Revision Total Knee Arthroplasty

Barrack, Robert L.; McClure, J. Thomas; Burak, Corey; Clohisy, John C.; Parvızı, Javad; Sharkey, Peter F.

doi:10.1097/blo.0b013e3181492955

Cited by 22 publications

(8 citation statements)

References 14 publications

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“…In addition, mean hospital stay was 4 days longer in our study cohort for revision arthroplasty compared to matched primary cases. A prolonged hospital stay for revision arthroplasty has been previously reported in literature [ 36 ]. This further adds costs to the public health care sector as well as higher implant costs resulting in higher procedural charges [ 3 ].…”

Section: Discussionmentioning

confidence: 99%

Revision Surgery in Total Joint Replacement Is Cost-Intensive

Weber

Renkawitz

Voellner

et al. 2018

BioMed Research International

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Revisions after total joint replacement increase constantly. In the current study, we analyzed clinical outcome, complication rates, and cost-effectiveness of revision arthroplasty. In a retrospective analysis of 162 revision hip and knee arthroplasties from our institutional joint registry responder rate, patient-reported outcome measures (EQ-5D, WOMAC), complication rates, and patient-individual charges in relation to reimbursement were compared with a matched control group of primary total joint replacements. Positive responder rate one year postoperatively was lower for revision arthroplasties with 72.9% than for primary arthroplasties with 90.1% (OR=0.30, 95%CI=0.18–0.59, p=0.001). Correspondingly, improvement in patient-reported outcome measures one year after surgery was lower in revision than in primary joint arthroplasty with EQ-5D 0.19±0.25 to 0.30±0.24 (p<0.001) and WOMAC 24.3±30.3 to 41.2±21.3 (p<0.001). Infection rate was higher in revision (6.8%) compared to primary replacements (0%, p=0.001). Mean charges in revision arthroplasty were 76.0% higher than in matched primary joint replacements (7110.8±2249.4$ to 4041.1±975.7$, p<0.001), whereas reimbursement was only 23.6% higher (9243.3±2258.4$ in revision and 7477.9±703.1$ in primary arthroplasty, p<0.001). Revision arthroplasty is associated with lower outcome and higher infection rate compared to primary replacements. The high financial expense of revision arthroplasty is only partly covered by a higher reimbursement.

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Section: Discussionmentioning

confidence: 99%

Revision Surgery in Total Joint Replacement Is Cost-Intensive

Weber

Renkawitz

Voellner

et al. 2018

BioMed Research International

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“…The actual estimates showed that a 7-fold increase in revision TKA surgery is expected between 2005 and 2030, while primary knee replacement surgeries will rise by approximately 174% (2). Although good results after this procedure have been presented, the outcomes are worse in comparison with those of primary TKA, with a higher failure rate (2,3).…”

Section: Introductionmentioning

confidence: 99%

Outcomes in revision total knee arthroplasty (Review)

et al. 2021

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“…Unplanned re-operation (UR) has been reported to be a cause of increasing patient waiting list and prolonged hospital stay, subsequently raising hospital costs [1][2][3][4][5]. Additionally, UR is known to greatly affect patient satisfaction and trust-level with the healthcare service providers, while diminishing hospital staff self-confidence [6,7]. Increasing re-operations rate is also correlated with higher morbidity and mortality [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database

Lim

Jordan

Jain

et al. 2014

Journal of Plastic Surgery and Hand Surgery

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Studies that evaluate the predictors and causes of unplanned re-operation in outpatient plastic surgery. This study retrospectively reviewed the American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) and identified all plastic surgery outpatient cases performed in 2011. Multiple logistic regression analysis was utilised to identify independent risk factors and causes of unplanned reoperations. Of the 6749 outpatient plastic surgery cases identified, there were 125 (1.9%) unplanned re-operations (UR). Regression analysis demonstrated that body mass index (BMI, OR = 1.041, 95% CI = 1.019-1.065), preoperative open wound/wound infection (OR = 3.498, 95% CI = 1.593-7.678), American Society of Anesthesiologists (ASA) class 3 (OR = 2.235, 95% CI = 1.048-4.765), and total work relative value units (RVU, OR = 1.014, 95% CI = 1.005-1.024) were significantly predictive of UR. Additionally, the presence of any complication was significantly associated with UR (OR = 15.065, 95% CI = 5.705-39.781). In an era of outcomes-driven medicine, unplanned re-operation is a critical quality indicator for ambulatory plastic surgery facilities. The identified risk factors will aid in surgical planning and risk adjustment.

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Revision Total Knee Arthroplasty

Cited by 22 publications

References 14 publications

Revision Surgery in Total Joint Replacement Is Cost-Intensive

Revision Surgery in Total Joint Replacement Is Cost-Intensive

Outcomes in revision total knee arthroplasty (Review)

Predictors and causes of unplanned re-operations in outpatient plastic surgery: a multi-institutional analysis of 6749 patients using the 2011 NSQIP database

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