INTRODUCTION: There is anecdotal evidence of poorer outcomes from prosthetic joint replacement performed in independent treatment centres but very few comparative studies. PATIENTS AND METHODS: We compared the early re-operation, dislocation, re-admission, major wound infection and audit rates of 880 total hip (THA) and 874 total knee (TKA) arthroplasties carried out at a regional orthopaedic hospital (Avon Orthopaedic Centre; AOC) with 368 THAs and 365 TKAs from an NHS (WGH) and 67 THAs and 86 TKAs from a private hospital (CNH) independent treatment centre. RESULTS: Early re-operation rates were 9% at CNH, 1.4% at WGH and 0.6% at AOC after THA and 8% at CNH, 1.9% at WGH and 1% at AOC after TKA. After THA, dislocation rates after THA were 6% at CNH and 1.8% at both WGH and AOC. Re-admission rates were 13% at CNH, 0.6% at WGH and 1.2% at AOC. Major wound problems were 20% at CNH, 3.8% at WGH and 0.4% at AOC after THA and 19% at CNH, 1.9% at WGH and AOC (1.1%) after TKA. After TKA, re-admission rates from CNH were 13%, 1% at WGH and 1.1% at AOC. AOC and WGH audited their outcomes. None were available from CNH. CONCLUSIONS: Results and audit from independent treatment centres are variable and patients should be warned of this before undergoing treatment at them.
INTRODUCTION: There is anecdotal evidence of poorer outcomes from prosthetic joint replacement performed in independent treatment centres but very few comparative studies. PATIENTS AND METHODS: We compared the early re-operation, dislocation, re-admission, major wound infection and audit rates of 880 total hip (THA) and 874 total knee (TKA) arthroplasties carried out at a regional orthopaedic hospital (Avon Orthopaedic Centre; AOC) with 368 THAs and 365 TKAs from an NHS (WGH) and 67 THAs and 86 TKAs from a private hospital (CNH) independent treatment centre. RESULTS: Early re-operation rates were 9% at CNH, 1.4% at WGH and 0.6% at AOC after THA and 8% at CNH, 1.9% at WGH and 1% at AOC after TKA. After THA, dislocation rates after THA were 6% at CNH and 1.8% at both WGH and AOC. Re-admission rates were 13% at CNH, 0.6% at WGH and 1.2% at AOC. Major wound problems were 20% at CNH, 3.8% at WGH and 0.4% at AOC after THA and 19% at CNH, 1.9% at WGH and AOC (1.1%) after TKA. After TKA, re-admission rates from CNH were 13%, 1% at WGH and 1.1% at AOC. AOC and WGH audited their outcomes. None were available from CNH. CONCLUSIONS: Results and audit from independent treatment centres are variable and patients should be warned of this before undergoing treatment at them.
Authors: Olwen Williams; Ray Fitzpatrick; Shakoor Hajat; Barnaby C Reeves; Anne Stimpson; Richard W Morris; David W Murray; Marianne Rigge; Paul J Gregg Journal: J Arthroplasty Date: 2002-02 Impact factor: 4.757
Authors: J N Katz; E Losina; J Barrett; C B Phillips; N N Mahomed; R A Lew; E Guadagnoli; W H Harris; R Poss; J A Baron Journal: J Bone Joint Surg Am Date: 2001-11 Impact factor: 5.284
Authors: Simon W Young; Niall P T Sullivan; Matthew L Walker; Sherina Holland; Ali Bayan; Bill Farrington Journal: Clin Orthop Relat Res Date: 2020-06 Impact factor: 4.755
Authors: David Williams; Andrew Metcalfe; June Madete; Gemma Whatling; Peter Kempshall; Mark Forster; Kathleen Lyons; Cathy Holt Journal: J Biomech Date: 2020-09-11 Impact factor: 2.712
Authors: Mehdi Javanbakht; Atefeh Mashayekhi; Angeline Carlson; Eoin Moloney; Martyn Snow; James Murray; Tim Spalding Journal: Pharmacoecon Open Date: 2022-05-17