Hip and Knee Arthroplasty

Soffin, Ellen M.; Wainwright, Thomas W

doi:10.1016/j.anclin.2021.11.003

Cited by 6 publications

(5 citation statements)

References 60 publications

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“…Moreover, successful management of pain can promote a more rapid recovery and lead to a lower complication rate with increased patient satisfaction 26,27 . Enhanced recovery after surgery (ERAS) is one of the most successful protocols in the orthopedic field 28,29 . At our institution, the ERAS protocol is implemented for all ACDF cases to ensure fast and safe discharge 28 .…”

Section: Discussionmentioning

confidence: 99%

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Risk Factors for Unexpected Conversion from Ambulatory to Inpatient Admission Among One- or Two-level ACDF Patients

Tani

Okano

Dodo

et al. 2023

Spine

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Study Design/Setting. A retrospective observational study. Objective. To investigate the factors associated with the conversion of patient status from ambulatory anterior cervical discectomy and fusion (ACDF) to inpatient. Summary of Background Data. Surgeries are increasingly performed in an ambulatory setting in an era of rising healthcare costs and pressure to improve patient satisfaction. ACDF is a common ambulatory cervical spine surgery, however, there are certain patients who are unexpectedly converted from an outpatient procedure to inpatient admission and little is known about the risk factors for conversion. Methods. Patients who underwent one- or two-level ACDF in an ambulatory setting at a single specialized orthopedic hospital between February 2016 to December 2021 were included. Baseline demographics, surgical information, complications, and conversion reasons were compared between patients with Ambulatory or Observational stay (stay less than 48 hours) and Inpatient (stay greater than 48 hours). Results. In total 662 patients underwent one- or two-level ACDF (median age, 52 y; 59.5% were male), 494 (74.6%) patients were discharged within 48 hours and 168 (25.4%) patients converted to inpatient. Multivariable logistic regression analysis demonstrated that females, low body mass index < 25, American Society of Anesthesiologists classification (ASA) ≥3, long operation, high estimated blood loss, upper-level surgery, two-level fusion, late operation start time, and high postoperative pain score were considered independent risk factors for conversion to inpatient. Pain management was the most common reason for the conversion (80.0%). Ten patients (1.5%) needed reintubation or remained intubated for airway management. Conclusions. Several independent risk factors for prolonged hospital stay after ambulatory ACDF surgery were identified. Although some factors are unmodifiable, other factors, such as procedure duration, operation start time, and blood loss could be potential targets for intervention. Surgeons should be aware of the potential for life-threatening airway complications in ambulatory-scheduled ACDF.

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Section: Discussionmentioning

confidence: 99%

“…26,27 Enhanced recovery after surgery (ERAS) is one of the most successful protocols in the orthopedic field. 28,29 At our institution, the ERAS protocol is implemented for all ACDF cases to ensure fast and safe discharge. 28 However, it is still unknown if ERAS protocols affect conversion.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Unexpected Conversion from Ambulatory to Inpatient Admission Among One- or Two-level ACDF Patients

Tani

Okano

Dodo

et al. 2023

Spine

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“…A number of studies indicate constant demands for total hip and knee arthroplasties [ 11 , 13 ], and these demands will increase over the next 10 years in most age groups [ 14 ]. Although recovery after arthroplasties is facilitated by the application of protocols such as Enhanced Recovery After Surgery for primary hip and knee arthroplasty [ 15 , 16 , 17 ], as well as the provision of basic elements in improvement pathways [ 18 ], there is an increase in the incidence of the total hip and knee revision procedures [ 19 ]. At the same time, the number of operated fractures [ 20 , 21 ] and bone tumors [ 22 , 23 ] are also increasing.…”

Section: Introductionmentioning

confidence: 99%

A Comprehensive Research on the Prevalence and Evolution Trend of Orthopedic Surgeries in Romania

Moldovan

Bățagă

2023

Healthcare

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Accurate knowledge of the prevalence and trends of orthopedic surgeries can facilitate the design of medical plans for effective treatments. The National Endoprosthetic Registry (NER) in Romania provides statistics on endoprosthetic activity (hip, knee), cases of fractures and bone tumors as a result of the legal obligations to report interventions performed by all orthopedic traumatology hospitals/wards in the country. The aim of this study is to describe the annual volumes of orthopedic surgeries between 2001 and 2022 in Romania and analyze the current and future evolution trends of the studied surgeries, gender differences and regional differences based on a complete survey carried out at a national level. For the period 2001–2022, we extracted from the NER the annual volumes of orthopedic interventions performed. With these data, we studied the prevalence and estimated, with the support of an original calculation methodology, the variation trends of orthopedic surgeries in two situations: over the entire 21-year period, respectively, and over the period 2001–2020, which does not include the pandemic period. For hip replacement surgery and knee replacement surgery, we showed the prevalence by subcategory of interventions, gender distribution, regional prevalence and regional density calculated by the annual averages of the total number of cases reported per 100,000 people in the 40 counties of the country and the capital, Bucharest. We also determined the variations in hip and knee arthroplasty revision burdens, calculated as a percentage between the number of revisions and the number of primary interventions in the same period. We determined the regional densities of revision burdens. The total number of orthopedic surgeries in the period 2001–2022 was 1,557,247, of which 189,881 were hip replacement surgeries; 51,035 were knee replacement surgeries; 11,085 were revision hip arthroplasty; 1497 were revision knee arthroplasty; 541,440 were operated fractures; and 16,418 were operated bone tumors. The growth rates of surgical interventions are hip replacement surgery, +8.19%; knee replacement surgery, +19.55%; revision hip arthroplasty, +9.43%; and revision knee arthroplasty, +28.57%. With these data, we have estimated a doubling of the volume of primary and revision interventions of the hip until 2034 and the knee until 2027, respectively. Operated bone tumors register an annual decrease of −4.52% thanks to modern treatments. There are clear gender differences; for primary hip interventions, the proportion of women is 58.82%, and for knee interventions, the proportion of women is 76.42%. This is the first research that, with the support of exhaustive data from the NER, analyzes for the period 2001–2022 the annual number of orthopedic surgeries in Romania. It allows knowledge of the large, anticipated increases in orthopedic surgery and provides a quantitative basis for future policy decisions related to the need for medical personnel and material resources.

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“…For patients undergoing TJA, enhanced recovery after surgery (ERAS) has long been a care model that has demonstrated improved patient outcomes and reduced lengths of stay and care costs [11,12,14]. In more than 20 years since the first descriptions of ERAS concepts, procedure-specific pathways have been developed across and within most surgical subspecialties.…”

Section: Introductionmentioning

confidence: 99%

Perioperative Acupuncture: A Novel and Necessary Addition to ERAS Pathways for Total Joint Arthroplasty

Cheng,

Swamidoss,

Soffin

2023

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Hip and Knee Arthroplasty

Cited by 6 publications

References 60 publications

Risk Factors for Unexpected Conversion from Ambulatory to Inpatient Admission Among One- or Two-level ACDF Patients

Risk Factors for Unexpected Conversion from Ambulatory to Inpatient Admission Among One- or Two-level ACDF Patients

A Comprehensive Research on the Prevalence and Evolution Trend of Orthopedic Surgeries in Romania

Perioperative Acupuncture: A Novel and Necessary Addition to ERAS Pathways for Total Joint Arthroplasty

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