Subscribe to RSS
DOI: 10.1055/s-0034-1376331
Differences in Readmission Rates for Two Total Knee Arthroplasty Prostheses
Publication History
10 January 2014
06 March 2014
Publication Date:
12 May 2014 (online)
Abstract
The readmission rates of cruciate-retaining (CR) and a posterior-stabilizing (PS) total knee arthroplasty (TKA) have not been extensively evaluated. We aimed to determine the following: (1) What are the readmission rates of TKA performed with the use of CR and PS prostheses at 30, 60, and 90 days following discharge? (2) Were the causes of the unplanned readmission surgically or medically related? (3) What were the medical comorbidities associated with readmission? A prospectively collected database of 845 TKAs (441 CR and 404 PS TKAs) at 22 institutions (24 surgeons) was reviewed. Outcomes evaluated included the incidence of readmission at 30, 60, and 90 days after discharge, medical/surgical cause, and medical comorbidities. There were no significant differences in readmission rates between the two cohorts at the different time points. There was a readmission rate of 2% at 30 days and 3.2% at 60 days for the CR group, and 2.2% at 30 days and 4.0% at 60 days for the PS group after discharge. Medical causes accounted for a majority of the readmissions in both the CR and PS cohort. Readmitted patients had a higher incidence of increased body mass index, cardiovascular disorders, diabetes, and musculoskeletal disorders. The readmission rates for both prostheses in the setting of primary TKA are encouraging because these rates are lower than previously reported outcomes. The authors believe that the positive midterm clinical performance of the prostheses used in this study may have contributed to the lower readmission rates.
-
References
- 1 Neogi T. The epidemiology and impact of pain in osteoarthritis. Osteoarthr Cartil 2013; 21: 1145-1153
- 2 Ruiz Jr D, Koenig L, Dall TM , et al. The direct and indirect costs to society of treatment for end-stage knee osteoarthritis. J Bone Joint Surg Am 2013; 95 (16) 1473-1480
- 3 Kurtz S, Ong K, Lau E, Mowat F, Halpern M. Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. J Bone Joint Surg Am 2007; 89 (4) 780-785
- 4 Schairer WW, Vail TP, Bozic KJ. What are the rates and causes of hospital readmission after total knee arthroplasty?. Clin Orthop Relat Res 2014; 472 (1) 181-187
- 5 Vorhies JS, Wang Y, Herndon JH, Maloney WJ, Huddleston JI. Decreased length of stay after TKA is not associated with increased readmission rates in a national Medicare sample. Clin Orthop Relat Res 2012; 470 (1) 166-171
- 6 Zmistowski B, Restrepo C, Hess J, Adibi D, Cangoz S, Parvizi J. Unplanned readmission after total joint arthroplasty: rates, reasons, and risk factors. J Bone Joint Surg Am 2013; 95 (20) 1869-1876
- 7 Pugely AJ, Callaghan JJ, Martin CT, Cram P, Gao Y. Incidence of and risk factors for 30-day readmission following elective primary total joint arthroplasty: analysis from the ACS-NSQIP. J Arthroplasty 2013; 28 (9) 1499-1504
- 8 Saucedo JM, Marecek GS, Wanke TR, Lee J, Stulberg SD, Puri L. Understanding readmission after primary total hip and knee arthroplasty: who's at risk?. J Arthroplasty 2014; 29 (2) 256-260
- 9 Bercik MJ, Joshi A, Parvizi J. Posterior cruciate-retaining versus posterior-stabilized total knee arthroplasty: a meta-analysis. J Arthroplasty 2013; 28 (3) 439-444
- 10 Kolisek FR, McGrath MS, Marker DR , et al. Posterior-stabilized versus posterior cruciate ligament-retaining total knee arthroplasty. Iowa Orthop J 2009; 29: 23-27
- 11 Jacobs WC, Clement DJ, Wymenga AB. Retention versus removal of the posterior cruciate ligament in total knee replacement: a systematic literature review within the Cochrane framework. Acta Orthop 2005; 76 (6) 757-768
- 12 Healy WL, Della Valle CJ, Iorio R , et al. Complications of total knee arthroplasty: standardized list and definitions of the Knee Society. Clin Orthop Relat Res 2013; 471 (1) 215-220
- 13 Avram V, Petruccelli D, Winemaker M, de Beer J. Total joint arthroplasty readmission rates and reasons for 30-day hospital readmission. J Arthroplasty 2014; 29 (3) 465-468
- 14 van Veldhuisen DJ, Cohen-Solal A, Böhm M , et al; SENIORS Investigators. Beta-blockade with nebivolol in elderly heart failure patients with impaired and preserved left ventricular ejection fraction: data From SENIORS (Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors With Heart Failure). J Am Coll Cardiol 2009; 53 (23) 2150-2158
- 15 Husted H, Otte KS, Kristensen BB, Orsnes T, Kehlet H. Readmissions after fast-track hip and knee arthroplasty. Arch Orthop Trauma Surg 2010; 130 (9) 1185-1191
- 16 Dailey EA, Cizik A, Kasten J, Chapman JR, Lee MJ. Risk factors for readmission of orthopaedic surgical patients. J Bone Joint Surg Am 2013; 95 (11) 1012-1019