Total Joint Replacement Quality Measures Understanding Quality Measures Total Joint Replacement Quality Measures Annual Hospital and Surgeon Volume Board Certification of Orthopaedic Surgeons Correct Patient, Procedure and Site Average Length of Stay Antibiotic Prophylaxis Trident Health System MRSA Campaign Inpatient Prophylaxis for Deep Vein Thrombosis Dedicated Joint Services Inpatient Mortality Rate for Total Joint Replacement

Total Joint Replacement Quality Measures Understanding Quality Measures Approximately 300,000 total knee replacements, (also called total knee arthroplasty or TKA) and 250,000 total hip replacements, (also called total hip arthroplasty or THA) are performed each year in the U.S. Primary total knee replacement is most commonly performed for joint failure due to osteoarthritis (OA).  Other indications for joint replacement may also include rheumatoid arthritis (RA), juvenile rheumatoid arthritis, osteonecrosis (bone decay), and other types of inflammatory arthritis. The number of total knee replacements is increasing and the procedure is being performed on younger patients.  Currently, more than 43 million people have some form of arthritis.  It is estimated by the Centers for Disease Control and Prevention (CDC) that by 2030, about 41 million people 65 years of age or older will have chronic joint symptoms or arthritis.  Medicare paid more than $3.2 billion in the year 2000 for hip and joint replacements. The goal of total joint replacement is to relieve pain and to improve motion and function.  According to the National Institute of Health (NIH) Consensus Statement on Total Knee Replacement 2003, proper candidates for elective total joint replacement should have radiographic evidence of joint damage, moderate to severe persistent pain and significant functional limitation that is not relieved by non-surgical management. The surgical results of Total Joint Replacement have been measured by commonly used functional measures such as Knee Society scores (KS), the Hospital for Special Surgery Scale (HSS), the WOMAC (Western Ontario and McMaster Universities), Arthritis Scale, SF-36 and FIM scores.  There are few contraindications to this procedure and the mortality rate following the procedure is extremely low even though most patients are elderly. Complications following total joint replacement can occur and may include:  wound and deep tissue infection, deep vein thrombosis (blood clot), pulmonary embolism (blood clot that travels to the lungs), pneumonia, myocardial infarction (heart attack), joint instability, joint stiffness or poor alignment and nerve or vascular injury.  Some studies have demonstrated that complication rates were related to surgeon and hospital volume of procedures per year.