Differences in Readmission Rates for Two Total Knee Arthroplasty Prostheses

Abstract The readmission rates of cruciate-retaining (CR) and a posterior-stabilizing (PS) total knee arthroplasty (TKA) have not been extensively evaluated. We aimed to determine the following: (1) What are the readmission rates of TKA performed with the use of CR and PS prostheses at 30, 60, and 90 days following discharge? (2) Were the causes of the unplanned readmission surgically or medically related? (3) What were the medical comorbidities associated with readmission? A prospectively collected database of 845 TKAs (441 CR and 404 PS TKAs) at 22 institutions (24 surgeons) was reviewed. Outcomes evaluated included the incidence of readmission at 30, 60, and 90 days after discharge, medical/surgical cause, and medical comorbidities. There were no significant differences in readmission rates between the two cohorts at the different time points. There was a readmission rate of 2% at 30 days and 3.2% at 60 days for the CR group, and 2.2% at 30 days and 4.0% at 60 days for the PS group after discharge. Medical causes accounted for a majority of the readmissions in both the CR and PS cohort. Readmitted patients had a higher incidence of increased body mass index, cardiovascular disorders, diabetes, and musculoskeletal disorders. The readmission rates for both prostheses in the setting of primary TKA are encouraging because these rates are lower than previously reported outcomes. The authors believe that the positive midterm clinical performance of the prostheses used in this study may have contributed to the lower readmission rates.

[1]  M. Winemaker,et al.  Total joint arthroplasty readmission rates and reasons for 30-day hospital readmission. , 2014, The Journal of arthroplasty.

[2]  S. Stulberg,et al.  Understanding readmission after primary total hip and knee arthroplasty: who's at risk? , 2014, The Journal of arthroplasty.

[3]  Thomas P Vail,et al.  What Are the Rates and Causes of Hospital Readmission After Total Knee Arthroplasty? , 2014, Clinical orthopaedics and related research.

[4]  Javad Parvizi,et al.  Unplanned readmission after total joint arthroplasty: rates, reasons, and risk factors. , 2013, The Journal of bone and joint surgery. American volume.

[5]  John J Callaghan,et al.  Incidence of and risk factors for 30-day readmission following elective primary total joint arthroplasty: analysis from the ACS-NSQIP. , 2013, The Journal of arthroplasty.

[6]  T. Neogi,et al.  The epidemiology and impact of pain in osteoarthritis. , 2013, Osteoarthritis and cartilage.

[7]  Javad Parvizi,et al.  The direct and indirect costs to society of treatment for end-stage knee osteoarthritis. , 2013, The Journal of bone and joint surgery. American volume.

[8]  J. Chapman,et al.  Risk factors for readmission of orthopaedic surgical patients. , 2013, The Journal of bone and joint surgery. American volume.

[9]  Javad Parvizi,et al.  Posterior cruciate-retaining versus posterior-stabilized total knee arthroplasty: a meta-analysis. , 2013, The Journal of arthroplasty.

[10]  K. Berend,et al.  Complications of Total Knee Arthroplasty: Standardized List and Definitions of The Knee Society , 2013, Clinical orthopaedics and related research.

[11]  W. Maloney,et al.  Decreased Length of Stay After TKA Is Not Associated With Increased Readmission Rates in a National Medicare Sample , 2012, Clinical orthopaedics and related research.

[12]  H. Kehlet,et al.  Readmissions after fast-track hip and knee arthroplasty , 2010, Archives of Orthopaedic and Trauma Surgery.

[13]  A. Cohen-Solal,et al.  Beta-blockade with nebivolol in elderly heart failure patients with impaired and preserved left ventricular ejection fraction: Data From SENIORS (Study of Effects of Nebivolol Intervention on Outcomes and Rehospitalization in Seniors With Heart Failure). , 2009, Journal of the American College of Cardiology.

[14]  Michael A Mont,et al.  Posterior-stabilized versus posterior cruciate ligament-retaining total knee arthroplasty. , 2009, The Iowa orthopaedic journal.

[15]  S. Kurtz,et al.  Projections of primary and revision hip and knee arthroplasty in the United States from 2005 to 2030. , 2007, The Journal of bone and joint surgery. American volume.

[16]  W. Jacobs,et al.  Retention versus removal of the posterior cruciate ligament in total knee replacement: A systematic literature review within the Cochrane framework , 2005, Acta orthopaedica.