The American Joint Replacement Registry—the first 5 years

Etkin, Caryn D.; Springer, Bryan D.

doi:10.1016/j.artd.2017.02.002

Cited by 111 publications

(71 citation statements)

References 10 publications

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“…Hip and knee TJR are highly cost effective , with more than a million procedures performed in the United States annually . In 2014‐2015, there were over 110 000 TJRs performed in Canada, representing an approximate 20% increase over 5 years .…”

Section: Introductionmentioning

confidence: 99%

Patterns of Depressive Symptoms Before and After Surgery for Osteoarthritis: A Descriptive Study

Power

Kudesia

Nadeem

et al. 2019

ACR Open Rheumatology

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ObjectiveTo examine patterns of depressive symptoms before and over the year following osteoarthritis (OA) surgery, stratified by joint and postsurgical outcome.MethodsParticipants were hip (n = 287), knee (n = 360), and lumbar spine (n = 100) OA patients scheduled for joint replacement or decompression surgery with or without fusion. One pre‐ and 4 postsurgery questionnaires were completed. Depressive symptoms were quantified using the Hospital Anxiety and Depression Scale (HADS). One‐year outcomes were based on Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores for hip and knee patients and Oswestry Disability Index (ODI) scores for spine patients and were categorized as “worse” (top score tertile) vs. “better” outcomes (first, second tertiles). Plots over time were generated by joint and outcome: 1) mean pain/disability and depression scores and 2) percentage of patients meeting HADS cut‐off for depression “caseness,” reporting depression diagnosis and treatment.ResultsThere were notable decreases in depression scores for patients with better outcomes. For those with worse outcomes, decreases were smaller for hip patients and were not significant for knee and spine patients. Among those with poorer outcomes, 25% of spine and knee patients were depression “cases” pre‐ and postsurgery; an additional 16% of spine and 10% of knee patients developed new “caseness” postsurgery. The proportion of these patients deemed depression cases by score was much higher than the proportion reporting diagnosis/treatment.ConclusionAlthough depressive symptoms decrease overall in OA patients postsurgery, degrees of change vary by joint and surgical outcome. Greater attention to mental health postsurgery is warranted and may lead to improved surgical outcomes, particularly among knee and spine patients.

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Section: Introductionmentioning

confidence: 99%

Patterns of Depressive Symptoms Before and After Surgery for Osteoarthritis: A Descriptive Study

Power

Kudesia

Nadeem

et al. 2019

ACR Open Rheumatology

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“…More than 1 million patients receive total knee arthroplasty (TKA) or total hip arthroplasty (THA) every year in the United States, a number expected to grow to nearly 4 million by 2030 [1]. Although joint replacement has become a highly effective surgical intervention, it is also a costly one.…”

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confidence: 99%

Patient Outcomes Following Total Joint Replacement Surgery: A Comparison of Hospitals and Ambulatory Surgery Centers

Carey

Morgan

Lin

et al. 2020

The Journal of Arthroplasty

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Background: For several years, many orthopedic surgeons have been performing total joint replacements in hospital outpatient departments (HOPDs) and more recently in ambulatory surgery centers (ASCs). In a recent shift, the Centers for Medicare and Medicaid Services began reimbursing for total knee replacement surgery in HOPDs. Some observers have expressed concerns over patient safety for the Medicare population particularly if Centers for Medicare and Medicaid Services extends the policy to include total hip replacement surgery and coverage in ASCs. Methods: This study used a large claims database of non-Medicare patients to examine inpatient and outpatient total knee replacement and total hip replacement surgery performed on a near-elderly population during 2014-2016. We applied propensity score methods to match inpatients with ASC patients and HOPD patients with ASC patients adjusting for risk using the HHS Hierarchical Condition Categories risk adjustment model. We conducted statistical tests comparing clinical outcomes across the 3 settings and examined relative costs. Results: Readmissions, postsurgical complications, and payments were lower for outpatients than for inpatients. Within outpatient settings, readmissions and postsurgical complications were lower in ASCs than in HOPDs but payments for ASC patients were higher than payments for HOPD patients. Conclusion: Our findings support the argument that outpatient total joint replacement is appropriate for select patients treated in both HOPDs and ASCs, although in the commercially insured population, the latter services may come at a cost. Until further study of outpatient total joint replacement in the Medicare population becomes available, how this will extrapolate to the Medicare population is unknown.

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“…Therefore, various societies and associations have developed multiple voluntary registries that are beginning to yield published observations. [16][17][18] Unlike the existing international joint arthroplasty registries that are mandatory for all cases performed, voluntary participation in US domestic registries introduces a bias in the devices referenced and data collected. Prospective continuous case series studies can be used to generate information to use for publication, presentation or various hospital Value Added Technology (VAT) committees.…”

Section: Discussionmentioning

confidence: 99%

Restoration of Femoral Condylar Anatomy for Achieving Optimum Functional Expectations: Continuation of an Earlier Study At 5-Year Minimum Follow-Up

Durbhakula¹,

Durbhakula²,

Durbhakula³

2019

ReconRev

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BACKGROUND: Studying and reporting the continuous, prospective outcomes of a post-surgical orthopaedic population without loss to follow-up at various standard landmarks over time is rarely achieved in total knee arthroplasty (TKA) literature. Small case series populations reported at an early follow-up time is common, and usually not beyond any initial publication for further reporting. The purpose of this study was to advance the knowledge base of the performance of Freedom Knee system through the continuous monitoring of a previously reported early series TKA patient population.METHODS: A prospective, continuous series of 176 primary posterior stabilized (PS) TKAs were performed in 172 patients by a single surgeon. Femoral component size distribution was assessed and all patients were followed for a minimum of five-years post-operatively. Total Hospital for Special Surgery (HSS) scores and range of motion (ROM) was assessed for the entire cohort and by gender.RESULTS: There were no patients lost to follow-up. Two patients required incision and drainage for superficial wound infection of the indicated knees. One patient required tibial component and polyethylene insert revision following a motor vehicle accident resulting in a proximal tibial fracture and component loosening. There was no radiographic evidence of component failure. As expected, femoral component size frequency use was skewed by gender with the larger sizes in males. There were no pre- or post-operative clinical or functional differences by gender and at the recent follow-up (avg. 6.9 years). In addition, there was an average significant increase in change of HSS score (p<0.001) and ROM (P<0.001) when compared to pre-operative baseline but no significant difference in HSS or ROM between the two and five-year outcome results.CONCLUSIONS: The design characteristic for component sizing and functional expectations were re-confirmed in the reported Western population cohort series, and observed optimum safety, performance and efficacy through five-years. Further continued study efforts of this primary TKA system is warranted across multiple surgeons and all ethnic cultures.

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The American Joint Replacement Registry—the first 5 years

Cited by 111 publications

References 10 publications

Patterns of Depressive Symptoms Before and After Surgery for Osteoarthritis: A Descriptive Study

Patterns of Depressive Symptoms Before and After Surgery for Osteoarthritis: A Descriptive Study

Patient Outcomes Following Total Joint Replacement Surgery: A Comparison of Hospitals and Ambulatory Surgery Centers

Restoration of Femoral Condylar Anatomy for Achieving Optimum Functional Expectations: Continuation of an Earlier Study At 5-Year Minimum Follow-Up

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