Orthopedics 
Editor's Note The use of inpatient rehabilitation compared with a monitored home-based program did not improve mobility at 26 weeks after total knee surgery, this study finds. In the study, 81 patients received 10 days of hospital inpatient rehabilitation followed by an 8-week home-based program, and 87 patients received only…
Editor's Note In this study of patients undergoing total hip or knee replacement, smoking was associated with an increased risk of infectious complications that required further surgery. In addition, the amount that a patient had smoked, regardless of current smoking status, significantly contributed to increased risk of readmission. A total…
Editor's Note In this study, Medicare’s Comprehensive Care for Joint Replacement bundled payment model resulted in a decrease of $5,577 in total spending per episode. Most hospital savings came from implants and supplies, and most postacute care savings came from decreased use of inpatient rehabilitation and skilled nursing facility care.…
Editor's Note Nerve blocks in total knee patients were associated with statistically significant reductions in length of stay and readmissions, but no difference in emergency department visits or in-hospital falls, this Canadian study finds. In the analysis of 178,214 patients, adjusted: mean hospital stay was 4.7 days for patients with…
When leaders at Memorial Healthcare, a 154-bed community hospital in Owosso, Michigan, wanted to get a jump on preparing for bundled payments, they chose to focus on total hip and knee surgery. Creating a perioperative surgical home (PSH) for this patient population paid off in enhanced patient satisfaction and reductions…
Editor's Note In this study of inpatient and outpatient open reduction and internal fixation (ORIF) for ankle fractures, researchers found a reduced risk of 30-day medical morbidities with outpatient ORIF and no differences in surgical morbidity, reoperations, and readmissions between the two groups. The findings demonstrate that performing ORIF surgery…
Editor's Note A new survey shows the US implantable device market is expected to reach $73.9 billion by 2018, the January 6 Becker’s Spine Review reports. Among the survey findings: The market was valued at $43.1 billion in 2011. An increasing aging population, number of chronic degenerative diseases, and healthcare…
Editor's Note Surgical site infection (SSI) risk for coronary artery bypass graft (CABG) and hip arthroplasty patients is highest in hospitals with low annual procedure volumes, yet these hospitals are excluded from quality reporting, this study finds. Even for high-volume hospitals, year-to-year variation in SSI rates makes past performance an…
Editor's Note Early discharge of patients after total joint replacement did not increase readmission rates in this study. Of 174 patients discharged after 1 day and 285 discharged after 2 days, the readmission rates for both groups were similar−2.3% vs 2.5% at 30 days and 1.1% for both groups at…
Editor's Note Henry Ford Health System (Detroit, Michigan) is one of dozens of organizations that have dropped out of Medicare’s bundled payment model program in the past 3 years, the November 29 Modern Healthcare reports. In 2013, three of Henry Ford Health System hospitals participated in the first phase of…
