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Order of Total Hip or Total Knee Arthroplasty Does Not Affect Length of Stay or Discharge Disposition in Patients With Coexisting Hip and Knee Arthritis.
Orthopedics. 2019 Nov 01; 42(6):e528-e531.O

Abstract

Primary total joint arthroplasty (TJA) of the hip and knee are effective procedures for improving pain and function in patients with arthritis. This study examined whether order of surgery (TKA or THA first) affects length of stay (LOS) and discharge disposition among patients with coexisting knee and hip arthritis. A total joint arthroplasty database review was performed to collect all available data for arthroplasties performed at 2 campuses of a single institution between July 2013 and April 2017. Inclusion criteria were patients who underwent both primary THA and TKA within 18 months and were age 18 years or older. Patients were divided into 2 groups based on whether THA or TKA was performed first. For all procedures, the following data were collected: age, body mass index (BMI), time between cases, LOS, discharge disposition, and the number of 90-day adverse postoperative events. Adverse 90-day events included deep infection, fracture, hardware failure, urinary tract infection, other return to the operating room, emergency department visit, readmission, or death. A total of 211 patients underwent both THA and TKA within 18 months; 124 patients underwent THA first and 87 underwent TKA first. There was no difference in age or BMI between the 2 groups. There was a significantly longer time between the first and second arthroplasty in patients with TKA first by a mean of 2 months (P=.001). There was no difference in 90-day adverse postoperative events following THA whether done first or second (P=.371), and no difference in 90-day events following TKA whether done first or second (P=.524). There was no difference in discharge disposition (P=.833 and P=.395) or LOS (P=.695 and P=.473) between groups for the first or second procedure, respectively. In a patient with coexisting hip and knee arthritis, the current results do not support recommending THA or TKA first based on cost related to LOS and discharge disposition. [Orthopedics. 2019; 42(6):e528-e531.].

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

31185123

Citation

Siljander, Matthew P., et al. "Order of Total Hip or Total Knee Arthroplasty Does Not Affect Length of Stay or Discharge Disposition in Patients With Coexisting Hip and Knee Arthritis." Orthopedics, vol. 42, no. 6, 2019, pp. e528-e531.
Siljander MP, Cross J, Koueiter DM, et al. Order of Total Hip or Total Knee Arthroplasty Does Not Affect Length of Stay or Discharge Disposition in Patients With Coexisting Hip and Knee Arthritis. Orthopedics. 2019;42(6):e528-e531.
Siljander, M. P., Cross, J., Koueiter, D. M., Sobh, A., Moore, D., & Karadsheh, M. S. (2019). Order of Total Hip or Total Knee Arthroplasty Does Not Affect Length of Stay or Discharge Disposition in Patients With Coexisting Hip and Knee Arthritis. Orthopedics, 42(6), e528-e531. https://doi.org/10.3928/01477447-20190604-08
Siljander MP, et al. Order of Total Hip or Total Knee Arthroplasty Does Not Affect Length of Stay or Discharge Disposition in Patients With Coexisting Hip and Knee Arthritis. Orthopedics. 2019 Nov 1;42(6):e528-e531. PubMed PMID: 31185123.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Order of Total Hip or Total Knee Arthroplasty Does Not Affect Length of Stay or Discharge Disposition in Patients With Coexisting Hip and Knee Arthritis. AU - Siljander,Matthew P, AU - Cross,Jeffrey, AU - Koueiter,Denise M, AU - Sobh,Ali, AU - Moore,Drew, AU - Karadsheh,Mark S, Y1 - 2019/06/13/ PY - 2018/05/23/received PY - 2018/11/15/accepted PY - 2019/6/12/pubmed PY - 2020/2/28/medline PY - 2019/6/12/entrez SP - e528 EP - e531 JF - Orthopedics JO - Orthopedics VL - 42 IS - 6 N2 - Primary total joint arthroplasty (TJA) of the hip and knee are effective procedures for improving pain and function in patients with arthritis. This study examined whether order of surgery (TKA or THA first) affects length of stay (LOS) and discharge disposition among patients with coexisting knee and hip arthritis. A total joint arthroplasty database review was performed to collect all available data for arthroplasties performed at 2 campuses of a single institution between July 2013 and April 2017. Inclusion criteria were patients who underwent both primary THA and TKA within 18 months and were age 18 years or older. Patients were divided into 2 groups based on whether THA or TKA was performed first. For all procedures, the following data were collected: age, body mass index (BMI), time between cases, LOS, discharge disposition, and the number of 90-day adverse postoperative events. Adverse 90-day events included deep infection, fracture, hardware failure, urinary tract infection, other return to the operating room, emergency department visit, readmission, or death. A total of 211 patients underwent both THA and TKA within 18 months; 124 patients underwent THA first and 87 underwent TKA first. There was no difference in age or BMI between the 2 groups. There was a significantly longer time between the first and second arthroplasty in patients with TKA first by a mean of 2 months (P=.001). There was no difference in 90-day adverse postoperative events following THA whether done first or second (P=.371), and no difference in 90-day events following TKA whether done first or second (P=.524). There was no difference in discharge disposition (P=.833 and P=.395) or LOS (P=.695 and P=.473) between groups for the first or second procedure, respectively. In a patient with coexisting hip and knee arthritis, the current results do not support recommending THA or TKA first based on cost related to LOS and discharge disposition. [Orthopedics. 2019; 42(6):e528-e531.]. SN - 1938-2367 UR - https://www.unboundmedicine.com/medline/citation/31185123/Order_of_Total_Hip_or_Total_Knee_Arthroplasty_Does_Not_Affect_Length_of_Stay_or_Discharge_Disposition_in_Patients_With_Coexisting_Hip_and_Knee_Arthritis_ DB - PRIME DP - Unbound Medicine ER -