Between-Hospital Variation in Revision Rates After Total Hip and Knee Arthroplasty in the Netherlands

2020 ◽  
Vol 102 (4) ◽  
pp. 315-324 ◽  
Author(s):  
Peter van Schie ◽  
Liza N. van Steenbergen ◽  
Leti van Bodegom-Vos ◽  
Rob G.H.H. Nelissen ◽  
Perla J. Marang-van de Mheen
Keyword(s):  
The Netherlands ◽  
Knee Arthroplasty ◽  
Total Hip ◽  
Hospital Variation ◽  
Hip And Knee Arthroplasty

scholarly journals Antibiotic Prophylaxis and DAIR Treatment in Primary Total Hip and Knee Arthroplasty, A National Survey in The Netherlands

2018 ◽  
Vol 3 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Ewout S Veltman ◽  
Dirk Jan F ◽  
Rob GHH Nelissen ◽  
Rudolf W Poolman
Keyword(s):  
The Netherlands ◽  
Antibiotic Prophylaxis ◽  
Knee Arthroplasty ◽  
Online Survey ◽  
Common Ground ◽  
Hip Prosthesis ◽  
Knee Prosthesis ◽  
Total Hip ◽  
First Choice ◽  
Hip And Knee Arthroplasty

Abstract. Background: To prevent postoperative infection the use of systemic antibiotic prophylaxis is common ground. Type of antibiotic used and duration of prophylaxis are subject to debate. In case of suspected early periprosthetic infection a debridement, antibiotics and implant retention (DAIR) procedure is treatment of first choice. This study evaluated the antibiotic prophylaxis and DAIR treatment protocols nationwide as well as reporting of these DAIR procedures to the national joint registry.Methods: All institutions that performed total hip or knee arthroplasty were contacted to complete a 16-question online survey. Questions included availability of a protocol, type and duration of antibiotic prophylaxis used and tendency to register infectious complications in the Dutch Arthroplasty Register.Results: All ninety-nine consulted institutions responded to this survey. All but one institutions have a standardized hospital based protocol for antibiotic prophylaxis in primary total hip or knee arthroplasty. Cefazolin was antibiotic prophylaxis of choice in ninety-four institutions for both primary hip and knee arthroplasty. In ten institutions one preoperative gift of antibiotic prophylaxis was administered. A protocol describing treatment when suspecting early periprosthetic joint infection was present in seventy-one institutions. When performing a DAIR procedure modular parts were exchanged in seventy institutions in case of a hip prosthesis and in eighty-one institutions in case of a knee prosthesis. Sixty-three institutions register DAIR procedures in the Dutch Arthroplasty Register.Interpretation: In contradiction to the results of a recent study in Great Britain, we have found only little variety in availability of protocols and in the type of antibiotic used as prophylaxis in primary total hip and knee arthroplasty in The Netherlands. Not every institution has a protocol for treatment in suspicion of early infection. Although mobile parts are exchanged in the majority of cases, there appears to be an underreporting of DAIR procedures in the Dutch Arthroplasty Register.

Predictors of Successful Early Discharge for Total Hip and Knee Arthroplasty in Octogenarians

2021 ◽  
pp. 155633162110306
Author(s):  
Andrew B. Kay ◽  
Danielle Y. Ponzio ◽  
Courtney D. Bell ◽  
Fabio Orozco ◽  
Zachary D. Post ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Knee Arthroplasty ◽  
Early Discharge ◽  
Readmission Rates ◽  
Patients Âgés ◽  
Total Hip ◽  
Hip And Knee Arthroplasty ◽  
Student’S T ◽  
American Society ◽  
American Society Of Anesthesiologists

Background: Decreased length of stay after total joint arthroplasty (TJA) is becoming a more common way to contain healthcare costs and increase patient satisfaction. There is little evidence to support “early” discharge in elderly patients. Purpose: We sought to identify preoperative factors that correlated with early discharge (by postoperative day [POD] 1) in comparison to late discharge (after POD2) in octogenarians after TJA. Methods: In a retrospective cohort study from a single institution, we identified 482 patients ages 80 to 89 who underwent primary TJA from January 2014 to December 2017; 319 had total knee arthroplasty (TKA) and 163 had total hip arthroplasty (THA). Data collected included preoperative knee range of motion (ROM), demographics, and comorbidities; 90-day readmission and mortality rates were also evaluated. P values for continuous data were calculated using student’s t test and for categorical data using χ2 testing. Results: Of octogenarian patients, 30.9% were discharged by POD1. Early discharge was associated with being male, married, and nonsmoking, as well as having an American Society of Anesthesiologists (ASA) score of 2, independent preoperative ambulation, and a postoperative caregiver. Type of procedure (TKA vs THA), body mass index, laterality, preoperative range of motion (ROM) for TKA, and single vs multilevel home did not affect the probability of early discharge. Discharge on POD1 was not associated with increased 90-day readmission rates. There were no deaths. Conclusion: Early discharge for octogenarians can be successfully implemented in a select subset of patients without increasing 90-day readmission or death rates. There are multiple factors that predict successful early discharge.

Narcotic Consumption in Opioid-Naïve Patients Undergoing Total Hip and Knee Arthroplasty

2020 ◽  
Vol 35 (9) ◽  
pp. 2392-2396
Author(s):  
Jonathan R. Dattilo ◽  
Agnes D. Cororaton ◽  
Jeanine M. Gargiulo ◽  
James F. McDonald ◽  
Henry Ho ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

Prescribing and Consumption of Opioids After Primary, Unilateral Total Hip and Knee Arthroplasty in Opioid-Naive Patients

2020 ◽  
Vol 35 (4) ◽  
pp. 960-965.e1 ◽  
Author(s):  
Karl C. Roberts ◽  
Stephanie E. Moser ◽  
Angela C. Collins ◽  
Brian R. McCardel ◽  
Kyle A. Schultz ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

scholarly journals The Effects of Depression and Anxiety on 90-day Readmission Rates After Total Hip and Knee Arthroplasty

2021 ◽  
Vol 10 ◽  
pp. 175-179
Author(s):  
Paul Knapp ◽  
James T. Layson ◽  
Waleed Mohammad ◽  
Natalie Pizzimenti ◽  
David C. Markel
Keyword(s):  
Knee Arthroplasty ◽  
Depression And Anxiety ◽  
Readmission Rates ◽  
Total Hip ◽  
Hip And Knee Arthroplasty

Intersectionality of Net Worth and Race relative to Utilization of Total Hip and Knee Arthroplasty

2021 ◽  
Author(s):  
Chloe C. Dlott ◽  
Xun Pei ◽  
Jennifer Ittner ◽  
Steven Lefar ◽  
Mary I. O’Connor
Keyword(s):  
Knee Arthroplasty ◽  
Net Worth ◽  
Total Hip ◽  
Hip And Knee Arthroplasty
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