Survey Finds Gaps Between Belief and Practice in Early Rehabilitation After Orthopaedic Surgery

Most orthopaedic surgeons in Türkiye believe that starting physiotherapy soon after surgery reduces postoperative complications, yet fewer than a third report that their patients actually begin rehabilitation within the first three days after an operation, according to a cross-sectional survey published in BMC Musculoskeletal Disorders. The study, led by Mithat İbolar and colleagues, surveyed 597 participants, including 84 orthopaedic surgeons and 513 physiotherapists, to assess how interprofessional communication and collaboration shape early rehabilitation practices.

Participants completed a structured online questionnaire covering demographic and professional characteristics, referral patterns, communication and feedback processes, institutional practices, and attitudes toward early rehabilitation. The researchers analysed the data with group-specific analyses using Pearson chi-squared tests and multivariable binary logistic regression to identify factors independently associated with high direct communication between the two professions. The survey was descriptive and cross-sectional, so it captures reported practices and perceptions at a single point in time rather than measuring clinical outcomes.

The gap between belief and practice was striking. While 96.4 percent of orthopaedic surgeons stated that early physiotherapy reduces postoperative complications, only 27.4 percent reported that patients started physiotherapy within the first 0 to 3 postoperative days, and 45.3 percent reported initiation on day 16 or later. Low direct communication between surgeons and physiotherapists was common on both sides of the referral relationship, reported by 45.2 percent of orthopaedic surgeons and 49.9 percent of physiotherapists.

The analysis also identified factors linked to better communication. Among orthopaedic surgeons, the presence of a standard physiotherapy protocol was strongly associated with high direct communication, reported by 56.7 percent of those with high communication versus 14.9 percent of those with low communication (chi-squared = 16.638; p = 0.002). Among physiotherapists, direct referral by an orthopaedic surgeon, an institutional environment promoting interdisciplinary collaboration, participation in joint scientific meetings, and the presence of an orthopaedic surgeon in the same clinic were each significantly associated with higher communication levels (all p < 0.001).

In multivariable analyses, several factors remained independently associated with high direct communication. For orthopaedic surgeons, these were the availability of a standard protocol and the frequency of multidisciplinary meetings. For physiotherapists, institutional support, the presence of an orthopaedic surgeon in the same clinic, and meeting frequency remained significant.

The authors concluded that, despite strong awareness of the importance of early rehabilitation, substantial variation was observed in reported rehabilitation timing and interprofessional communication practices. Because the study relied on self-reported survey data from a single country and did not follow patients over time, the findings describe reported practice patterns rather than demonstrating the effect of any particular intervention on patient recovery. The survey did not include a clinical trial component, and the authors noted that its registration number was not applicable.

Subject of Research: Interprofessional communication and early rehabilitation practices after orthopaedic surgery in Türkiye

Article Title: Interprofessional communication and early rehabilitation practices in orthopaedic surgery: a cross-sectional survey

Article References: İbolar, M., Yılmaz, M. H., Akdoğan, B. M., Tam, E., Havıtçıoğlu, Ç., Atalay, G., & Barça, F. (2026). Interprofessional communication and early rehabilitation practices in orthopaedic surgery: a cross-sectional survey. BMC Musculoskeletal Disorders. https://doi.org/10.1186/s12891-026-10685-4

Image Credits: AI Generated

DOI: 10.1186/s12891-026-10685-4

Keywords: orthopaedic surgery, early rehabilitation, physiotherapy, interprofessional communication, cross-sectional survey, Türkiye, postoperative complications, multidisciplinary meetings, standard protocols, referral patterns, Interprofessional, communication