Periprosthetic joint infections (PJIs) centers are garnering the attention of different arthroplasty surgeons and practices alike. Nonetheless, their value has yet to be proven. Therefore, we evaluated weather PJI centers produce comparable outcomes to the national average of THA PJIs on a national cohort.

We performed a retrospective review of patient data available on PearlDiver from 2015 – 2021. PJI THA cases were identified through ICD-10 and CPT codes. Patients treated by 6 fellowship trained arthroplasty surgeons from a PJI center were matched based on age, gender, Charlson Comorbidity Index and Elixhauser comorbidity index at a 1:1 ratio to patients from the national cohort. Compared outcomes included LOS, ED visits, number of patients readmitted, total readmissions. Sample sized did not allow the evaluation of amputation, fusion or explantation. Normality was tested through the Kolmogorov-Smirnov test. And comparisons were made with Students t-tests and Chi Square testing.

A total of 33,001 THA PJIs and were identified. A total of 77 patients were identified as treated by the PJI center cohort and successfully matched. No differences were noted in regard to age, gender distribution, CCI or ECI (p=1, 1, 1 and 0.9958 respectively). Significant differences were noted in mean LOS (p<0.43), number of patients requiring readmissions (p=0.001) and total number of readmission events (p<0.001). No difference was noted on ED visits.

Our study demonstrates that a PJI for THA cases may be beneficial for the national growing trend of arthroplasty volume. Future data, that allows comparison of patient's specific data will allow for further validation of PJI centers and how these can play a role in helping the national PJI growing problem.

Introduction

In the United States, cementless femoral fixation remains the dominant mode of fixation for femoral neck fractures, despite strong worldwide registry data that supports cemented fixation. The reason for this discrepancy remains unknown, controversial and often difficult to compare due to multiple variables. The purpose of this study was to evaluate a matched cohort of patients undergoing arthroplasty for femoral neck fractures and assess outcomes of revisions, periprosthetic fractures and mortality.

Introduction

Morbid obesity (BMI>40) is a significant risk factor for complications following total joint arthroplasty (TJA). As such many have a restrictive practice of withholding elective primary TJA in the morbidly obese. The purpose of this study was to observe the implications of this practice.

Introduction

Bundle payment models have clinical and economic impacts on providers. Despite efforts made to improve care, experience has shown that a few episodes with costs well above a target (bundle busters) can reduce or negate positive performances. The purpose of this study was to identify both the primary episode drivers of cost and patient factors that led to episodes above target.

Introduction

Extraction of implants due to periprosthetic infection (PJI) following complex revision total knee arthroplasty (rTKA) with extensive hardware can be a daunting undertaking for surgeon and patient alike. We question whether irrigation and debridement (I&D) has a role in this difficult situation with respect to infection control, reoperation, and function.