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    Establishing Common Ground for Reporting Complications of TJA

    Not only are complications after total hip and total knee arthroplasty devastating for the patient and the surgeon, but they are also becoming a regulatory and reimbursement issue: For many health plans and the government, complication rates are being used as a proxy for quality of care.

    And make no mistake: Quality of care is emerging as a driver of reimbursement for joint replacement surgeons.

    The problem, noted William L. Healy, MD, in his presentation at the recent World Arthroplasty Congress in Paris, is the lack of standardization and stratification in reporting complications.

    The orthopaedic literature is not clear on what should be considered “complications” of these procedures, Dr. Healy said, with different investigators reporting different complications, with different definitions.

    So what are the complications of total hip and total knee arthroplasty? How should they be defined? Which are major complications…and which are more minor issues?

    In 2009, The Knee Society appointed a working group to investigate and answer these questions for total knee arthroplasty. The Hip Society followed 2 years later for total hip arthroplasty.

    The goal, Dr. Healy said, was to develop a list of “minimum necessary” complications and adverse events required for accurate reporting of outcomes of total hip and total knee arthroplasty. He presented the progress of the working groups toward achieving this goal at the World Arthroplasty Congress, a collaboration of the International Congress for Joint Reconstruction (ICJR), the newly formed European Knee Society, and ICJR’s global affiliates.

    In an interview exclusive to ICJR, Dr. Healy describes the methodology the working groups used in developing and validating the standardized, stratified lists of complications and their definitions.

    Click on the image above to hear his comments.

    Producer: Michael Szuch; Director: Michael Bugera; Post Production: Charles Maynard