Although good clinical outcomes have been reported for monolithic tapered, fluted, titanium stems (TFTS), early results showed high rates of subsidence. Advances in stem design may mitigate these concerns. This study reports on the use of a current monolithic TFTS for a variety of indications. A multi-institutional retrospective study of all consecutive total hip arthroplasty (THA) and revision total hip arthroplasty (rTHA) patients who received the monolithic TFTS was conducted. Surgery was performed by eight fellowship-trained arthroplasty surgeons at four institutions. A total of 157 hips in 153 patients at a mean follow-up of 11.6 months (SD7.8) were included. Mean patient age at the time of surgery was 67.4 years (SD 13.3) and mean body mass index (BMI) was 28.9 kg/m2 (SD 6.5). Outcomes included intraoperative complications, one-year all-cause re-revisions, and subsidence at postoperative time intervals (two weeks, six weeks, six months, nine months, and one year).Aims
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The Comprehensive Care for Joint Replacement (CJR) initiative was implemented to address the two most commonly billed inpatient surgical procedures, total hip and knee arthroplasty. The primary purpose of this manuscript is to review the economic implications of one institution's mandatory involvement in CJR in comparison to prior involvement in Bundled Payment for Care Improvement (BPCI). The average cost per episode of care (EOC) was calculated using our institution's historical data. The target prices, projected savings or losses per EOC, and the projected annual savings for both BPCI and CJR were established and comparatively analyzed.Introduction
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