The annual meeting of the American Academy of Orthopaedic Surgeons was held from Aug. 31 to Sept. 3 in San Diego and attracted approximately 5,000 participants from around the world. The conference highlighted recent advances in the diagnosis and management of musculoskeletal conditions, with presentations focusing on joint fractures, osteoarthritis, other musculoskeletal injuries, and factors impacting the outcomes of joint replacement procedures.
In one study, Ran Schwarzkopf, M.D., of the New York University Langone Orthopedic Hospital and Hospital for Joint Diseases in New York City, and colleagues found that patients who undergo total knee arthroplasty (TKA) or total hip arthroplasty (THA) who are married or have a supportive structure at home tend to go home upon discharge from the hospital rather than to a rehabilitation facility.
The authors evaluated a few years of outpatient records at NYU Langone Orthopedic Hospital. They used electronic health records for all patients who had undergone TKA or THA, extricating data on social status, whether they lived alone or were married, length of hospital stay, and discharge location. This was not a cause-and-effect study; rather, the goal was to identify associations. The researchers found that patients with supportive care at home were more likely to be discharged to their home environment rather than a rehabilitation or nursing home facility.
“Currently, every patient gets bundled together, and physicians get penalized by sending patients to a rehabilitation center or keeping patients in the hospital longer, even if it is the correct and safe way to treat a patient,” Schwarzkopf said. “If we are penalized on discharge by sending a patient to a nursing home or keeping them in the hospital longer, physicians start cherry picking their patients. This will lead to some patients with more comorbid conditions or lack of support at home to have limited access to care.”
In another study, Rushabh Vakharia, M.D., of Maimonides Medical Center in Brooklyn, New York, and colleagues found that patients with cannabis use disorder undergoing total joint arthroplasty have prolonged in-hospital stays, elevated rates of medical and prostheses-related complications, and higher costs of care compared with patients not using cannabis.