Outpatient Joint Arthroplasty Is on the Rise in the United States
Data presented at the AAOS Annual Meeting show a trend toward more and more THAs, TKAs, and UKAs being performed outpatient hospitals and ambulatory surgery centers.
Outpatient joint arthroplasty is a growing trend, fueled by less-invasive surgical techniques, improved pain management and rehabilitation protocols, and patients’ desire to return home as soon as possible.
A review of a private insurance provider’s data provides evidence that an increasing number of hip and knee replacement procedures are being performed at outpatient hospitals and ambulatory surgery centers (ASC),
The data were part of a study presented at the American Academy of Orthopaedic Surgeons’ 2015 Annual Meeting in Las Vegas.
Approximately 6 million beneficiaries are in the database that was searched. The researchers used CPT codes for total hip arthroplasty (THA), total knee arthroplasty (TKA), and unicompartmental knee arthroplasty (UKA) procedures performed between 2007 and 2011, with service locations of outpatient hospitals or ASCs.
Here’s what they found:
- Total hip arthroplasty. From 2007 to 2011,1,562 THAs were performed at outpatient hospitals or ASCs, or 3.7% of 42,759 of total cases. The number of outpatient procedures increased 37% during the study period, from 0.46 cases per 10,000 patients in 2007 to 0.61 cases per 10,000 patients in 2011.
- Total knee arthroplasty. The researchers said 3,468 outpatient TKAs were performed, or 4.7% of the total number of TKAs. The number of outpatient cases increased 17%, from 1.07 cases per 10,000 patients in 2007 to 1.22 cases per 10,000 patients in 2011.
- Unicompartmental knee arthroplasty. A more dramatic increase in UKAs was seen during the study period: a 66% increase in outpatient procedures, from 0.41 cases per 10,000 patients in 2007 to 0.66 cases per 10,000 patients in 2011. The total number of UKAs was smaller – only 1,708 – but that was expected, given that not as many surgeons perform this procedure as they do TKAs. But it also represents 26.4% of the total number of UKAs performed from 2007 to 2011.
An analysis of the demographic data revealed that outpatient TKA was performed most commonly in patients ages 60 to 64 years (5.46 cases per 10,000 patients), while outpatient THA and UKA were performed most commonly in patients ages 55 to 59 years (1.51 and 1.49 cases per 10,000 patients, respectively).
Henderson RA, Watters TS, Godin JA, Mather III RC, Berend KR, Bolognesi MP. Outpatient joint arthroplasty is increasing in the United States. Presented at: American Academy of Orthopaedic Surgeons (AAOS) 2015 Annual Meeting; March 24-28, 2015; Las Vegas, NV. E-poster P165-2015.