Referral to high-volume hospitals has been recommended for operations with a demonstrated volume-outcome relationship. The characteristics of patients who receive care at low-volume may be different from those hospitals. These differences limit their ability access or hospital.To identify patient associated the use hospitals, using California's Office Statewide Health Planning and Development discharge database.Retrospective study Californians receiving following inpatient 2000 through 2004:...

Background: Ankle fractures are among the most common injuries treated by orthopaedic surgeons. The purpose of present investigation was to examine risks complications after open reduction and internal fixation ankle in a large population-based study. Methods: With use California's discharge database, we identified 57,183 patients who had undergone lateral malleolar, bimalleolar, or trimalleolar fracture as inpatients years 1995 through 2005. Short-term were examined on basis rates...

Despite the overall effectiveness of total knee arthroplasty (TKA), a subset patients do not experience expected improvements in pain, physical function, and quality life as documented by patient-reported outcome measures (PROMs), which assess patient's emotional health pain. It is therefore important to develop preoperative tools capable identifying unlikely improve clinically margin after surgery.The purpose this study was determine if an association exists between PROM scores patients'...

Despite the overall effectiveness of total hip arthroplasty (THA), a subset patients remain dissatisfied with their results because persistent pain or functional limitations. It is therefore important to develop predictive tools capable identifying at risk for poor outcomes before surgery.The purpose this study was use preoperative patient-reported outcome measure (PROM) scores predict which undergoing THA are most likely experience clinically meaningful change in 1 year after surgery.A...

The purpose of this investigation was to expand on previous studies by more fully examining the role a variety patient and hospital characteristics in determining adverse outcomes following total knee replacement.With use data from all admissions California 1991 through 2001, multiple logistic regression performed information regarding patients treated with replacement. Rates mortality readmission due infection pulmonary embolism during first ninety days after discharge were regressed...

This study evaluates the validity of AOFAS Clinical Rating Systems by examining their level correlation to Medical Outcomes Study Short Form-36 (SF-36) in patients with foot and ankle complaints. The SF-36 is an extensively validated outcomes tool that has been used as a benchmark instruments designed for upper extremity, knee, shoulder, general orthopaedic conditions. sample was 91 seen at clinic university-based practice. Patients were administered both instruments. Pearson coefficients...

Background: The role of ankle arthroplasty in the treatment arthritis is controversial. Ankle fusion commonly performed, but there ongoing concern about functional limitations and adjacent subtalar joint following arthrodesis. use as an alternative to expanding, reported results have been limited those case series. purpose this study was compare reoperation rates arthrodesis replacement on basis observational, population-based data from all inpatient admissions California over a ten-year...

There remains uncertainty regarding the relative importance of patient factors such as comorbidity and provider hospital volume in predicting complication rates after total hip arthroplasty (THA).We therefore identified complications THA.We reviewed discharge data from 138,399 patients undergoing primary THA California 1995 to 2005. The rate during first 90 days postoperatively (mortality, infection, dislocation, revision, perioperative fracture, neurologic injury, thromboembolic disease)...

In 2012, the American Orthopaedic Foot & Ankle Society(®) established a national network for collecting and sharing data on treatment outcomes improving patient care. One of network's initiatives is to explore use computerized adaptive tests (CATs) patient-level outcome reporting.We determined whether CAT from NIH Patient Reported Outcome Measurement Information System(®) (PROMIS(®)) Physical Function (PF) item bank provides efficient, reliable, valid, precise, adequately covered point...

There is uncertainty regarding which outcomes tools should be used to report the results of treatment for patients with foot and ankle disorders. This study compared responsiveness Foot Function Index (FFI), American Orthopaedic Ankle Society (AOFAS) Clinical Rating Systems, Medical Outcomes Study Short Form-36 (SF-36) in surgery.Twenty-five were recruited at a tertiary referral practice. The mean age patient sample was 40 years (range 21 69) 19 women (76%). Thirteen (52%) had conditions...

