Hospitals are performing more knee replacement procedures on Medicare patients than they did two decades ago—and while inpatient stays have gotten shorter, readmissions and infection rates have gone up.
A study in the Sept. 26 issue of the Journal of the American Medical Association looked at total knee replacement procedures—both primary operations and revisions—performed on more than 3.5 million Medicare patients between 1991 and 2010.
It found that more patients are undergoing the procedure, also known as total knee arthoplasty and used to treat severe arthritis, both in absolute terms and per capita. The number of primary procedures increased 161.5% during the study period, while there was a 99.2% per capita increase.
The number of revisions performed increased 105.9% overall and 59.4% per capita.
At the same time, patients are spending less time in the hospital—3.5 days in 2007-2010 compared with 7.9 days in 1991-1994 for primary procedures. But they are also more likely to be readmitted within 30 days: Readmission rates increased to 5% during 2007-2010 compared with 4.2% from 1991-1994.