Determinants of patient compliance with post-operative rehabilitation after lower limb orthopaedic surgery: a prospective study

Objective: To assess patients’ compliance with post-operative rehabilitation protocols following orthopaedic lower limb surgeries, and to identify clinical, demographic, and socioeconomic factors leading to variability in compliance within and across different types of surgeries performed. Methods: This was a prospective study conducted in a tertiary healthcare hospital in South India. 240 patients who underwent orthopaedic lower limb surgery under the same unit, aged above 18 years, with cognitive capability to comprehend rehabilitation protocols, were included in the study. Patient compliance was assessed according to five parameters: adherence to appointments, weight-bearing activities, exercises, use of walking aids, and intake of medications. Patients’ compliance is scored dichotomously for a total score of five, followed by statistical evaluation (binary and multivariate regression analysis) to identify factors leading to variability in compliance. Results: 53.7% patients were compliant (5/5). The highest compliance was with the intake of medications (91.7%), and the lowest was weight-bearing advice (75.4%). Statistical significance observed for compliance with the appointment date and exercises advised. Males (58.2%) and married individuals (58.3%) with (p value = 0.041 and 0.022, respectively) demonstrated higher compliance. 70.5% of patients in the government scheme in arthroscopy surgeries demonstrated non-compliance. 76.2% married individuals were compliant in the subgroup of other surgeries. 70% females who underwent arthroplasty demonstrated non-compliance. However, no independent predictor was statistically significant in the regression analysis. Conclusion: Understanding the factors leading to variation in compliance and tailoring the rehabilitation plan is essential to balance the intervention demands and the patient’s needs.