Journal ArticleDOI
Collection of surgical specimens in total joint arthroplasty. Is routine pathology cost effective
TLDR
Questions are raised about the necessity of routinely submitting pathologic specimens in uncomplicated total hip and knee arthroplasty and the cost effectiveness of routine pathologic examination.Abstract:
A retrospective review of 715 consecutive cases of total joint arthroplasty (283 hips, 432 knees), performed for a variety of indications during 1992 and 1993, was undertaken to assess the cost effectiveness of routine pathologic examination. The charts were reviewed for preoperative, operative, and pathologic diagnosis, and any discrepancies in diagnosis were noted. Particular attention was paid to pathologic findings suggestive of neoplasia or rheumatoid arthritis that were not noted in the preoperative or operative diagnoses. Six of the 715 cases fit into this category, but all failed to have any clinical significance. No alteration in patient care resulted from routine pathologic examination. This paper questions the necessity of routinely submitting pathologic specimens in uncomplicated total hip and knee arthroplasty.read more
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Efficacy of periarticular multimodal drug injection in total knee arthroplasty. A randomized trial.
Constant A. Busch,Benjamin J. Shore,Rakesh Bhandari,Su Ganapathy,Steven J. MacDonald,Robert B. Bourne,Cecil H. Rorabeck,Richard W. McCalden +7 more
TL;DR: Intraoperative periarticular injection with multimodal drugs can significantly reduce the requirements for patient-controlled analgesia and improve patient satisfaction, with no apparent risks, following total knee arthroplasty.
Journal ArticleDOI
A multimodal analgesia protocol for total knee arthroplasty. A randomized, controlled study.
Pascal-André Vendittoli,Patrice Makinen,Pierre Drolet,Martin Lavigne,Michel Fallaha,Marie-Claude Guertin +5 more
TL;DR: This multimodal perioperative analgesia protocol that included infiltration of a local anesthetic offered improved pain control and minimal side effects to patients undergoing total knee arthroplasty and the safety of the protocol was confirmed.
Journal ArticleDOI
Histopathology of retrieved allografts of the femoral head.
S. Sugihara,A. D. van Ginkel,Timothy U. Jiya,B.J. van Royen,P. J. van Diest,P. I. J. M. Wuisman +5 more
TL;DR: Since it is essential to confirm the quality of donor bones in bone banking, it is advised that histopathological screening of donor bone should be performed to exclude abnormal allografts.
Journal ArticleDOI
Single Price/Case Price Purchasing in orthopaedic surgery : Experience at the Lahey Clinic
William L. Healy,Richard Iorio,Mark J. Lemos,Douglas A. Patch,Bernard A. Pfeifer,Paul M. Smiley,Richard M. Wilk +6 more
TL;DR: The Single Price/Case Price Purchasing Program at the Lahey Clinic allowed the hospital to reduce its cost of orthopaedic operations by lowering the cost of operating-room supplies, important in a health-care economy in which hospital revenues per unit of service or care are decreasing.
Journal ArticleDOI
Cost and Effectiveness of Routine Pathological Examination of Operative Specimens Obtained During Primary Total Hip and Knee Replacement in Patients with Osteoarthritis
TL;DR: Routine pathological examination of surgical specimens from patients undergoing primary total hip or knee replacement because of the clinical diagnosis of osteoarthritis had limited cost-effectiveness at this hospital due to the low prevalence of findings that altered patient management.
References
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Book
Basic and Clinical Biostatistics
TL;DR: Here is absolutely everything medical students need to know about biostatistics and quantitative methods as applied to medicine, clinical practice, and research.
National hospital discharge survey: annual summary, 1994.
Graves Ej,Gillum Bs +1 more
TL;DR: In this paper, the authors presented national estimates of the use of non-federal short-stay hospitals in the United States during 1994, based on data collected through the National Hospital Discharge Survey for 1994.
National Hospital Discharge Survey: annual summary, 1993.
TL;DR: In this paper, the authors present statistics on the utilization of non-Federal short-stay hospitals based on data collected through the National Hospital Discharge Survey from a national sample of the hospital records of discharged inpatients.
Journal ArticleDOI
Surgical pathology of the intervertebral disc. Is routine examination necessary
Pier Boutin,Howard Hogshead +1 more
TL;DR: The elimination of routine pathologic examination of surgical discectomy specimens would not have lowered the standard of care; the pathologist's report had no discernible influence on patient management.
Journal ArticleDOI
Clinical evaluation and cost effectiveness of preoperative laboratory assessment on patients undergoing total hip arthroplasty.
TL;DR: It is recommended that only a minimal set of preoperative laboratory tests be added to the detailed medical history and physical examination in otherwise healthy patients about to undergo total hip replacement surgery.