The Journal of arthroplasty
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Forty-nine patients revised from UKA to TKA and 43 from HTO to TKA were matched to 43 aseptic, both component revision TKAs (rTKA) and 97 primary TKAs. At a mean of 4.8 years, the KSS and function scores in the UKA to TKA, HTO to TKA and primary TKA cohorts were similar. ⋯ The rate of complications and reoperations were higher in HTO to TKA and rTKA compared to UKA to TKA and primary TKA. Thus, revising an HTO and UKA both had functional outcomes more similar to a primary TKA, however, the complication rate of revising an HTO was similar to an rTKA.
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Mortality following hip arthroplasty is affected by a large number of confounding variables each of which must be considered to enable valid interpretation. Relevant variables available from the 2011 NJR data set were included in the Cox model. ⋯ Schemper's statistic showed that only 18.98% of the variation in mortality was explained by the variables available in the NJR data set. It is inappropriate to use NJR data to study an outcome affected by a multitude of confounding variables when these cannot be adequately accounted for in the available data set.
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This study investigated the impact of metabolic syndrome (MetS) on perioperative and postoperative complication rates: the results of a cohort of 168 total hip and knee arthroplasties, 63 of normal weight, 105 with obesity without risk factors for metabolic syndrome and 39 with obesity and other factors that classify them with metabolic syndrome. Patients with metabolic syndrome were more likely to have complications than those without metabolic syndrome (P=0.0156). ⋯ The presence of MetS in patients undergoing total joint arthroplasty has a significant impact on surgical complication rates. This cannot be attributed to the BMI component alone, and may help guide efforts of patient optimization prior to total joint arthroplasty.
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Understanding the impact of obesity on elective total joint arthroplasty (TJA) remains critical. Perioperative outcomes were reviewed in 316 patients undergoing primary TJA. ⋯ Additionally, PBF of 43.5 was associated with a 2.4× greater likelihood of blood transfusion, PBF of 36.5 with a 1.9× greater likelihood for LOS >3 days, and PBF of 36.0 with a 1.4× greater likelihood for discharge to an extended care facility. PBF may be a more effective measure than BMI to use in screening for perioperative risks and acute outcomes associated with obese total joint patients.
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Although regional variations in Medicare spending are known, it is not clear whether regional variations exist in hospital charges for total joint arthroplasty. Data from Centers for Medicare and Medicaid Services (CMS) on Diagnosis Related Groups 469 and 470 (Major Joint with and without Major Complicating or Comorbid Condition) from 2011 were analyzed for variation by region. ⋯ The median hospital charge nationwide was $71,601 and $46,219 for Diagnosis Related Groups 469 and 470, respectively, with corresponding median payments of $21,231 and $13,743. Weak to no correlation was found between hospital charges and payments despite adjustments for wage index, cost of living, low-income care and teaching institution status.