Editor's Note Total joint patients benefited from preoperative one-on-one educations sessions provided by a physical therapist and access to a custom web portal, in this study presented February 20 at the annual meeting of the American Physical Therapy Association. Researchers from the Hospital for Special Surgery, New York City, followed…

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Editor's Note Bariatric surgery before total knee replacement (TKR) is cost-effective in improving outcomes in obese patients, this study finds. Researchers used a computer software program to compare the cost utility of two treatment protocols for patients who were morbidly obese and had advanced knee osteoarthritis. The model predicted that…

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Editor's Note About 7 million Americans are living with a total hip or knee replacement, including 620,000 who have had both, this study finds. In 2010, the prevalence of total hip and total knee replacement was 0.83% and 1.52%, respectively. Prevalence was higher in women and increased with age, reaching…

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Editor's Note The Oregon Outpatient Surgery Center (Tigard, Oregon) is the first ambulatory surgery center in the Northwest to perform same-day total hip replacements, the January 4 Oregonian reports. The center offers both posterior and anterior total hips for qualified patients. Patients are carefully screened and must be in good…

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Editor's Note A new, optional advanced certification program for total hip and total knee replacement is now available from the Joint Commission. The program will help accredited hospitals, critical access hospitals, and ambulatory surgery centers provide a consistent approach to patient care that reduces the risk of error and improves…

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Editor's Note Very low pressure irrigation with saline is an acceptable, low-cost alternative for irrigating open fractures, this study finds. Managing open fractures requires wound irrigation and debridement, but the effectiveness of various pressures and solutions remains controversial. Researchers investigated the effects of castile soap versus normal saline irrigation delivered…

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Editor's Note In this study, patients with psychiatric disorders (PsDs) requiring psychopharmacological treatments had an increase in postoperative morbidity after fast-track total hip and total knee arthroplasties, regardless of treatment type and preoperative comorbidities. Among PsD patients: Pain, postoperative anemia, and pulmonary complications were the most frequent causes of length…

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Editor's Note This study from Johns Hopkins Bayview Medical Center, Baltimore, found a significant relationship between OR door openings and room pressure. The OR door was opened, on average, once every 2.5 minutes of surgery. For 77 of 191 knee and hip arthroplasties, the doors were open long enough for…

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Editor's Note The Centers for Medicare and Medicaid Services (CMS) has finalized the rule that will require hospitals in 67 geographic areas to participate in a test of bundled payments for hip and knee replacements, Modern Healthcare reports. Medicare's average bundled payment ranges from $16,500 to $33,000 for surgery, hospitalization,…

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Editor's Note Though recent studies using large databases have concluded that neuraxial compared with general anesthesia is associated with a decreased incidence of SSIs in total joint patients, this 11-year retrospective, controlled study found no difference. The use of peripheral nerve blocks also was not found to influence the incidence…

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