The purpose of this study was to assess total knee arthroplasty (TKA) volume and rates of early complications in morbidly obese patients over the last decade, where the introduction of quality models influencing perioperative care pathways occurred. Patients undergoing TKA between 2011 to 2018 were identified in the American College of Surgeons National Surgical Quality Improvement Program database. Patients were stratified by BMI < 40 kg/m2 and ≥ 40 kg/m2 and evaluated by the number of cases per year. The 30-day rates of any complication, wound complications, readmissions, and reoperation were assessed. Trends in these endpoints over the study period were compared between groups using odds ratios (ORs) and multivariate analyses.Aims
Methods
Perioperative optimization efforts have improved outcomes following primary total knee arthroplasty (TKA). However, morbidly obese patients continue to have increased rates of complications. The purpose of this study was to assess if rates of early complications after TKA have similarly improved for both morbidly obese and non-morbidly obese patients. Elective, primary TKA patients from 2011–2018 were identified in the National Surgical Quality Improvement Program database. Patients were stratified by body mass index (BMI) <40 kg/m2 and ≥40 kg/m2. Thirty-day rates of infectious complications, readmissions, and reoperation were assessed. Trends in these endpoints over the study period were compared between BMI groups utilizing odds ratios (OR) and multivariate analyses.Introduction
Methods
There have been significant advancements in postoperative care following total hip arthroplasty (THA) over the past decade and it is essential to quantify the impact of efforts made to better optimize patients and improve postoperative care. The purpose of this study was to assess trends in discharge destination, length of stay (LOS), and readmissions following primary THA. Patients undergoing primary THA during 2011–2017 were identified in the American College of Surgeons National Quality Improvement Program using CPT code 27130. Non-elective surgery and simultaneous bilateral THA procedures were excluded. Patients were classified as having discharged home or to not home locations. Trends in discharge destination, LOS, 30-day readmission, 30-day reoperation, and American Society of Anesthesiologists (ASA) classification were assessed using the Cochran-Armitage test.Introduction
Methods
In 2015, the healthcare system transitioned from International Classification of Diseases, Ninth Revision (ICD-9) coding to the Tenth Revision (ICD-10). Given that administrative claims are used for quality initiatives, risk adjustment models and clinical research, we sought to determine the effect of new, more detailed coding on the incidence of complications following primary total knee arthroplasty (TKA). The Humana administrative claims database was queried from 2-years prior to October 1, 2015 (ICD-9 cohort) and for 1-year after this date (ICD-10 cohort) to identify all primary TKA procedures. Each TKA was then tracked for occurrence of an arthroplasty specific post-operative complication within 6 months of surgery using the respective coding systems. Laterality and joint specific codes were utilized for the ICD-10 cohort to ensure complications occurred on the same side and joint as the index procedure. Incidence of each complication was compared between cohorts using risk ratios (RR) and 95% confidence intervals.Introduction
Methods
Obesity has previously been demonstrated to be an independent risk factor for increased complications following total hip (THA) and total knee arthroplasty (TKA). The purpose of this study was to compare the effects of obesity and BMI to determine whether the magnitude of the effect was similar for both procedures. We queried the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database to identify patients who underwent primary THA or TKA between 2010 and 2014. Patients were stratified by procedure and classified as non-obese, obese, or morbidly obese according to BMI. Thirty-day rates of wound complications, deep infection, total complications, and reoperation were compared using univariate and multivariate logistic regression analyses.Purpose
Materials & Methods
The purpose of this study was to evaluate trends in opioid use
after unicompartmental knee arthroplasty (UKA), to identify predictors
of prolonged use and to compare the rates of opioid use after UKA,
total knee arthroplasty (TKA) and total hip arthroplasty (THA). We identified 4205 patients who had undergone UKA between 2007
and 2015 from the Humana Inc. administrative claims database. Post-operative
opioid use for one year post-operatively was assessed using the
rates of monthly repeat prescription. These were then compared between
patients with and without a specific variable of interest and with
those of patients who had undergone TKA and THA.Aims
Materials and Methods
