Orthopedics
Some 60% of hospitals could face penalties under new joint replacement rule
Editor's Note A new analysis by Avalere Health (Washington, DC) finds that 60% of hospitals participating in Medicare’s Comprehensive Care for Joint Replacement bundled-payment model could face penalties if they don’t reduce their costs. The average total joint costs around $13,000, but the entire episode-of-care costs twice that at $26,000.…
ERAS program for total joints reduces length of stay
Editor's Note Use of an Enhanced Recovery after Surgery (ERAS) program in total hip and total knee patients reduced length of stay by 1 day in this study. Short term complications and readmission rates were similar for patients in the ERAS program and those managed in a traditional perioperative care…
Peripheral nerve blocks linked to better total joint outcomes
Editor's Note Peripheral nerve blocks were associated with fewer complications and lower costs in total hip and knee patients in this study, which was presented March 23 at the annual meeting of the American Society of Regional Anesthesia and Pain Medicine. In this analysis of more than 1 million patients…
Surgical approach for total hip doesn’t affect outcome
Editor's Note The surgical approach to total hip (ie, anterior or posterior) has no effect on outcomes at 6 months after surgery, finds this study presented March 3 at the annual meeting of the American Academy of Orthopaedic Surgeons. Of 274 patients who had total hip replacements between June 2012…
Same-day discharge safe for total hips
Editor's Note Total hips can be performed safely and effectively on an outpatient basis, finds a study presented March 3 at the annual meeting of the American Academy of Orthopedic Surgeons. The analysis included 549 patients who had mini-posterior arthroplasties at an ASC from 2008 to 2014 and were discharged…
Study: Performing total knees in high-volume hospitals could save billions
Editor's Note If all total knee replacements were performed at high-volume hospitals, it could save the US healthcare system between $2.5 and $4 billion annually by 2030, finds a study presented March 4 at the annual meeting of the American Academy of Orthopedic Surgeons. In this study of nearly 90,000…
Intraop hypothermia linked to SSIs after hip fracture repair
Editor's Note Hypothermia is associated with an increased risk for surgical site infections (SSIs) in patients having surgery to repair a hip fracture, finds this study presented March 2 at the annual meeting of the American Academy of Orthopedic Surgeons. Of 1,525 patients analyzed: hypothermia occurred in 13.2% of cases…
Nurse staffing, work environment linked to readmissions after total joints
Editor's Note Readmissions after total hip and knee replacements are associated with nurse staffing levels and poor nurse work environments, finds this study from the University of Pennsylvania School of Nursing, Philadelphia. The study analyzed data on more than 112,000 Medicare patients in nearly 500 hospitals. Adjusting for patient and…
Medicare bundled payments improve outcomes for total joint patients
Editor's Note Implementing bundled payments for Medicare patients having total joint replacements resulted in improved quality of care and outcomes and reduced costs, finds this study presented March 2 at the annual meeting of the American Academy of Orthopedic Surgeons. As a pilot site for Medicare’s Bundled Payment for Care…
Total hip too soon after steroid injection increases SSI risk
Editor's Note The risk of developing a surgical site infection (SSI) increased significantly in patients who had a total hip within 3 months of receiving a steroid injection in the hip joint, finds this study presented March 2 at the annual meeting of the American Academy of Orthopedic Surgeons. Analyzing…
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