Evidence-Based Thresholds for the Volume and Cost Relationship in Total Hip Arthroplasty: Outcomes and Economies of Scale

2018 ◽  
Vol 33 (8) ◽  
pp. 2398-2404 ◽  
Author(s):  
Heather S. Haeberle ◽  
Sergio M. Navarro ◽  
William C. Frankel ◽  
Michael A. Mont ◽  
Prem N. Ramkumar
2018 ◽  
Vol 33 (7) ◽  
pp. 2031-2037 ◽  
Author(s):  
Prem N. Ramkumar ◽  
Sergio M. Navarro ◽  
William C. Frankel ◽  
Heather S. Haeberle ◽  
Ronald E. Delanois ◽  
...  

2018 ◽  
Vol 33 (10) ◽  
pp. 3343-3353 ◽  
Author(s):  
Assem A. Sultan ◽  
William A. Cantrell ◽  
Anton Khlopas ◽  
Ryan J. Berger ◽  
Nipun Sodhi ◽  
...  

Hematology ◽  
2019 ◽  
Vol 2019 (1) ◽  
pp. 351-358 ◽  
Author(s):  
Oyebimpe O. Adesina ◽  
Lynne D. Neumayr

Abstract Osteonecrosis, a form of ischemic bone injury that leads to degenerative joint disease, affects ∼30% of people with sickle cell disease. Although osteonecrosis most commonly affects the femoral head (often bilaterally, with asymmetric clinical and radiographic progression), many people with sickle cell disease also present with multifocal joint involvement. We present the case of a young woman with bilateral osteonecrosis of the femoral head at varying stages of progression; we also highlight other important comorbid complications (eg, chronic pain requiring long-term opioids, debility, and social isolation) and postoperative outcomes. In this review, partly based on recommendations on osteonecrosis management from the 2014 evidence-based report on sickle cell disease from the National Heart, Lung and Blood Institutes, we also discuss early signs or symptoms of osteonecrosis of the femoral head, radiographic diagnosis and staging criteria, hydroxyurea effect on progression to femoral head collapse, and surgical outcomes of total hip arthroplasty in the modern era. In summary, we failed to find an association between hydroxyurea use and femoral head osteonecrosis; we also showed that evidence-based perioperative sickle cell disease management resulted in superior postoperative outcomes after cementless total hip arthroplasty in sickle cell–related osteonecrosis of the femoral head.


2021 ◽  
Vol 2 (2) ◽  
pp. 93-102
Author(s):  
Joshua W. Thompson ◽  
Warran Wignadasan ◽  
Mazin Ibrahim ◽  
Lucy Beasley ◽  
Sujith Konan ◽  
...  

Aims We present the development of a day-case total hip arthroplasty (THA) pathway in a UK National Health Service institution in conjunction with an extensive evidence-based summary of the interventions used to achieve successful day-case THA to which the protocol is founded upon. Methods We performed a prospective audit of day-case THA in our institution as we reinitiate our full capacity elective services. In parallel, we performed a review of the literature reporting complication or readmission rates at ≥ 30-day postoperative following day-case THA. Electronic searches were performed using four databases from the date of inception to November 2020. Relevant studies were identified, data extracted, and qualitative synthesis performed. Results Our evaluation and critique of the evidence-based literature identifies day-case THA to be safe, effective, and economical, benefiting both patients and healthcare systems alike. We further validate this with our institutional elective day surgery arthroplasty pathway (EDSAP) and report a small cohort of successful day-case THA cases as an example in the early stages of this practice in our unit. Conclusion Careful patient selection and education, adequate perioperative considerations, including multimodal analgesia, surgical technique and blood loss management protocols and appropriate postoperative pathways comprising reliable discharge criteria are essential for successful day-case THA. Cite this article: Bone Jt Open 2021;2(2):93–102.


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