Periprosthetic joint infection (PJI) is a significant challenge to the orthopedic surgeon, patient, hospital, and insurance provider. As the number of total hip and knee replacements has increased, the number of revision procedures has also increased. Revisions for infection require a greater amount of hospital and surgeon resources than noninfectious revisions. Our study compares the financial information for all two-stage revision surgeries performed at our tertiary referral center for hip or knee PJI over the last four years, separating them into two groups: referral versus self-originating cases. We performed a review of all patients who underwent two-stage revision hip or knee arthroplasty for infection between 2008 and 2013 at our facility. We collected detailed financial information for patients and separated them into referral versus self-originating cases, indicating whether index surgery was performed at an outside facility or at our facility, respectively. Only those patients who underwent full two-stage procedure at our facility were included.Introduction
Methods
Hospitalists have assumed an evolving role in the care of postsurgical orthopaedic patients. Literature has provided evidence to suggest improved outcomes in postsurgical hip fracture patients managed by hospitalists in nonteaching hospitals. However, the full impact of a hospitalist co-management model has not been fully investigated with regard to elective joint arthroplasty patients in a multispecialty teaching facility. We hypothesized that a hospitalist co-management model in the setting of a teaching hospital would lead to an increase in unnecessary medical workups for joint arthroplasty patients. We retrospectively evaluated 2231 patients who underwent total hip arthroplasty (THA) or total knee arthroplasty (TKA) between May 2010 and January 2014 at one teaching facility, excluding any non-elective trauma patients. The patients were separated into a non-hospitalist (NH) cohort of 1062 patients that did not receive hospitalist co-management postsurgery, and a hospitalist (H) cohort of 1169 patients that received hospitalist co-management postsurgery. We used Student t test and significance of (Background
Methods
Complications following hip and knee arthroplasty can occur in any given patient. However, specific risk factors such as increased age, history of coexistent disease, and increased body mass index have been found to increase the risk of complications after such procedures. Complications often require prolonged hospital admission periods and added hospital resources which ultimately results in increased costs per hospital stay. However, if patients are pre-operatively risk stratified, and followed post-operatively for specific high risk medical issues, many complications may be avoided. By using a hospital standardised peri-operative risk stratification process, the cost per hospital stay for hip and knee arthroplasty may decrease. Overall hospital costs related to joint arthroplasty will be decreased by using a multi-disciplinary peri-operative risk stratification programme.Background:
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