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J Knee Surg 2022; 35(07): 776-781
DOI: 10.1055/s-0040-1718600
Original Article

An Academic Orthopaedic Specialty Hospital Provides the Shortest Operative Times within a Single Health System for Primary and Revision Total Knee Arthroplasty

Jenna A. Bernstein 
1   Division of Orthopedics–Adult Joint Reconstruction, NYU Langone Orthopedic Hospital, New York, New York
,
Stephen Zak
1   Division of Orthopedics–Adult Joint Reconstruction, NYU Langone Orthopedic Hospital, New York, New York
,
Ran Schwarzkopf
1   Division of Orthopedics–Adult Joint Reconstruction, NYU Langone Orthopedic Hospital, New York, New York
,
Joshua C. Rozell
1   Division of Orthopedics–Adult Joint Reconstruction, NYU Langone Orthopedic Hospital, New York, New York
› Author Affiliations Funding None.
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Abstract

The study aimed to optimize value-based health care practices in total joint arthroplasty (TJA), and we need to understand how the surgical setting can influence efficiency of care. While this has previously been investigated, the purpose of this study was to clarify if these findings are generalizable to an institution with an orthopaedic specialty hospital. A retrospective review was conducted of 6,913 patients who underwent primary or revision total knee arthroplasty (TKA) at one of four hospitals within a single, urban, and academic health system: a high volume academic (HVA) hospital, a low volume academic (LVA) hospital, a high volume community (HVC) hospital, or a low volume community (LVC) hospital. Patient demographics were collected in an arthroplasty database, as were operating room (OR) times and several specific time points during the surgery. The HVA (orthopaedic specialty) hospital had the shortest total primary TKA OR times and the LVC that had the longest times (156.69 vs. 174.68, p < 0.0001). The HVA hospital had the shortest total revision TKA OR times, and the LVC had the longest times (158.20 vs. 184.95, p < 0.0001). In our health system, the HVA orthoapedic specialty hospital had the shortest overall OR time, even when compared with the HVC hospital. This is in contradistinction to prior findings that HVC institutions had the shortest OR times in a health system that did not have an orthopaedic specialty hospital. This provides evidence that an orthopaedic specialty hospital can be a model for efficient care, even at an academic teaching institution.

Keywords

total knee arthroplasty - efficiency - operating room time - hospital setting


Publication History

Received: 08 May 2020

Accepted: 25 August 2020

Article published online:
27 October 2020

© 2020. Thieme. All rights reserved.

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