The Journal of arthroplasty
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Retraction Of Publication
Withdrawn: A Randomized Controlled Trial Comparing Modular and Nonmodular Neck Versions of a Titanium Stem.
This article has been withdrawn at the request of the author(s) and/or editor. The Publisher apologizes for any inconvenience this may cause. The full Elsevier Policy on Article Withdrawal can be found at https://www.elsevier.com/about/our-business/policies/article-withdrawal.
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In contrast to postdischarge arthroplasty readmission rates, the unscheduled reattendance burden to primary care is under-reported. Understanding reasons for reattendance would allow for implementation of strategies to reduce this burden. The present study aims to quantify the out-of-hours (OOH) general practitioner and emergency department (ED) service reattendance burden and readmission rate after primary total hip arthroplasty and total knee arthroplasty, with estimation of the associated costs. ⋯ The postdischarge arthroplasty reattendance burden is associated with significant costs, and strategies to reduce this should be developed. Further research is required to assess the effectiveness and cost-effectiveness of multicomponent strategies to reduce reattendance operating at scale.
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Bundled payments are meant to reduce costs and improve quality of care. Without adequate risk adjustment, bundling may be inequitable to providers and restrict access for certain patients. This study examines patient factors that could improve risk stratification for the Comprehensive Care for Joint Replacement (CJR) bundled-payment program. ⋯ Large database analysis; Level III.
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After the first year in the Comprehensive Care for Joint Replacement (CJR) model, hospitals must repay Medicare for spending above a target price. Hospitals are incentivized to reduce spending in a 90-day episode and generate internal cost savings through, for example, the use of lower-cost implants. ⋯ The CJR model holds great promise. However, it incentivizes hospitals to choose lower-cost implants and adopt newer technology more slowly, which could potentially increase revision rates and offset benefits of the program. Policy makers should monitor revision rates and consider changes to the CJR model to ensure beneficiary access to valuable technology.
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Multicenter Study
Short-term Complications After Revision Hip Arthroplasty for Prosthetic Joint Infection Are Increased Relative to Noninfectious Revisions.
Periprosthetic joint infection (PJI) after total hip arthroplasty (THA) is associated with significant morbidity and cost. The purpose of this study was to determine how rates of perioperative complications, operative duration, and postoperative length of stay (LOS) in patients undergoing revision THA for PJI compare to primary THA and to revision THA for non-PJI. ⋯ III.