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Withdrawn: A Randomized Controlled Trial Comparing Modular and Nonmodular Neck Versions of a Titanium Stem.
This article has been withdrawn at the request of the author(s) and/or editor.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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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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Randomized Controlled Trial
Multiple-Dose Intravenous Tranexamic Acid Further Reduces Hidden Blood Loss After Total Hip Arthroplasty: A Randomized Controlled Trial.
The most appropriate dose of tranexamic acid in total hip arthroplasty (THA) has not been decided. This study was conducted to evaluate the clinical effects of multiple-dose intravenous tranexamic acid (IV-TXA) in THA. ⋯ The 5-dose IV-TXA regimen can further diminish HBL, decrease maximum Hb drop, provide additional fibrinolysis control, and ameliorate postoperative inflammatory response following THA.
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The prevalence of dialysis-dependent patients is growing, and an increasing number of these patients are being considered for total knee arthroplasty (TKA). Studies assessing the preoperative risk associated with TKA in this population are limited to institutional cohorts with small sample sizes or national inpatient databases that lack follow-up data. ⋯ 3.
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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.