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PURPOSE: Recent studies have reported nearly 40% of costs associated with a 30-day episode-of-care for total joint replacements are due to post-discharge activities and 81% of those are specifically due to unplanned readmissions and discharging patients to post-acute care facilities. The purpose of this study was to determine these two key variables for total hip arthroplasty (THA) patients implanted using a tissue-sparing surgical technique and to see how these values compare to those previously reported in the United States. METHODS: The healthcare databases at three institutions were searched for primary THA patients implanted using the supercapsular percutaneously-assisted total hip (SuperPath) surgical technique between January 2013 and July 2014. Data elements included 30-day all-cause readmission rate, discharge status, transfusion rate, complications, and length of stay (LOS). RESULTS: Data were available for 479 THAs. The 30-day all-cause readmission rate, transfusion rate, and average LOS was 2.3, 3.3%, and 1.6 days, respectively. Over 91% of patients were discharged routinely home, 4.1% to skilled nursing facilities, 3.8% to home health care, and 0.6% to inpatient rehabilitation facilities. Complications included dislocation (0.8%), periprosthetic fracture (0.8%), and deep vein thrombosis (0.2 %). There were no infections reported. CONCLUSIONS: Patients implanted using this tissue-sparing technique experienced reduced 30-day all-cause readmission rates (2.3% vs. 4.2%) and more were routinely discharged home (91.5% vs. 27.3%) than have been previously reported for patients in the United States. Use of this tissue-sparing technique has the potential to significantly reduce post-discharge costs.
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Gofton et al. (2014) studied this question.
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