Orthopedics

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Prevalence of total joint replacement in the US

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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By: Judy Mathias
February 5, 2016
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Oregon Outpatient Surgery Center performs same-day total hips

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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By: Judy Mathias
January 12, 2016
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Joint Commission now offering advanced certification for total joints

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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By: Judy Mathias
January 7, 2016
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Effectiveness of various pressures, solutions for wound irrigation of open fractures

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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By: Judy Mathias
January 7, 2016
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Psychiatric disorder linked to morbidity after fast-track total joints

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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By: Judy Mathias
November 19, 2015
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Door openings affect OR pressure during joint arthroplasty

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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By: Judy Mathias
November 18, 2015
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CMS finalizes rule for hip and knee bundled payments

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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By: Judy Mathias
November 17, 2015
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Effect of anesthetic management on total joint SSIs

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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By: Judy Mathias
November 10, 2015
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Influence of race on risk of total knee revision

Editor's Note Blacks are at a significantly higher risk of having total knee revision surgery within 5 years than whites, finds a study presented at the American College of Rheumatology Annual Meeting in San Francisco. The risk of revision was 38% higher in blacks. When blacks undergo knee replacement they…

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By: Judy Mathias
November 9, 2015
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Effect of total joint infection control bundle on SSIs

Editor's Note Quality improvement initiatives combined with pulsed xenon ultraviolet room disinfection reduced total knee surgical site infections (SSIs) from four to zero and total hip SSIs from three to zero for a combined prevention of seven SSIs and a savings of $290,990 in 1 year at Trinity Medical Center,…

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By: Judy Mathias
November 3, 2015
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