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J Arthroplasty. 2009 Jun;24(4):518-27. doi: 10.1016/j.arth.2008.01.307. Epub 2008 Apr 15.

Trends in demographics, comorbidity profiles, in-hospital complications and mortality associated with primary knee arthroplasty.

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  • 1Department of Anesthesiology, Hospital for Special Surgery, Weill Medical College of Cornell University, New York, NY 10021, USA.


We analyzed the National Hospital Discharge Survey to elucidate temporal changes in the demographics, comorbidities, hospital stay, in-hospital complications, and mortality of patients undergoing primary total knee arthroplasties (TKAs) in the United States. Three 5-year periods were created (1990-1994, 1995-1999, and 2000-2004), and temporal changes were analyzed. The number of TKAs performed increased by 125% for the 3 periods. The increasing proportion of younger patients was accompanied by a concomitant decrease of Medicare-insured patients. Length of stay decreased from 8.44 to 4.18 days. An increase in the proportion of discharges to long-term and short-term care facilities and in procedures performed in small hospitals was noted. Although the prevalence of procedure-related complications decreased over time, comorbidities increased. Despite a decrease in mortality from the first to the second study period (0.50% vs 0.21%), a slight increase was noticed more recently (0.28%). We identified significant changes in most variables studied.

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