OBJECTIVES

Cemented total knee arthroplasty (TKA) is an established, gold standard surgical procedure with excellent survivorship, however the impact on resource utilization is less well understood. Readmission rates also impact quality metrics and could incur penalties. This study therefore evaluated healthcare resource utilization among patients treated with cemented TKA in real-world settings over time.

METHODS

Through data partnership with Mercy Technology Services, adult patients who underwent primary cemented TKA were extracted from the Mercy electronic health records between 2015-2019, which is a comprehensive longitudinal real-world database including pre-operative/intra-operative and post-operative information. Only patients with diagnosis of knee osteoarthritis were included. The date of procedure for cemented TKA was defined as the index. Bilateral cases were excluded from this analysis. Healthcare resources that were evaluated included (1) hospital length of stay, (2) percent of patients discharged home, to a home health agency and to a skilled nursing facility (SNF), and (3) all-cause readmissions over 30-, 60-, 90-, 180- and 365-days post-index discharge.

RESULTS

A total of 11,190 patients were included in the analysis. Mean (standard deviation, SD) age was 67.1 (9.5) years, 62.3% were female, and 91.9% were Caucasian. 92.2% Patients had an Elixhauser score >0. The mean (SD) hospital length of stay was 2.3 (3.7) days. There were 40.5% patients discharged home, 46.2% discharged to a home health agency and 9.8% patients discharged to a SNF post-index cemented TKA. The all-cause readmissions were 3.0%, 3.8%, 4.6%, 6.6%, and 10.2% over 30-, 60-, 90-, 180- and 365-days, respectively post-index discharge.

CONCLUSIONS

The mean hospital length of stay after cemented TKA was 2.3 days with only 40.5% patients discharged home post-surgery, and 10.2% readmissions within one-year. Given the cost to the healthcare system, measures to reduce utilization of these resources would be meaningful.