Combined total hip and knee arthroplasty during the same hospital admission

2019 ◽  
Vol 101-B (5) ◽  
pp. 573-581
Author(s):  
A. M. Almaguer ◽  
K. H. Cichos ◽  
G. McGwin Jr ◽  
J. M. Pearson ◽  
B. Wilson ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Joint Infection ◽  
Hospital Costs ◽  
Revision Arthroplasty ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Prosthetic Joint ◽  
Increased Risk ◽  
Hip And Knee Arthroplasty ◽  
Deep Vein

Aims The purpose of this study was to compare outcomes of combined total joint arthroplasty (TJA) (total hip arthroplasty (THA) and total knee arthroplasty (TKA) performed during the same admission) versus bilateral THA, bilateral TKA, single THA, and single TKA. Combined TJAs performed on the same day were compared with those staged within the same admission episode. Patients and Methods Data from the National (Nationwide) Inpatient Sample recorded between 2005 and 2014 were used for this retrospective cohort study. Postoperative in-hospital complications, total costs, and discharge destination were reviewed. Logistic and linear regression were used to perform the statistical analyses. p-values less than 0.05 were considered statistically significant. Results Combined TJA was associated with increased risk of deep vein thrombosis, prosthetic joint infection, irrigation and debridement procedures, revision arthroplasty, length of stay (LOS), and in-hospital costs compared with bilateral THA, bilateral TKA, single THA, and single TKA. Combined TJA performed on separate days of the same admission showed no statistically significant differences when compared with same-day combined TJA, but trended towards decreased total costs and total complications despite increased LOS. Conclusion Combined TJA is associated with increased in-hospital complications, LOS, and costs. We do not recommend performing combined TJA during the same hospital stay. Cite this article: Bone Joint J 2019;101-B:573–581.

scholarly journals Clinical experience with fondaparinux in antiaggregate patients undergoing total hip and knee arthroplasty

2013 ◽  
pp. 179-182
Author(s):  
Guido Grappiolo ◽  
Marco Scardino ◽  
Giuseppe Mazziotta ◽  
Stefano Quaini ◽  
Corrado Lodigiani ◽  
...  
Keyword(s):  
Venous Thromboembolism ◽  
Antiplatelet Therapy ◽  
Knee Arthroplasty ◽  
Operative Therapy ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Effective Prophylaxis ◽  
Hip And Knee Arthroplasty ◽  
Total Knee ◽  
Deep Vein

Patients undergoing total hip arthroplasty or total knee arthroplasty have a high risk for post-operative venous thromboembolism. The current study addressed the use of fondaparinux post-operatively in 556 patients with antiplatelet therapy in order to prevent deep vein thrombosis as well as demonstrate efficacy in preventing arterial thrombotic events. Results provided evidence for a safe and effective prophylaxis strategy, involving the change from low molecular weight heparin pre-operatively to fondaparinux postoperatively. Also, fondaparinux proved effective as a unique post-operative therapy in the prevention of venous thromboembolism with no adverse effects, such as major bleeding or arterial thrombosis in patients with pre-operative antiplatelet therapy.

Physician compliance with guidelines for deep-vein thrombosis prevention in total hip and knee arthroplasty

2008 ◽  
Vol 24 (1) ◽  
pp. 87-97 ◽  
Author(s):  
Richard J. Friedman ◽  
Alexander S. Gallus ◽  
Fred D. Cushner ◽  
Gordon Fitzgerald ◽  
Frederick A. Anderson ◽  
...  
Keyword(s):  
Deep Vein Thrombosis ◽  
Knee Arthroplasty ◽  
Total Hip ◽  
Vein Thrombosis ◽  
Physician Compliance ◽  
Hip And Knee Arthroplasty ◽  
Deep Vein

scholarly journals The Influence of Obesity on the Infection Risk of Prosthetic Joint Infection in the Geriatric Orthopedic Population

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S98-S98
Author(s):  
Allina Nocon ◽  
Michael Henry ◽  
Celeste Russell ◽  
Geoffrey Westrich ◽  
Barry Brause ◽  
...  
Keyword(s):  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
The Elderly ◽  
Hospital Data ◽  
Total Hip ◽  
Prosthetic Joint ◽  
Increased Risk ◽  
Hip And Knee Arthroplasty ◽  
Hip Arthroplasties ◽  
Univariate Analyses

Abstract Background Prosthetic joint infection (PJI) is a dreaded complication of arthroplasty. PJI are more common in the elderly and are associated with a substantial increase in 5-year mortality risk. PJI risk may correlate with increasing body mass index (BMI). However, the effect of BMI on PJI risk in the elderly has not been evaluated, to our knowledge. We sought to evaluate this relationship in a cohort of geriatric arthroplasty patients at an orthopedic specialty hospital. Methods A retrospective cohort of hip and knee arthroplasty patients (age >75) from 2009–2014 was identified through administrative hospital data using ICD-9 codes. Patients with a BMI <14 or >60 kg/m2, height <142 or >200 cm, and weight <36 or >226 kg were excluded. The presence of infection was confirmed via chart review; all PJIs met MSIS criteria. Obesity was defined as having a BMI >30. Univariate analyses were done using χ 2 tests and adjusted models were assessed using logistic regression. Results 13,755 geriatric arthroplasty patients (6,408 total hip arthroplasties [THA] and 7,347 total hip arthroplasties [TKA]) were assessed. Mean age and BMI were 82 (±5.4) and 28.1 (±5.3), respectively. In an unadjusted model, obesity was associated with infection in THA (P = 0.02), but not TKA (P = 0.31). This association remained after adjusting for age, sex, and diabetes. Obesity was associated with an increased risk of infection in THA [OR=1.89 (95% CI 1.12–3.21); P = 0.02]. However, as with the unadjusted model, this relationship was not found in TKA (P = 0.50). Conclusion Obesity increases THR PJI risk in the elderly. However, no such association was found for TKA. Future studies are needed to quantify the compounded risk of obesity in the geriatric arthroplasty patient. Disclosures All authors: No reported disclosures.

Prosthetic Joint Infection Risk Following Total Hip and Knee Arthroplasty in the Medicare Population

2009 ◽  
Vol 24 (2) ◽  
pp. e4 ◽  
Author(s):  
Steven M. Kurtz ◽  
Kevin Ong ◽  
Edmund Lau ◽  
Kevin J. Bozic ◽  
Javad Parvizi ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Prosthetic Joint Infection ◽  
Joint Infection ◽  
Infection Risk ◽  
Total Hip ◽  
Medicare Population ◽  
Prosthetic Joint ◽  
Hip And Knee Arthroplasty
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