Orthopedics

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Predictors of persistent opioid use after total joints

Editor's Note Many total hip and knee patients are still taking opioid pain medication up to 6 months after surgery, finds this study. The study identifies several predictors for persistent opioid use: Of patients taking opioids before surgery, 53% of total knee and 35% of total hip patients were still…

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By: Judy Mathias
June 1, 2016
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Shoulder surgery new testing ground for opioid alternatives

Editor's Note As part of the drive to reduce opioid use, rotator-cuff repairs are becoming a testing ground for alternative approaches to pain management, the May 23 Wall Street Journal reports. Because rotator-cuff surgery is one of the most painful procedures to recover from, physicians hope that if alternative painkilling…

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By: Judy Mathias
May 26, 2016
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Postop morbidity, discharge in elderly fast-track total joint patients

Editor's Note Fast-track total hip and knee arthroplasties with a median length of stay of 3 days and discharge to home are feasible in most patients 85 years of age or older, this study finds. Of 13,775 procedures included in the analysis: median age was 87 years and median length…

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By: Judy Mathias
May 24, 2016
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Improving SSI surveillance after total hips, knees

Editor's Note Medical chart review for surgical site infections (SSIs) that were identified through administrative data is an efficient supplemental SSI surveillance strategy following total hip and knee arthroplasty, this study finds. Of 162 patients with potential SSIs identified by diagnosis or procedure code, 46 (28%) were confirmed as an…

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By: Judy Mathias
May 23, 2016
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Arthroscopic hip surgery may not be best option for arthritis

Editor's Note Arthroscopic surgery may not be the best option for patients over 60 years of age with hip arthritis, this study finds. Though most patients prefer minimally invasive hip arthroscopy rather than total hip replacement, researchers from the Hospital for Special Surgery, New York City, found that more than…

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By: Judy Mathias
May 19, 2016
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Thomas Jefferson University Hospital awarded first Joint Commission total joint certification

Editor's Note The Joint Commission on April 27 announced that Thomas Jefferson University Hospital, Philadelphia, is the first hospital in the US to achieve its Advanced Certification for Total Hip and Total Knee Replacement. The certification recognizes that Thomas Jefferson University Hospital is committed to providing safe and efficient care…

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By: Judy Mathias
May 2, 2016
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Safety of hand and arm procedures in freestanding ASCs

Editor's Note Hand and arm surgical procedures can be completed safely in the outpatient setting at a freestanding ambulatory surgery center (ASC), this study finds. In this retrospective review of nearly 29,000 cases performed at a freestanding ASC over an 11-year period, there were 58 adverse events, for an overall…

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By: Judy Mathias
April 26, 2016
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Orthopedic service line takes health system to another level

Total joint replacements have grown rapidly in recent years, thanks to an aging population and advances in surgical techniques and pain management. As a result, many healthcare facilities have added joint and spine procedures to their service lines. Others would like to know how to do this. What’s involved in…

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By: OR Manager
April 20, 2016
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Some 60% of hospitals could face penalties under new joint replacement rule

Editor's Note A new analysis by Avalere Health (Washington, DC) finds that 60% of hospitals participating in Medicare’s Comprehensive Care for Joint Replacement bundled-payment model could face penalties if they don’t reduce their costs. The average total joint costs around $13,000, but the entire episode-of-care costs twice that at $26,000.…

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By: Judy Mathias
April 13, 2016
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ERAS program for total joints reduces length of stay

Editor's Note Use of an Enhanced Recovery after Surgery (ERAS) program in total hip and total knee patients reduced length of stay by 1 day in this study. Short term complications and readmission rates were similar for patients in the ERAS program and those managed in a traditional perioperative care…

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By: Judy Mathias
March 28, 2016
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