The Journal of arthroplasty
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The purpose of our study is to examine post-operative opioid use in total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients and describe factors associated with the need for refill prescriptions. ⋯ Compared to THA patients, TKA patients were twice as likely to require refill opioid prescriptions and were prescribed a greater total MED for a longer period of time post-operatively. Patients undergoing TKA who present with a comorbidity or are currently being treated for anxiety or depression are more likely to require a refill.
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In the era of the online orthopedic market, patients tend to equate publicly available online satisfaction surveys with what they presume their ultimate surgical outcome will be. Therefore, the purpose of this study was to assess whether there is a correlation between Press Ganey (PG) scores and (1) Hip Western Ontario and McMaster Universities Osteoarthritis Index and Harris Hip Score; (2) Short Form-12 and Short Form-36 scores; (3) University of California Los Angeles and Visual Analog Scale scores assessed at a mean of 3 years (range, 1 to 6 years) after surgery. In addition, we assessed whether (4) these correlations persist in patients who were evaluated under 2 years and 3 or more years after surgery. ⋯ No statistically significant relationship was found between commonly used total hip arthroplasty assessment tools and the PG overall hospital rating. Based on these results, PG surveys may not be a suitable implementation of the Center for Medicare and Medicaid services. A set of measures that can be widely collected and reported by hospitals for patients to use in order to evaluate hip arthroplasty outcomes needs to be developed. These results are of paramount importance, indicating a necessary reevaluation of PG surveys as a major determinant for reimbursements rendered by orthopedists and their use by patients.
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Treatment of unstable intertrochanteric fracture in elderly patients remains challenging. The purpose of this prospective study is to determine clinical and radiological results of cementless bipolar hemiarthroplasty using a fully porous-coated stem in osteoporotic elderly patients with unstable intertrochanteric fractures with follow-up over 5 years. ⋯ Cementless bipolar hemiarthroplasty using a fully porous-coated stem is a useful surgical treatment option for unstable intertrochanteric fracture in elderly patients with osteoporosis.
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The Bundled Payments for Care Improvement initiative was developed to reduce costs associated with total joint arthroplasty through a single payment for all patient care from index admission through a 90-day post-discharge period, including care at skilled nursing facilities (SNFs). The aim of this study is to investigate whether forming partnerships between hospitals and SNFs could lower the post-discharge costs. We hypothesize that institutionally aligned SNFs have lower post-discharge costs than non-aligned SNFs. ⋯ Institution-owned partner SNFs demonstrated the shortest patient LOS, and the lowest SNF and total 90-day costs, without increased risk of readmissions, compared with other SNFs.
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The purpose of this study is to evaluate clinical and radiographic outcomes after gender-specific patellofemoral arthroplasty (PFA) either isolated or combined with unicompartmental knee arthroplasty (UKA). ⋯ Excellent clinical and radiographic outcomes were achieved after PFA with a gender-specific implant both as isolated replacement and when combined with medial UKA. Bicompartmental replacement with small implants can be considered in patients with bicompartmental osteoarthritis and intact anterior cruciate ligament.