The COVID-19 pandemic led to a swift adoption of telehealth in orthopaedic surgery. This study aimed to analyze the satisfaction of patients and surgeons with the rapid expansion of telehealth at this time within the division of adult reconstructive surgery at a major urban academic tertiary hospital. A total of 334 patients underging arthroplasty of the hip or knee who completed a telemedicine visit between 30 March and 30 April 2020 were sent a 14-question survey, scored on a five-point Likert scale. Eight adult reconstructive surgeons who used telemedicine during this time were sent a separate 14-question survey at the end of the study period. Factors influencing patient satisfaction were determined using univariate and multivariate ordinal logistic regression modelling.Aims
Methods
Liposomal bupivacaine (LB) as part of a periarticular injection protocol continues to be a highly debated topic in total knee arthroplasty (TKA). We evaluated the effect of discontinuing the use of LB in a periarticular protocol on immediate postoperative pain scores, opioid consumption, and objective functional outcomes. On 1 July 2019, we discontinued the use of intraoperative LB as part of a periarticular injection protocol. A consecutive group of patients who received LB as part of the protocol (Protocol 1) and a subsequent group who did not (Protocol 2) were compared. All patients received the same opioid-sparing protocol. Verbal rating scale (VRS) pain scores were collected from our electronic data warehouse and averaged per patient per 12-hour interval. Events relating to the opiate administration were derived as morphine milligram equivalences (MMEs) per patient per 24-hour interval. The Activity Measure for Post-Acute Care (AM-PAC) tool was used to assess the immediate postoperative function.Aims
Methods
The COVID-19 pandemic led to a swift adoption of telehealth in orthopedic surgery. The purpose of this study was to analyze patient and surgeon satisfaction with a rapid expansion of telehealth use during COVID-19 pandemic within the division of adult reconstructive surgery at a major urban academic hospital. 334 hip and knee arthroplasty patients who completed a telemedicine visit from March 30th, 2020 through April 30th, 2020 were sent a 14-question survey. Eight adult reconstructive surgeons who used telemedicine were sent a separate 14-question survey at the end of the study period. Factors influencing patient satisfaction were determined using univariate and multivariate ordinal logistic regression modeling.Introduction
Methods
Previous studies have reported an increased risk for postoperative complications in the Medicaid population undergoing total hip arthroplasty (THA). These studies have not controlled for the surgeon’s practice or patient care setting. This study aims to evaluate whether patient point of entry and Medicaid status plays a role in quality outcomes and discharge disposition following THA. The electronic medical record at our institution was retrospectively reviewed for all primary, unilateral THA between January 2016 and January 2018. THA recipients were categorized as either Medicaid or non-Medicaid patients based on a visit to our institution’s Hospital Ambulatory Care Center (HACC) within the six months prior to surgery. Only patients who had been operated on by surgeons (CML, JV, JDS, RS) with at least ten Medicaid and ten non-Medicaid patients were included in the study. The patients included in this study were 56.33% female, had a mean age of 60.85 years, and had a mean BMI of 29.14. The average length of follow-up was 343.73 days.Aims
Methods
Previous studies have reported an increased risk for postoperative complications in the Medicaid population undergoing total hip arthroplasty (THA). These studies have focused on payer type and have not controlled for the surgeon's practice or patient care setting. This study aims to evaluate whether patient point of entry plays a role in quality outcomes and discharge disposition following THA. The electronic medical record at our institution was retrospectively reviewed for all primary, elective, unilateral THA between January 2016 and June 2018. THA recipients were categorized as either Hospital Ambulatory Clinic Centers (HACC) with Medicaid as the primary payer or private office patients with a non-Medicaid primary payer based on a previous visit to our institution's HACC within the 6-months prior to surgery. Only patients who had been operated on by a surgeon with at least 10 HACC and 10 private office patients were included.Introduction
Methods
Patients who undergo total joint arthroplasty (TJA) are at a high risk for the development of thromboembolic complications. The rate at which venous thromboembolism occurs following TJA has been reported to be between 1.3–9.4%. As a result, the utilization of prophylactic therapies is considered standard of care in this patient population. The primary purpose of the current study was to 1) evaluate patient satisfaction with the use of intermittent compression devices 2) evaluate the risk of self-reported falls secondary to the use of these devices following TJA. This is a single institution, prospective study on patients who underwent TJA at an urban, academic orthopedic specialty hospital. Patients were surveyed using an electronic patient rehabilitation application regarding their use and satisfaction with their home intermittent compression devices with a battery and power cord attachment that the patient must wear while using the devices. They were also asked if any falls or near-falls they may have experienced. Surveys were administered on postoperative Day 14, and patients were given 10 days to submit their responses. Using our institutions data warehouse, patient demographics were also collected (Table 1).Introduction
Methods
Knee arthroplasty (KA) is a highly effective surgical procedure. However, research suggests that a considerable number of patients continue to experience substantial pain and functional loss following surgical recovery. We aimed to estimate pain and function outcome trajectories for persons undergoing KA depicting the outcome, the relationship between the pain and function trajectory types, and pre-surgery predictors of trajectory type (i.e., good versus poor). Participants included 384 patients who took part in the Knee Arthroplasty Skills Training (KASTPain) clinical trial. Pain and function was assessed at 2-week pre- and 2-, 6-, and 12-month post-surgery using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) Pain and Function Scales. Piecewise latent class growth models were used to estimate pain and function trajectories. Dumenci's latent kappa was used to estimate the chance-corrected agreement between pain and function trajectory types. Pre-surgery variables were used to predict trajectory types.Introduction
Methods
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
Methods
