The Journal of arthroplasty
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Observational Study
Continued Inpatient Care After Primary Total Knee Arthroplasty Increases 30-Day Post-Discharge Complications: A Propensity Score-Adjusted Analysis.
Discharge destination, either home or skilled care facility, after total knee arthroplasty (TKA) may be associated with significant variation in postacute care outcomes. The purpose of this study was to characterize the 30-day postdischarge outcomes after primary TKA relative to discharge destination. ⋯ After controlling for predischarge characteristics, discharge to skilled care facilities vs home after primary TKA is associated with higher odds of numerous complications and unplanned readmission. These results support coordination of care pathways to facilitate home discharge after hospitalization for TKA whenever possible.
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Multicenter Study
Higher Patient Expectations Predict Higher Patient-Reported Outcomes, But Not Satisfaction, in Total Knee Arthroplasty Patients: A Prospective Multicenter Study.
The relationship between patient expectations, patient-reported outcomes (PROs), and satisfaction in total knee arthroplasty (TKA) patients is not well understood. ⋯ In TKA patients, preoperative expectations are not influenced by patient demographics or preoperative function. Higher preoperative expectations predict greater postoperative improvement in PROs and fulfillment of expectations. These findings highlight the importance of preoperative patient expectations on postoperative outcome.
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This collaboration between the American College of Rheumatology and the American Association of Hip and Knee Surgeons developed an evidence-based guideline for the perioperative management of antirheumatic drug therapy for adults with rheumatoid arthritis (RA), spondyloarthritis (SpA) including ankylosing spondylitis and psoriatic arthritis, juvenile idiopathic arthritis (JIA), or systemic lupus erythematosus (SLE) undergoing elective total hip (THA) or total knee arthroplasty (TKA). ⋯ This guideline should help decision-making by clinicians and patients regarding perioperative antirheumatic medication management at the time of elective THA or TKA. These conditional recommendations reflect the paucity of high-quality direct randomized controlled trial data.
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The study's purpose was to determine if there is an association between ABO blood group and the development of symptomatic venous thromboembolism (VTE) after total joint arthroplasty (TJA). ⋯ AB blood group increased the risk of VTE after TJA. Patient's ABO blood group should be considered in terms of risk stratification and selection of appropriate postoperative VTE prophylaxis.
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Preoperative anemia is a common, important risk factor for adverse events after joint arthroplasty surgery. It affects 21%-35% patients undergoing total joint arthroplasty. To date, few studies have investigated the effect of preoperative anemia, specifically in revision total joint arthroplasty surgery. ⋯ Preoperative anemia is independently associated with postoperative complications, mortality, and increased length of stay in revision total joint arthroplasty. Further studies are needed to evaluate if preoperative treatment of anemia may modify this risk.