Aims. This study aims to evaluate the impact of metabolic syndrome in the setting of obesity on in-hospital outcomes and resource use after total joint replacement (TJR). Methods. A retrospective analysis was conducted using the National Inpatient Sample from 2006 to the third quarter of 2015. Discharges representing patients aged 40 years and older with obesity (BMI > 30 kg/m. 2. ) who underwent primary TJR were included. Patients were stratified into two groups with and without metabolic syndrome. The inverse probability of treatment weighting (IPTW) method was used to balance covariates. Results. The obese cohort with metabolic syndrome was significantly older, more likely to be female, had higher rates of
The aim of this study was to evaluate the healthcare costs and benefits of enoxaparin compared to aspirin in the prevention of symptomatic venous thromboembolism (VTE) after total hip arthroplasty (THA) or total knee arthroplasty (TKA) using data from the CRISTAL trial. This trial-based economic analysis reports value for money as incremental cost per quality-adjusted life-year (QALY) gained in 2022 Australian dollars, compared to a single threshold value of AUD$70,000 per QALY. Event costs were estimated based on occurrence of VTEs and bleeds, and on published guidelines for treatment. Unit costs were taken from Australian sources. QALYs were estimated using CRISTAL six-month follow-up data. Sensitivity analyses are presented that vary the cost of VTE treatment, and extend the analyses to two years.Aims
Methods
Breast cancer survivors have known risk factors that might influence the results of total hip arthroplasty (THA) or total knee arthroplasty (TKA). This study evaluated clinical outcomes of patients with breast cancer history after primary THA and TKA. Our total joint registry identified patients with breast cancer history undergoing primary THA (n = 423) and TKA (n = 540). Patients were matched 1:1 based upon age, sex, BMI, procedure (hip or knee), and surgical year to non-breast cancer controls. Mortality, implant survival, and complications were assessed via Kaplan-Meier methods. Clinical outcomes were evaluated via Harris Hip Scores (HHSs) or Knee Society Scores (KSSs). Mean follow-up was six years (2 to 15).Aims
Methods
It is unclear whether mortality outcomes differ for patients undergoing total hip arthroplasty (THA) or total knee arthroplasty (TKA) surgery who are readmitted to the index hospital where their surgery was performed, or to another hospital. We analyzed linked hospital and death records for residents of New South Wales, Australia, aged ≥ 18 years who had an emergency readmission within 90 days following THA or TKA surgery between 2003 and 2022. Multivariable modelling was used to identify factors associated with non-index readmission and to evaluate associations of readmission destination (non-index vs index) with 90-day and one-year mortality.Aims
Methods
The present study aimed to investigate whether patients with inflammatory bowel disease (IBD) undergoing joint arthroplasty have a higher incidence of adverse outcomes than those without IBD. A comprehensive literature search was conducted to identify eligible studies reporting postoperative outcomes in IBD patients undergoing joint arthroplasty. The primary outcomes included postoperative complications, while the secondary outcomes included unplanned readmission, length of stay (LOS), joint reoperation/implant revision, and cost of care. Pooled odds ratios (ORs) and 95% confidence intervals (CIs) were calculated using a random-effects model when heterogeneity was substantial.Aims
Methods
Periprosthetic joint infections (PJIs) are among the most devastating complications after joint arthroplasty. There is limited evidence on the efficacy of different antiseptic solutions on reducing biofilm burden. The purpose of the present study was to test the efficacy of different antiseptic solutions against clinically relevant microorganisms in biofilm. We conducted an in vitro study examining the efficacy of several antiseptic solutions against clinically relevant microorganisms. We tested antiseptic irrigants against nascent (four-hour) and mature (three-day) single-species biofilm created in vitro using a drip-flow reactor model.Aims
Methods
Aims. Currently, the US Center for Medicaid and
Aims. The purpose of this study is to determine if higher volume hospitals
have lower costs in revision hip and knee arthroplasty. Materials and Methods. We questioned the Centres for
Total knee arthroplasty (TKA) and total hip arthroplasty
(THA) are recognised and proven interventions for patients with
advanced arthritis. Studies to date have demonstrated a steady increase
in the requirement for primary and revision procedures. Projected
estimates made for the United States show that by 2030 the demand
for primary TKA will grow by 673% and for revision TKA by 601% from
the level in 2005. For THA the projected estimates are 174% and
137% for primary and revision surgery, respectively. The purpose
of this study was to see if those predictions were similar for England
and Wales using data from the National Joint Registry and the Office
of National Statistics. Analysis of data for England and Wales suggest that by 2030,
the volume of primary and revision TKAs will have increased by 117%
and 332%, respectively between 2012 and 2030. The data for the United
States translates to a 306% cumulative rate of increase between
2012 and 2030 for revision surgery, which is similar to our predictions
for England and Wales. The predictions from the United States for primary TKA were similar
to our upper limit projections. For THA, we predicted an increase
of 134% and 31% for primary and revision hip surgery, respectively. Our model has limitations, however, it highlights the economic
burden of arthroplasty in the future in England and Wales as a real
and unaddressed problem. This will have significant implications
for the provision of health care and the management of orthopaedic
services in the future. Cite this article:
Using general practitioner records and hospital
notes and through direct telephone conversation with patients, we investigated
the accuracy of nine patient-reported complications gathered from
a self-completed questionnaire after elective joint replacement
surgery of the hip and knee. A total of 402 post-discharge complications
were reported after 8546 elective operations that were undertaken
within a three-year period. These were reported by 136 men and 240
women with a mean age of 71.8 years (34 to 93). A total of 319 reported
complications (79.4%; 95% confidence interval 75.4 to 83.3) were
confirmed to be correct. High rates of correct reporting were demonstrated
for infection (94.5%) and the need for further surgery (100%), whereas
the rates of reporting deep-vein thrombosis (DVT), pulmonary embolism,
myocardial infarction and stroke were lower (75% to 84.2%). Dislocation,
peri-prosthetic fractures and nerve palsy had modest rates of correct
reporting (36% to 57.1%). More patients who had knee surgery delivered
incorrect reports of dislocation (p = 0.001) and DVT (p = 0.013). Despite these variations, it appears that post-operative complications
may form part of a larger patient-reported outcome programme after
elective joint replacement surgery.