Assessment of 90-Day Outcomes Following Total Joint Arthroplasty in Ambulatory Surgery Centers, Hospital Outpatient Departments, and Hospitals: A Michigan Arthroplasty Registry Collaborative Quality Initiative Analysis
Background: Total joint arthroplasty is shifting from hospitals to ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). A Michigan Arthroplasty Registry Quality Collaborative Initiative quality improvement project examined readmissions, emergency room (ER) visits, periprost...
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Elsevier
2025-04-01
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| Series: | Arthroplasty Today |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352344125000469 |
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| author | Simarjeet Puri, MD Martin Weaver, MD Lisheng Chen, PhD Tae Kim, MHSA Elizabeth Dailey, MD David C. Markel, MD |
| author_facet | Simarjeet Puri, MD Martin Weaver, MD Lisheng Chen, PhD Tae Kim, MHSA Elizabeth Dailey, MD David C. Markel, MD |
| author_sort | Simarjeet Puri, MD |
| collection | DOAJ |
| description | Background: Total joint arthroplasty is shifting from hospitals to ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). A Michigan Arthroplasty Registry Quality Collaborative Initiative quality improvement project examined readmissions, emergency room (ER) visits, periprosthetic joint infection (PJI), fracture, and dislocation after primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) across sites. Methods: Primary TJAs between July 1, 2021, and June 30, 2022 (N = 41,696: 3910 ASC, 1,834 HOPD, and 35,952 hospital) were reviewed. Of 17,100 THAs, 9.5% (1,631) were at ASCs, 4.7% (798) at HOPDs, and 85.8% (14,671) at hospitals. Of 24,596 TKAs, 9.3% (2,279) were at ASC, 4.2% (1,036) at HOPDs, and 86.5% (21,281) at hospitals. Hospitals treated more elderly, women, non-White, obese, diabetics, smokers, and governmental insurance. Results: For THAs, ASCs had the lowest 30-day (ASC 1%, HOPD 1.8%, hospital 3.4%, P < .001) and 90-day (ASC 1.7%, HOPD 3.4%, hospital 5.5%, P < .001) readmissions, 30-day ER visits (ASC 1.8%, HOPD 3.5%, hospital 5.3%, P < .001), and fractures (ASC 0.4%, HOPD 0.6%, hospital 1.2%, P < .001). Similar trends were observed for TKAs: 30-day readmissions (ASC 1.3%, HOPD 1.4%, hospital 3.1%, P < .001), 90-day readmissions (ASC 2.2%, HOPD 2.3%, hospital 5.2%, P < .001), and 30-day ER visits (ASC 3%, HOPD 6.5%, hospital 6.4%, P < .001). PJI (THA: P = .1, TKA: P = .6) and dislocation rates (P = .5) were similar across sites. Conclusions: Patients receiving primary total joint arthroplasty at an ASC had the least postoperative hospital-based care despite similar rates of PJI and dislocation. |
| format | Article |
| id | doaj-art-ac963d2c11ff4b44a6b64df474ebc3ae |
| institution | DOAJ |
| issn | 2352-3441 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Arthroplasty Today |
| spelling | doaj-art-ac963d2c11ff4b44a6b64df474ebc3ae2025-08-20T03:06:41ZengElsevierArthroplasty Today2352-34412025-04-013210165910.1016/j.artd.2025.101659Assessment of 90-Day Outcomes Following Total Joint Arthroplasty in Ambulatory Surgery Centers, Hospital Outpatient Departments, and Hospitals: A Michigan Arthroplasty Registry Collaborative Quality Initiative AnalysisSimarjeet Puri, MD0Martin Weaver, MD1Lisheng Chen, PhD2Tae Kim, MHSA3Elizabeth Dailey, MD4David C. Markel, MD5Section of Orthopedic Surgery, Ascension Providence Hospital, Southfield, MI, USA; Corresponding author. Ascension Providence Hospital Southfield Campus, 1303 South Main Street, Royal Oak, MI 48067, USA. Tel.: +1 262 309 2238.Section of Orthopedic Surgery, Ascension Providence Hospital, Southfield, MI, USAMichigan Arthroplasty Registry Collaborative Quality Initiative, Ann Arbor, MI, USADepartment of Surgery and Biomedical Engineering, University of Michigan, Ann Arbor, MI, USADepartment of Orthopedic Surgery, University of Michigan, Ann