Background: The role of ankle arthroplasty in the treatment arthritis is controversial. Ankle fusion commonly performed, but there ongoing concern about functional limitations and adjacent subtalar joint following arthrodesis. use as an alternative to expanding, reported results have been limited those case series. purpose this study was compare reoperation rates arthrodesis replacement on basis observational, population-based data from all inpatient admissions California over a ten-year...

Selecting optimal patient-reported outcome (PRO) instruments is critical to improving the quality of health care. The purpose this study was compare reliability, responsiveness, and efficiency three PRO measures: Foot Ankle Ability Measure-Activity Daily Living subscale (FAAM_ADL), Function Index 5-point verbal rating scale (FFI-5pt), PROMIS Physical computerized adaptive test (PF CAT).Data were aggregated from 10 clinical sites in AOFAS's National Orthopaedic Research (OFAR) Network 311...

Background: Although tibiotalar fusion has historically been considered the gold standard treatment for end-stage arthritis of ankle, performance total ankle replacement appears to be gaining favor as improved outcomes have observed with new implant designs and surgical techniques. The purpose this study was compare trends demographics in United States. Methods: Current Procedural Terminology (CPT) codes patients undergoing were searched using PearlDiver Patient Record Database, a national...

As concerns regarding health-care expenditure in the U.S. remain at national forefront, outpatient arthroplasty is an appealing option for carefully selected patient populations. The purpose of this study was to determine nationwide trends and complication rates associated with total knee (TKA) comparison standard inpatient TKA.We performed a retrospective review Humana subset PearlDiver Patient Record Database identify patients who had undergone TKA (Current Procedural Terminology [CPT]...

This study provides an updated comparison of the reoperation rates following primary ankle arthrodesis and total replacement on basis observational, population-based data from California. We previously reported 1995 to 2004, our current includes new 2005 2010. Our hypothesis was that would demonstrate increasing utilization lower complication given advances in implant design growth surgeon experience.California's hospital discharge database used identify patients who had undergone or between...

The purpose of this study was to compare the cost-effectiveness unicompartmental knee arthroplasty as an alternative total in patients with degenerative arthritis limited either medial or lateral compartment.A decision model created for treatment end-stage arthritis. A literature review used identify possible outcomes and their probabilities following arthroplasty. Each outcome weighted quality life use a utility factor, effectiveness expressed units quality-adjusted years. Gross costs were...

Background: There currently is no widely used, validated, self-administered instrument for measuring musculoskeletal functional status in individuals with nonsystemic foot disorders. The purpose of this paper was to report on the assessment reliability one these instruments. We wanted determine if Foot Function Index (FFI), which has been validated rheumatoid patients without fixed deformity or prior surgery, would be reliable a population complaints systemic disease. Methods: Patients were...

Background: There is uncertainty regarding which outcomes tools should be used to report the results of treatment for patients with foot and ankle disorders. This study evaluates validity Foot Function Index (FFI) by examining its level correlation Medical Outcomes Study Short Form-36 (SF-36). The SF-36 an extensively validated tool that has been as a benchmark in several orthopaedic tools. Methods: Seventy-three were recruited at tertiary referral practice. Patients completed packets...

Readmission rates following total hip arthroplasty (THA) and knee (TKA) are increasingly used to measure hospital performance. that not adjusted for race/ethnicity socioeconomic status, patient risk factors beyond a hospital's control, may accurately reflect In this study, we examined the extent which risk-adjusting status affected performance in terms of readmission THA TKA.We calculated 2 sets risk-adjusted by (1) using Centers Medicare & Medicaid Services standard risk-adjustment...

With healthcare expenditure in the national forefront, outpatient arthroplasty is an appealing option select patient populations. The purpose of this study was to determine complication rates associated with total hip (THA) comparison standard inpatient THA.We performed a retrospective review Humana subset PearlDiver insurance records database identify patients undergoing THA (Current Procedural Terminology-27130 and Current Terminology-27132) as either outpatients or inpatients from 2007...