New Joint Commission requirements for total hip, knee replacements focus on opioids, diabetes

Editor's Note

The Joint Commission has released revised requirements for the advanced disease-specific care certification for total hip and total knee replacement (THKR). The requirements, which are designed to align with the updated AAOS clinical practice guidelines, go into effect July 1, 2024 and focus largely on addressing opioids and diabetes. 

Perioperative care pathways must now include identification and mitigation of risks associated with diabetes and opioids. Intraoperative requirement revisions include using peripheral nerve block or periarticular local infiltration to reduce both pain and post-operative opioid use. Postoperative revisions include: glycemic control for patients with diabetes, and glycemic monitoring and referral for patients without diabetes who had an elevated postoperative glucose level.