The Journal of arthroplasty
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The aim of this study is to investigate which anesthetic technique is superior on 30-day outcomes after primary total knee arthroplasty (TKA) in United States veteran patients. To our knowledge, this is the first account from the Veterans Health Administration comparing the effects of different anesthesia modalities in patients undergoing TKA. ⋯ Veteran patients undergoing TKA under neuraxial anesthesia had reduced postoperative complications and decreased hospitalization stay compared to patients undergoing general anesthesia.
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Knee arthrodesis (KA) and above-knee amputation (AKA) have been used for salvage of failed total knee arthroplasty (TKA) after periprosthetic joint infection (PJI). However, few studies have assessed the outcomes of KA after TKA PJI, as it remains an uncommon procedure. We investigated rates of AKA, control of infection, and ambulatory status after KA for TKA PJI treatment. ⋯ Level IV-case series.
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The economic impact of hip fractures on the health care system continues to rise with continued pressure to reduce unnecessary costs while maintaining quality patient care. This study aimed to analyze the trend in hospital charges and payments relative to surgeon charges and payments in a Medicare population for hip hemiarthroplasty and total hip arthroplasty (THA) for femoral neck fracture. ⋯ Hospital charges and payments relative to surgeon charges and payments have increased substantially for hemiarthroplasty and THA performed for femoral neck fractures.
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The American Society of Anesthesiologists physical status classification 4 (ASA PS 4) comprises patients with "severe systemic disease that is a constant threat to life." The purpose of this study is to conduct a retrospective analysis to report the rate of complications in the ASA PS 4 patients who undergo elective total joint arthroplasty (TJA). In addition, we report whether neuraxial anesthesia is associated with improved outcomes compared to general anesthesia in these patients. ⋯ The elevated risks for ASA PS 4 patients undergoing TJA may be too high to justify surgery. Neuraxial anesthesia is a reasonable alternative to general anesthesia if pursuing TJA in patients with a very high comorbidity burden.