Extended Lateral Femoral Osteotomy

Paprosky, Wayne G.; Sekundiak, Todd D.; Younger, T I

doi:10.1007/978-1-4612-1406-9_40

Cited by 1 publication

(1 citation statement)

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“…Fourth, time trends in revision TJAs according to geographic regions and health-care systems were unable to be assessed. This is essential, as the Southern region has been shown to have a significantly higher revision burden compared with other geographic areas in the United States, and larger academic centers also perform more revision procedures compared with community centers 20,29 . Fifth, the NSQIP database counts readmissions within 30 days following the surgical procedure; however, readmission defined by Medicare is 30 days after a hospital discharge 30 .…”

Section: Discussionmentioning

confidence: 99%

Temporal Trends in Revision Total Hip and Knee Arthroplasty from 2008 to 2018

Warren

Manrique-Succar

Molloy

et al. 2021

Journal of Bone and Joint Surgery

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Background: An overall assessment of how patient demographic characteristics and comorbidities are improving or worsening can allow better understanding of the value of revision total joint arthroplasty (TJA). Therefore, the purpose of this study was to identify patient demographic characteristics and comorbidities trends and episode-of-care outcome trends from 2008 to 2018 in patients undergoing revision TJA. Methods:The National Surgical Quality Improvement Program database was queried to identify patient demographic characteristics, comorbidities, and episode-of-care outcomes in patients undergoing revision TJA from 2008 to 2018 (n = 45,706). Pairwise t tests and pairwise chi-square tests were performed on consecutive years with Bonferroni correction. Trends were assessed using the 2-tailed Mann-Kendall test of the temporal trend.Results: Among patients undergoing revision TJA, there was no clinically important difference, from 2008 to 2018, in age, body mass index (BMI), percentages with >40 kg/m 2 BMI, diabetes (18.8% to 19%), chronic obstructive pulmonary disease (4.1% to 5.4%), congestive heart failure within 30 days (0% to 1%), or acute renal failure (0% to 0.2%). However, modifiable comorbidities including smoking status (14.7% to 12.0%; p = 0.01), hypertension (66% to 26.0%; p = 0.02), anemia (34.5% to 26.3%; p < 0.001), malnutrition (10.4% to 9.3%; p = 0.004), and overall morbidity or mortality probability have improved, with a decrease in the hospital length of stay and 30-day readmission and a significant increase in home discharge (p < 0.001 for all).Conclusions: Time-difference analysis demonstrated that the overall health status of patients undergoing revision TJA improved from 2008 to 2018. However, formal time-trend analysis demonstrated improvements to a lesser degree. The multidisciplinary effort to improve value-based metrics including patient comorbidity optimization and episode-of-care outcomes for primary TJA has been shown to potentially have an impact on revision TJA.

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Section: Discussionmentioning

confidence: 99%