title: Can a Total Knee Arthroplasty Perioperative Surgical Home Close the Gap Between Primary and Revision TKA Outcomes?
abstract: Given the steady increase in the number of primary and revision total knee arthroplasties (TKAs) performed in the United States, we wanted to determine if an evidence-based TKA perioperative surgical home could close the perioperative morbidity gap between primary and revision TKAs. We conducted a prospective cross-sectional cohort study comparing outcomes of patients who had primary TKA (n = 235) with outcomes of patients who had revision TKA (n = 50). We measured several perioperative outcomes: length of stay, discharge disposition, 30-day readmission rate, and 30-day reoperation rate. Mean length of stay was 2.55 days for primary TKA and 2.92 days for revision TKA (P = .061). Eighty (34%) of the 235 primary TKA patients and 21 (41%) of the 51 revision TKA patients were discharged to a subacute nursing facility (P = .123). One primary TKA patient (0.4%) and 2 revision TKA patients (4%) were readmitted within 30 days after surgery (P = .081). None of the primary TKAs and 2 (4%) of the revision TKAs underwent reoperation (P = .993). There was no difference in perioperative outcomes between the primary and revision TKA groups in our Total Joint Replacement Perioperative Surgical Home (TJR-PSH) cohort. Advances in multidisciplinary co-management of TKA patients are highlighted in the TJR-PSH. The similarity in primary and revision TKA outcomes has significant implications regarding costs and potential increased patient satisfaction.
authors.forename: Chijioke
authors.initials: C
authors.lastname: Iwuchukwu
authors.forename: David
authors.initials: D
authors.lastname: Wright
authors.forename: Anna
authors.initials: A
authors.lastname: Sofine
authors.affiliation: D Department of Orthopedic Surgery, Hospital for Joint Diseases, New York University Langone Medical Center, New York, NY. schwarzk@gmail.com.
authors.forename: Ran
authors.initials: R
authors.lastname: Schwarzkopf
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000191:economics / Q000379:methods*; D003430:Cross-Sectional Studies; D005260:Female; D017048:Health Care Costs; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D007720:Knee Prosthesis; D007902:Length of Stay / Q000191:economics; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D011446:Prospective Studies; D012086:Reoperation; D016896:Treatment Outcome; D014481:United States