Arbor, MI, USASection of Orthopedic Surgery, Ascension Providence Hospital, Southfield, MI, USA; The Core Institute, Novi, MI, USABackground: Total joint arthroplasty is shifting from hospitals to ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). A Michigan Arthroplasty Registry Quality Collaborative Initiative quality improvement project examined readmissions, emergency room (ER) visits, periprosthetic joint infection (PJI), fracture, and dislocation after primary total hip arthroplasty (THA) or total knee arthroplasty (TKA) across sites. Methods: Primary TJAs between July 1, 2021, and June 30, 2022 (N = 41,696: 3910 ASC, 1,834 HOPD, and 35,952 hospital) were reviewed. Of 17,100 THAs, 9.5% (1,631) were at ASCs, 4.7% (798) at HOPDs, and 85.8% (14,671) at hospitals. Of 24,596 TKAs, 9.3% (2,279) were at ASC, 4.2% (1,036) at HOPDs, and 86.5% (21,281) at hospitals. Hospitals treated more elderly, women, non-White, obese, diabetics, smokers, and governmental insurance. Results: For THAs, ASCs had the lowest 30-day (ASC 1%, HOPD 1.8%, hospital 3.4%, P < .001) and 90-day (ASC 1.7%, HOPD 3.4%, hospital 5.5%, P < .001) readmissions, 30-day ER visits (ASC 1.8%, HOPD 3.5%, hospital 5.3%, P < .001), and fractures (ASC 0.4%, HOPD 0.6%, hospital 1.2%, P < .001). Similar trends were observed for TKAs: 30-day readmissions (ASC 1.3%, HOPD 1.4%, hospital 3.1%, P < .001), 90-day readmissions (ASC 2.2%, HOPD 2.3%, hospital 5.2%, P < .001), and 30-day ER visits (ASC 3%, HOPD 6.5%, hospital 6.4%, P < .001). PJI (THA: P = .1, TKA: P = .6) and dislocation rates (P = .5) were similar across sites. Conclusions: Patients receiving primary total joint arthroplasty at an ASC had the least postoperative hospital-based care despite similar rates of PJI and dislocation.http://www.sciencedirect.com/science/article/pii/S2352344125000469Registry studyOutpatient surgeryTotal joint arthroplasty |
| spellingShingle | Simarjeet Puri, MD Martin Weaver, MD Lisheng Chen, PhD Tae Kim, MHSA Elizabeth Dailey, MD David C. Markel, MD Assessment of 90-Day Outcomes Following Total Joint Arthroplasty in Ambulatory Surgery Centers, Hospital Outpatient Departments, and Hospitals: A Michigan Arthroplasty Registry Collaborative Quality Initiative Analysis Arthroplasty Today Registry study Outpatient surgery Total joint arthroplasty |
| title | Assessment of 90-Day Outcomes Following Total Joint Arthroplasty in Ambulatory Surgery Centers, Hospital Outpatient Departments, and Hospitals: A Michigan Arthroplasty Registry Collaborative Quality Initiative Analysis |
| title_full | Assessment of 90-Day Outcomes Following Total Joint Arthroplasty in Ambulatory Surgery Centers, Hospital Outpatient Departments, and Hospitals: A Michigan Arthroplasty Registry Collaborative Quality Initiative Analysis |
| title_fullStr | Assessment of 90-Day Outcomes Following Total Joint Arthroplasty in Ambulatory Surgery Centers, Hospital Outpatient Departments, and Hospitals: A Michigan Arthroplasty Registry Collaborative Quality Initiative Analysis |
| title_full_unstemmed | Assessment of 90-Day Outcomes Following Total Joint Arthroplasty in Ambulatory Surgery Centers, Hospital Outpatient Departments, and Hospitals: A Michigan Arthroplasty Registry Collaborative Quality Initiative Analysis |
| title_short | Assessment of 90-Day Outcomes Following Total Joint Arthroplasty in Ambulatory Surgery Centers, Hospital Outpatient Departments, and Hospitals: A Michigan Arthroplasty Registry Collaborative Quality Initiative Analysis |
| title_sort | assessment of 90 day outcomes following total joint arthroplasty in ambulatory surgery centers hospital outpatient departments and hospitals a michigan arthroplasty registry collaborative quality initiative analysis |
| topic | Registry study Outpatient surgery Total joint arthroplasty |
| url | http://www.sciencedirect.com/science/article/pii/S2352344125000469 |
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