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Same-Day Bilateral Total Knee Arthroplasty: Incidence and Perioperative Outcome Trends from 2009 to 2016.
Remily, Ethan A; Wilkie, Wayne A; Mohamed, Nequesha S; Gilson, Greg; Smith, Tyler; Zweigle, Joshua W; Nace, James; Delanois, Ronald E.
Affiliation
  • Remily EA; Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, United States.
  • Wilkie WA; Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, United States.
  • Mohamed NS; Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, United States.
  • Gilson G; Philadelphia College of Osteopathic Medicine, Department of Orthopaedic Surgery, Philadelphia College of Osteopathic Medicine, 4170 City Ave, Philadelphia, PA 19131, United States.
  • Smith T; Philadelphia College of Osteopathic Medicine, Department of Orthopaedic Surgery, Philadelphia College of Osteopathic Medicine, 4170 City Ave, Philadelphia, PA 19131, United States.
  • Zweigle JW; Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, United States.
  • Nace J; Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, United States.
  • Delanois RE; Rubin Institute for Advanced Orthopedics, Center for Joint Preservation and Replacement, Sinai Hospital of Baltimore, 2401 West Belvedere Avenue, Baltimore, MD 21215, United States. Electronic address: rdelanoi@lifebridgehealth.org.
Knee ; 27(6): 1963-1970, 2020 Dec.
Article in En | MEDLINE | ID: mdl-33221694
ABSTRACT

BACKGROUND:

Same-day bilateral total knee arthroplasty (BiTKA) is a controversial topic in orthopedics, prompting a consensus statement to be released by national experts. To date, no studies have evaluated the trends of this method since these recommendations. This study utilized a national database to evaluate 1) incidence; 2) patient characteristics; 3) hospital characteristics; and 4) inpatient course for same-day BiTKAs in the United States from 2009 to 2016.

METHOD:

The National Inpatient Sample database was queried for individuals undergoing same-day BiTKAs, yielding 245,138 patients. Patient demographics included age, sex, race, obesity status and Charlson Comorbidity Index (CCI) score. Hospital characteristics consisted of location/teaching status, geographic region, charges, and costs. Inpatient course included length of stay, discharge disposition, and complications.

RESULTS:

Same-day BiTKA incidence decreased from 5.6% to 4.0% over the study (p < 0.001). Decreases in patient age and female proportion (p < 0.001 for both) were seen, while African American and Hispanic patients increased (p < 0.001), as did obese patient proportions (p < 0.001). Patients with CCI scores of 2 increased, while those with ≥3 decreased (p < 0.001). Hospital charges increased, while costs decreased (p < 0.001 for both). Length of stay following same-day BiTKA decreased (p < 0.001) and routine home discharges increased (p < 0.001). Most inpatient complications decreased, although the percentage of mechanical complications and respiratory failures increased (p < 0.01 for all).

CONCLUSIONS:

During the study period, younger patients with fewer comorbidities underwent BiTKAs, which likely resulted from improved patient assessment and management. Future investigations should include an evaluation of long-term complications and outcomes in certain patient populations for this procedure.
Subject(s)
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Postoperative Complications / Hospital Charges / Arthroplasty, Replacement, Knee / Inpatients Type of study: Incidence_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: Knee Journal subject: ORTOPEDIA Year: 2020 Document type: Article Affiliation country: United States

Full text: 1 Collection: 01-internacional Database: MEDLINE Main subject: Postoperative Complications / Hospital Charges / Arthroplasty, Replacement, Knee / Inpatients Type of study: Incidence_studies / Prognostic_studies / Risk_factors_studies Limits: Aged / Aged80 / Female / Humans / Male / Middle aged Country/Region as subject: America do norte Language: En Journal: Knee Journal subject: ORTOPEDIA Year: 2020 Document type: Article Affiliation country: United States