NEW ORLEANS— When total joint arthroplasty is performed at a larger hospital, most patients who require revision surgery within the first postoperative year return to the same hospital, according to research presented in a poster at the American Academy of Orthopaedic Surgeons Annual Meeting.
“We studied patient and facility characteristics associated with risk of migration and institutional mobility for individuals 65 years of age and older,” study co-author Caryn D. Etkin, PhD, MPH, American Joint Replacement Registry (AJRR) director of analytics, told Healio.com/Orthopedics. “It was clear from our analysis that the likelihood of attending a different hospital for revision strengthened with increasing time since the primary procedure. While AJRR has over 1,000 participating institutions, it is critical that in order to assess implant performance with as little bias as possible, AJRR needs to continue to grow an ever-larger network of participants.”
Etkin and colleagues used medical hospital records of beneficiaries in a Medicare fee-for-service to identify primary and revision total knee or total knee arthroplasties. A multivariate logistic regression model was used to assess the propensity for retuning for any subsequent revision to same facility or surgeon.
Results showed 74.8% of patients who underwent surgery in hospitals with fewer than 150 beds returned at 1 year to the same hospital when surgery was needed. Investigators noted 87.3% of patients who underwent primary TJA performed at a facility with 450 beds or more returned to the same hospital for revision surgery within 1 year.
With regard to infection-related revisions performed within 1 year, 82.1% were performed at the same hospital and 72.1% were performed the same surgeon. Eighty-six percent of dislocation-related THA revisions were performed at the same hospital and 78.6% were performed by the same surgeon. – by Monica Jaramillo
Gioe TJ, et al. Poster #168. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting; March 6-10, 2018; New Orleans.
Disclosure: Etkin reports no relevant financial disclosures.