Editor's Note Hip fracture surgery was associated with a higher risk of mortality and morbidity than elective total hip replacement (THR) even after adjustment for age, gender, and comorbidities, in this French study. Hip fracture patients had a 1.8% chance of dying before hospital discharge compared to 0.3% for THR…

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Editor's Note Between 2000 and 2010, more than 5.2 million total knee replacements were performed in the US, and the rate at which adults had their knees replaced more than doubled (from 24 per 10,000 adults to 45 per 10,000), according to the Centers for Disease Control and Prevention’s National…

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Editor's Note Total knee and total hip arthroplasties are associated with a substantially increased risk of myocardial infarction during the first postoperative month, finds this study. The MI risk gradually declined overtime, but the risk for venous thromboembolism remained years after the procedure. The study included 40,000 patients, half of…

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Editor's Note The rate of major complications was significantly higher in Canada than the US after total knees, but there was no significant difference after total hips, this study finds. US patients also had substantially shorter lengths of stay, which perhaps reflects more efficient postoperative care and discharge planning, the…

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Editor's Note Characteristics of total hip replacements (THRs) were found to be related to early prosthetic revision in this French study.  Antibiotic-free cemented and antibiotic-impregnated cemented THRs were compared with uncemented. Ceramic-on-ceramic, ceramic-on-polyethylene, and metal-on-metal THRs were compared with metal-on-polyethylene.  The antibiotic-impregnated cemented THRs had a better prognosis than uncemented,…

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Editor's Note In this study, patients having hip fracture surgery under regional anesthesia had significantly more complications than patients who received general anesthesia. Spinal anesthesia had the highest complication rate (19.6%), followed by general anesthesia (17.9%), and regional nerve blocks (12.6%). After combining regional nerve block and spinal anesthesia patients,…

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Editor's Note The Centers for Medicare & Medicaid Services is planning to require more than 800 hospitals in 75 geographic areas to participate in a bundled payments initiative for hip and knee replacements. These procedures are among the most common that Medicare beneficiaries receive, and prices vary significantly across geographic…

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Postsurgical pain scores are highly correlated with reports of overall patient satisfaction during hospital stays, according to a poster presented at the 2014 American Academy of Pain Medicine annual meeting. Dermot Maher, MD, and his colleagues from Cedars Sinai Medical Center in Los Angeles examined patient responses on HCAHPS (Hospital…

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Solid teamwork and a commitment to high-quality patient care are the hallmarks of a successful healthcare facility. But egos sometimes get in the way, and competition among surgeons in the orthopedic service line at St Louis-based SSM Health Care was impeding progress. The surgeons were affiliated with three independent groups,…

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Medicare administrative contractors (MACs) in several states recently ratcheted up their documentation requirements for joint replacement surgery and other orthopedic procedures. For hospital ORs, these changes represent the tip of an iceberg that calls for careful navigation. Enhanced medical necessity documentation requirements were launched in Florida in 2011. The state’s…

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