OBJECTIVES:

Centers for Medicare and Medicaid Services has made hospitals accountable for better clinical and economical outcomes of total joint arthroplasty (TJA) by introducing the Comprehensive Care for Joint Replacement Model. The objective of this study was to evaluate 90-day outcomes and costs of using Oxidized Zirconium (OxZr) compared to non-OxZr use on elective TKA at a single high-volume institution (Hospital for Special Surgery NY).

METHODS:

We conducted a retrospective study by reviewing deidentified Medicare fee-for-service claims data 2017 fourth quarter to 2022 second quarter, using a proprietary software EpisodeInsights™ provided by Loopback. We measured these outcomes: 90-day readmissions, length of hospital stay (LOS), consumption of post-acute care: such as home health agency (HHA), skilled nursing facilities (SNF), long term acute care (LTAC), inpatient rehabilitation facility (IRF) and standardized total 90-day episode of care costs.

RESULTS:

We identified 2615 OxZr and 9715 non-OxZr patients. The mean LOS was 2.4 and 2.58 days, the LACE index was 2.74 and 2.90 for OxZr compared to non-OxZr while fewer patients were readmitted over the 90-day period (3.82% vs 4.47%) for OxZr compared to non-OxZr treated patients. Fewer patients treated with OxZr received post-acute care HHAs (69% vs 75%), SNFs (7% vs 12%), IRFs (1% vs 2%) while the 90-day costs were $16,667 and $18,650 for patients treated with OxZr compared to non-OxZr respectively. This resulted in cost-savings of $1,983 per patient in favor of OxZr treated patients.

CONCLUSIONS:

Our single high volume institution retrospective study demonstrated that treating patients with OxZr can potentially lead to reductions in readmission, LOS and less healthcare episodic spending overall. These results are from a single institution, in the future we would like to conduct this study across the country to enhance the generalizability of these findings.