As health systems face increasing financial pressure and expanding value-based care requirements, discharge planning after total joint arthroplasty (TJA) has come under renewed scrutiny. Inpatient rehabilitation–long considered a default element of recovery–has gradually become a less common occurrence in TJA recovery, but is still utilized in some systems, representing a costly, resource-intensive, and typically unnecessary undertaking for optimal patient outcomes.
Now, new research from Force Therapeutics is showcasing real-world data across more than 20,000 patients, demonstrating that the vast majority of TJA patients are today being discharged home, and they are recovering just as well, if not better, than those sent to rehabilitation facilities.
Why Discharge Destination Matters in Value-Based Care
Post-acute care is one of the largest cost drivers in the 30-day surgical episode. Under models like the Transforming Episode Accountability Model (TEAM), hospitals are accountable not only for clinical outcomes, but also for the cost of care across the episode.
Historically, concerns about safety, functional recovery, and patient satisfaction have fueled the use of inpatient rehab following TJA. However, advances in surgical techniques, perioperative protocols, remote monitoring, and digital care management are changing what is possible at home.
Study Overview: A Real-World Look at TJA Recovery
A blinded, retrospective cohort study examined discharge patterns and patient outcomes across three large, anonymized healthcare organizations using the Force Therapeutics digital patient engagement platform. The analysis included:
- 14,197 total knee arthroplasty (TKA) patients
- 9,650 total hip arthroplasty (THA) patients
- Surgeries performed between 2018 and 2025
Patients were stratified by discharge location, either home or inpatient rehabilitation, and followed through recovery using validated patient-reported outcome measures (PROMs) and satisfaction scores.
Functional outcomes were assessed at one year postoperatively using the Knee Injury and Osteoarthritis Outcome Score (KOOS) Jr. for TKA patients and Hip Disability and Osteoarthritis Outcome Score (HOOS) Jr. for THA patients. Patient satisfaction was measured at 12 weeks postoperatively.
The Results: Home Discharge Is the Norm, Not the Exception
The data revealed a striking trend. Home discharge with Force Therapeutics was not only common, it was overwhelmingly the predominant pathway.
Total Knee Arthroplasty Outcomes
- 96% of TKA patients were discharged home
- At one year, KOOS Jr. improvement averaged 25.1 points for home-discharge patients versus 26.2 points for those discharged to rehab, a difference that was not statistically significant (p > 0.05)
- At 12 weeks, 90% of home-discharge patients reported high satisfaction scores (4 or 5 out of 5), compared to 85% of patients discharged to inpatient rehab
Total Hip Arthroplasty Outcomes
- 96% of THA patients were discharged home
- At one year, HOOS Jr. improvement averaged 34.6 points for home-discharge patients versus 31.4 points for rehab patients, a statistically significant advantage for home discharge (p < 0.05)
- Satisfaction was also higher among home-discharge THA patients, with 93% reporting high satisfaction compared to 84% of those discharged to rehab
What This Means for Health Systems
These findings challenge enduring assumptions about post-acute care after joint replacement. Functional recovery for patients discharged home was comparable to, and in some cases better than, recovery among those sent to inpatient rehabilitation facilities.
Equally important, patients discharged home consistently reported higher satisfaction, underscoring the value of recovering in a familiar environment when appropriate support is in place. From an operational and financial perspective, these results reinforce home discharge as a high-value strategy that aligns with both patient preferences and organizational goals.
The Role of Digital Engagement in Successful Home Recovery
Discharging patients home does not mean reducing or eliminating components of care. It means delivering care differently.
The Force Therapeutics digital patient engagement platform plays a critical role in enabling safe and effective recovery at home by:
- Delivering clinically validated education tailored by procedure, recovery phase, and risk profile
- Guiding patients through daily expectations and functional milestones
- Collecting PROMs and satisfaction data to monitor recovery progress
- Enabling timely communication between patients and care teams
By maintaining visibility into patient outcomes and experiences, care teams can identify issues early, intervene proactively, and ensure patients stay on track without unnecessary utilization of post-acute care resources.
Implications for the Future of TJA Care
As healthcare organizations prepare for evolving, widely applicable, and rigorous value-based payment models, the ability to safely discharge patients home at scale will be a defining capability. This research demonstrates that, while in-person rehab facilities may still be the correct approach for select patients, the right virtual care infrastructure coupled with clinical oversight renders home discharge the right choice for most patients, from both an outcomes and cost perspective.
For health systems seeking to reduce episode costs, improve patient satisfaction, and meet evolving quality requirements, the takeaway is clear. More patients are already going home after TJA than many leaders realize, and they are doing great.
Learn how Force Therapeutics supports safe discharge to home, high PROMs collection rates, and optimized recovery across the full surgical episode:
