Does gender influence how patients rate their patient experience after total hip arthroplasty?

Delanois, Ronald E.; Gwam, Chukwuweike U.; Chughtai, Morad; Khlopas, Anton; Yakubek, George; Ramkumar, Prem N.; Piuzzi, Nicolás S.; Mont, Michael A.

doi:10.5301/hipint.5000510

Cited by 42 publications

(41 citation statements)

References 20 publications

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“…With increased government and private sector pressures to reduce costs, increased expenditure from cementless fixation may result unfavorably. 2,3,42 As such, the use of cementless fixation modalities may warrant some bargaining between arthroplasty providers and implant companies to decrease implant costs. This was demonstrated by Elbuluk and Bosco 43 in a continuous series involving 52 revision TKA episodes.…”

Section: Discussionmentioning

confidence: 99%

Cementless versus Cemented Fixation in Total Knee Arthroplasty: Usage, Costs, and Complications during the Inpatient Period

et al. 2018

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Cemented fixation has been the gold standard in total knee arthroplasty (TKA). However, with younger and more active patients requiring TKA, cementless (press-fit) fixation has sparked renewed interest. Therefore, we investigated differences in (1) patient demographics, (2) inpatient costs, (3) short-term complications, and (4) discharge disposition between patients who underwent TKA with cemented and cementless fixation. The National Inpatient Sample database was queried for TKA patients with cement or cementless fixation between October 1 and December 31, 2015. Primary outcomes of interest included complications, length of stay (LOS), discharge disposition, and inpatient costs. Student's t-test and chi-square analysis were used to assess continuous and categorical data, respectively. Multivariable analysis evaluated the effects of fixation type on the continuous and categorical dependent variables. Patients who received cementless fixation were more often younger (63.5 vs. 65.9 years), male (47.4 vs. 40.3%), Black (10.7 vs. 7.7%), from the Northeast census region (29.1 vs. 17.1%), and under private insurance (49.2 vs. 40.3%; p < 0.001 for all). Cementless fixation involved higher inpatient hospital costs (US$17,357 vs. US$16,888) and charges (US$67,366 vs. US$64,190; p < 0.001 for both), lower mean LOS (2.63 vs. 2.71 days; p < 0.001), and higher odds of being discharged to home (odds ratio = 1.99; p = 0.002). This study revisited the outcomes of TKA with cementless fixation and demonstrated higher inpatient charges and costs, shorter mean LOS, and higher odds of being discharged home. Future studies should investigate patient outcomes and complications past the inpatient period, evaluate long-term survivorship and failure rates, and implement a prospective study design.

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Section: Discussionmentioning

confidence: 99%

Cementless versus Cemented Fixation in Total Knee Arthroplasty: Usage, Costs, and Complications during the Inpatient Period

et al. 2018

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“…Presently, patient satisfaction is typically assessed in a self-reported survey format using questionnaire, numerical or Likert scales. The Press Ganey (PG) survey, a validated patient experience evaluation that asks questions about patient's interactions with staff, wait times, and overall assessment of their care, has one question on patient satisfaction that is only relevant to the outpatient visit [3][4][5]. The visual analog scale (VAS) for patient satisfaction, which has been cited as a simple, valid, and reliable method of assessing patient satisfaction, has been used after both THA and total knee arthroplasty (TKA) [6,7].…”

Section: Patient Satisfaction Measurement In Orthopedic Surgerymentioning

confidence: 99%

“…Numerous studies have explored pain management as predictors of patient satisfaction [4,5]. In evaluation of the VAS for patient satisfaction, a high correlation between a patient's pain score and Oxford hip score suggested that pain was one of the most important factors in patient satisfaction [5,6]. Additional studies have also supported this claim, citing pain relief as a critical component of maximizing patient satisfaction after THA [4,[27][28][29].…”

Section: Pain Managementmentioning

confidence: 99%

Patient satisfaction and total hip arthroplasty: a review

Okafor

Chen

2019

Arthroplasty

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Primary total hip arthroplasty (THA) has been recognized as a reliable intervention for patients with end-stage osteoarthritis. Despite several notable advances in this procedure, studies have identified at least 7% of patients who remain dissatisfied. There is no general consensus on how to measure patient satisfaction in orthopedic surgery. However, validated tools have been used in multiple studies to further investigate this problem. A comprehensive review was conducted to examine the factors associated with patient satisfaction following THA. Associations in literature included patient expectation, age, sex, pain management, patient comorbidities (medical or psychiatric that existed prior to surgery), and length of stay. The continuous collection of patient satisfaction data using validated and reliable measurement tools is necessary to improve this important patient-reported outcome after THA.

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“…20 Patient-reported outcome measures are increasingly important for patients who expect to return to their baseline activity levels, and to physicians and hospitals with the introduction of the value-based healthcare model. [21][22][23][24][25][26][27] Therefore, the purpose of this study was to perform a short-term, 3-month interim comparative analysis on outcomes between 150 consecutive robotic-arm-assisted and 102 consecutive manual TKA patients. Specifically, we evaluated (1) patient self-reported symptoms, (2) expectations and satisfaction, and (3) functional activities, based on the new Knee Society Scoring System.…”

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confidence: 99%

Patient-Reported Functional and Satisfaction Outcomes after Robotic-Arm-Assisted Total Knee Arthroplasty: Early Results of a Prospective Multicenter Investigation

et al. 2019

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The purpose of this study was to perform a 3-month interim comparative analysis on outcomes between robotic-arm-assisted total knee arthroplasty (RATKA) and manual TKA patients. Specifically, we evaluated (1) patient self-reported symptoms, (2) expectations and satisfaction, and (3) functional activities, based on the 2011 Knee Society Scoring System. Between June 1, 2016, and March 31, 2018, 252 patients (102 manual and 150 robotic) were enrolled into a prospective, nonrandomized, open-label, multicenter comparative cohort study. Functional activity scores, patient-reported symptoms, as well as satisfaction and expectation scores were obtained from the 2011 Knee Society Scoring System preoperatively, at 4 to 6 weeks, and at 3 months postoperatively. Student's t-tests, Wilcoxon rank-sum tests, and chi-square tests with α set at 0.05 were used to compare between-group mean improvements from baseline. At 4 to 6 weeks postoperatively, RATKA patients were found to have significantly larger improvements in walking and standing (1.4 vs. –1.2 points; p = 0.019). RATKA patients were also found to have larger improvements in advanced activities (1.3 vs. 2.3 points), pain with walking (3.3 vs. 3.2 points), satisfaction score (12.4 vs. 12 points), and expectations score (5.1 vs. 4.4 points) when compared with manual TKA patients. At 3 months, RATKA patients were also found to have larger improvements in walking and standing (6.0 vs. 4.8 points), standard activities (11.4 vs. 10.1 points), advanced activities (6.2 vs. 4.6 points), functional activities total score (22.8 vs. 21.2 points), pain with walking (4.3 vs. 4.1 points), total symptoms score (10.5 vs. 10.3 points), satisfaction score (17.0 vs. 15.5 points), expectations score (4.8 vs. 4.0 points) when compared with manual TKA patients. The data indicate RATKA patients to have equal or greater improvements in 9 out of 10 of the Knee Society Scoring System components assessed at 3 months postoperatively, though not all findings were statistically significant. Since this is an early results report, this study will be continued for a longer follow-up, but we are encouraged by these interim results.

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Does gender influence how patients rate their patient experience after total hip arthroplasty?

Abstract: It is advantageous for orthopaedic surgeons to focus on the PG domains most pertinent to each patient gender post-THA. Focusing efforts based on gender may allow for better patient satisfaction, optimised reimbursements, and improved hospital ratings.

Cited by 42 publications

References 20 publications

Cementless versus Cemented Fixation in Total Knee Arthroplasty: Usage, Costs, and Complications during the Inpatient Period

Cementless versus Cemented Fixation in Total Knee Arthroplasty: Usage, Costs, and Complications during the Inpatient Period

Patient satisfaction and total hip arthroplasty: a review

Patient-Reported Functional and Satisfaction Outcomes after Robotic-Arm-Assisted Total Knee Arthroplasty: Early Results of a Prospective Multicenter Investigation

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