Costs Versus Benefits of Routine Histopathological Examination in Total Ankle Replacement

Soukup, Dylan S.; O’Malley, Martin J.; Ellis, Scott J.

doi:10.1177/1071100715576371

Cited by 3 publications

(2 citation statements)

References 26 publications

(72 reference statements)

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“…Besides, 17 (2.62%) studies compared different surgical techniques [ 28 , 53 , 144 , 145 , 186 , 253 , 338 , 358 , 362 , 374 , 390 , 428 , 538 , 552 , 578 , 650 , 651 ] and seven (1.08%) studies evaluated various levels of surgeons’ experience [ 30 , 33 , 36 , 214 , 255 , 294 , 299 ], while in 18 (2.78%) studies, a prediction of pre- or postoperative risk factors was made [ 14 , 39 , 52 , 54 , 98 , 131 , 132 , 143 , 355 , 367 , 389 , 404 , 435 , 448 , 456 , 457 , 604 , 620 ]. Finally, 15 (2.31%) were cost analysis studies [ 57 , 65 , 75 , 90 , 138 , 140 , 142 , 156 , 158 , 226 , 315 , 326 , 328 , 399 , 486 ], 13 papers (2%) studied the patients’ mortality rate [ 31 , 60 , 76 , 258 , 259 , 313 , 320 , …”

Section: Resultsmentioning

confidence: 99%

“…Sinai HS, Baltimore [ 86 ] 4. HS for Special Surgery [ 11 , 19 , 59 , 61 , 63 , 98 , 113 , 116 , 119 , 121 , 128 , 148 , 156 , 167 , 170 , 173 , 181 , 187 , 193 , 206 – 208 , 210 , 217 , 222 , 223 , 233 , 235 , 236 , 238 , 241 – 243 , 246 , 261 , 265 , 266 , 268 , 270 , 279 , 281 , 283 , 298 , 301 , 307 , 479 , 483 – 485 , 488 , 493 , 494 , 499 , 501 , 512 , 517 , 521 , 530 , 533 , 541 , 542 , ...…”

Section: Resultsunclassified

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Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Zgouridou,

Kenanidis,

Potoupnis

et al. 2023

Eur J Orthop Surg Traumatol

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Purpose Four joint arthroplasty registries (JARs) levels exist based on the recorded data type. Level I JARs are national registries that record primary data. Hospital or institutional JARs (Level II–IV) document further data (patient-reported outcomes, demographic, radiographic). A worldwide list of Level II–IV JARs must be created to effectively assess and categorize these data. Methods Our study is a systematic scoping review that followed the PRISMA guidelines and included 648 studies. Based on their publications, the study aimed to map the existing Level II–IV JARs worldwide. The secondary aim was to record their lifetime, publications’ number and frequency and recognise differences with national JARs. Results One hundred five Level II–IV JARs were identified. Forty-eight hospital-based, 45 institutional, and 12 regional JARs. Fifty JARs were found in America, 39 in Europe, nine in Asia, six in Oceania and one in Africa. They have published 485 cohorts, 91 case-series, 49 case–control, nine cross-sectional studies, eight registry protocols and six randomized trials. Most cohort studies were retrospective. Twenty-three per cent of papers studied patient-reported outcomes, 21.45% surgical complications, 13.73% postoperative clinical and 5.25% radiographic outcomes, and 11.88% were survival analyses. Forty-four JARs have published only one paper. Level I JARs primarily publish implant revision risk annual reports, while Level IV JARs collect comprehensive data to conduct retrospective cohort studies. Conclusions This is the first study mapping all Level II–IV JARs worldwide. Most JARs are found in Europe and America, reporting on retrospective cohorts, but only a few report on studies systematically.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsunclassified

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Zgouridou,

Kenanidis,

Potoupnis

et al. 2023

Eur J Orthop Surg Traumatol

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Non-neoplastic bone, joint, and soft tissue pathology: What every pathologist should know

Klein

2024

Human Pathology

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Cost Analysis of Routine Histopathologic Evaluation of Specimens Following Total Ankle Arthroplasty

Padilla,

Andriani,

Papalia

et al. 2024

Foot Ankle Int.

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Background: Routine histopathologic examination of orthopaedic surgical specimens is a standard practice at many institutions. Previous studies have demonstrated that this practice seldom altered patient management for several orthopaedic procedures. As a result, the value of such practices has come into question. The purpose of this study is to determine the cost-effectiveness of routine histopathologic analysis of specimens obtained during total ankle arthroplasty (TAA). Methods: A retrospective analysis was performed of patients who underwent uncomplicated primary TAA at a large, academic, health system between January 2015 and December 2021. The postoperative histopathologic diagnoses were compared with the respective patient’s preoperative clinical and intraoperative diagnoses. The prevalence of concordant, discrepant, and discordant diagnoses was determined. Cost-effectiveness analysis was conducted to assess the financial implications of obtaining routine specimens for histopathologic examination for TAA. Results: A total of 85 TAAs were identified in 85 individual patients and were included in the present study. A total of 172 specimens were sent for routine histopathologic review. On histopathologic analysis, a final diagnosis was confirmed in 82 (96.5%) of the total specimens reviewed. A discrepant diagnosis was discovered in 3 (3.5%; 2 cases of gout/pseudogout and 1 case of osteonecrosis) cases and 0 (0%) discordant diagnoses were discovered, corresponding to positive and negative predictive values of 97% and 100%, respectively The total estimate of costs incurred for the routine analysis of all specimens included in the study was between $12 299.20 and 17 846.00. The estimated cost to establish each discrepant diagnosis ranged between $4099.73 and $5948.67, and the cost for a discordant diagnosis was unable to be established. Conclusion: Routine histopathologic analysis of specimens obtained during TAA rarely revealed a discordant diagnosis and resulted in no alterations to patients’ plan of care. Furthermore, the additional costs of routine histopathologic examination are significant. As such, it is recommended that such interventions in TAA should be performed on a per-case basis at the operating surgeon’s discretion.

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Costs Versus Benefits of Routine Histopathological Examination in Total Ankle Replacement

Abstract: Level IV, retrospective case series.

Cited by 3 publications

References 26 publications

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Global mapping of institutional and hospital-based (Level II–IV) arthroplasty registries: a scoping review

Non-neoplastic bone, joint, and soft tissue pathology: What every pathologist should know

Cost Analysis of Routine Histopathologic Evaluation of Specimens Following Total Ankle Arthroplasty

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