The cost of healthcare procedures is continuously rising and more emphasis is being placed on increasing the quality and effectiveness of healthcare services. A combined total of 711,000 hip and knee arthroplasties are performed yearly. This figure is expected to increase to 4 million by the year 2030. The American Joint Replacement Registry has been developed to monitor the performance of devices, determine the cost-effectiveness of procedures, and increase patient safety for individuals in need of hip and knee replacement procedures.

Platelet-rich plasma (PRP), a portion of autologous blood containing concentrated platelets above baseline values, has gained recent popularity in the field of orthopaedics. Many orthopaedic surgeons feel that PRP plays an influential role in enhancing the healing process following soft-issue injuries in patients who have failed conservative management or in patients requiring surgical intervention. Platelet-rich plasma is currently being used to treat acute and chronic tendinopathies in the clinical and surgical settings. For clinicians to fully understand the role of PRP, it is imperative that they have a general understanding of the body's healing process. Clinicians should also be aware of the various commercial systems available that may be utilized to produce PRP and the basis behind the performance of these systems. The presence of PRP provides additional treatment options when managing and treating soft-tissue injuries. However, clinicians must realize that little clinical evidence exists supporting the efficacy of PRP and more well-designed, controlled, clinical trials are needed.

As the current population continues to increase in age, so does the degeneration of the musculoskeletal system and the development of knee osteoarthritis. Total knee arthroplasty (TKA) will be the treatment of choice when it comes to improving physical function and decreasing pain associated with osteoarthritis of the knee. The global push for more cost-effective healthcare services has led to new models of care and payment delivery methods such as performing TKA in the ambulatory surgery center (ASC) setting. With deeply invasive surgical procedures such as TKA being done in the ASC setting, orthopaedic nurses must be mindful of best practices that will promote quality and safety while considering the importance of using current evidence to guide nursing practice when promoting appropriate patient selection and effective patient education of self-management of postoperative care pertaining to TKA being performed in the ASC setting. This is critical to consider during a time when financial profits in the ASC setting may take a front seat to the delivery of high-quality and safe patient care.

The UP-HIP allows the OP and case manager to ensure continuity of postoperative care by conducting remote follow-up postoperative visits with elderly patients with hip fracture while they remain in the rural SNF setting. Comprehensive evidence-based protocols assist OPs and case managers with remotely monitoring rehabilitation progress in the rural SNF setting more efficiently and consistently. Telehealth technology added to evidence-based protocols enables the OP and case manager to conduct real-time visual assessments of the patient without the patient having to leave the rural SNF setting.

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