93, P < 0.001), and higher functional activity (t = 4.33, P <0.001).

Effects of multimedia with printed nursing guide in education on self-efficacy and functional activity and hospitalization in patients with hip replacement

3. The present study supports the use of preoperative training in end -stage OA patients to improve early postoperative outcomes. High- intensity strength training during the preoperative period reduces pain and improves lower limb muscle strength, ROM and functional task performance before surgery, resulting in a reduced length of stay at the hospital and a faster physical and functional recovery after TKA. The present training programme can be used by specialists to speed up recovery after TKA.

High-intensity preoperative training improves physical and functional recovery in the early post-operative periods after total knee arthroplasty: a randomized controlled trial.
link http://www.ncbi.nlm.nih.gov/pubmed/26768606

4. The following significant risk factors for PJI were identified: body mass index; diabetes mellitus, hypoalbuminaemia, blood transfusion, superficial surgical site infection... .

Risk factors for periprosthetic joint infection after total joint arthroplasty: a systematic review and meta-analysis

5. Exercise participation prior to total joint arthroplasty dramatically reduces the odds (adjusted odds ratio 0.27, 95% CI) of inpatient rehabilitation.

Effect of preoperative exercise on measures of functional status in men and women undergoing total hip and knee arthroplasty

6. Prehabilitation improves physical function even in the compromised patients with OA awaiting TJA.

Prehabilitation improves physical function of individuals with severe disability from hip or knee osteoarthritis.

7. Fear of pain and avoidance of movement are strongly correlated both with the acute post-operative pain perception and recovery after surgery up to 1 year, thus presenting a relevant clinical impact on the outcome after TKA.

Patient kinesiophobia affects both recovery time and final outcome after total knee arthroplasty

8. Several interventions can be used together in a multi-modal fashion, or integrated into a clinical pathway to achieve better functional outcomes, enhance recovery, and reduce hospital stay. Reviewed interventions include intensive pre-operative patient education and pre-operative nutritional status.

Peri-operative interventions producing better functional outcomes and enhanced recovery following total hip and knee arthroplasty: an evidence-based review

9. The principal predictive factor of the postoperative range of motion was the preoperative range of motion.

Predicting Range of Motion After Total Knee Arthroplasty

10. Anxiety and depression and higher American Society of Anesthesiologists score were independent predictors of complications.
Respectively, 12.7% and 6.4% of knee and the hip arthroplasty patients had concomitant depression or anxiety. Knee patients had $3420 higher episode of care costs in patients with depression/anxiety (P b .001).

Direct Cost and Complications Associated With Total Joint Arthroplasty in Patients With Preoperative Anxiety and Depression