Outcomes of total joint arthroplasty in academic versus community hospitals.

BACKGROUND Most joint-replacement surgeries are currently performed in community hospitals. We sought to determine whether the functional outcomes of joint-replacement surgery differ between academic and community hospitals. METHODS We surveyed 471 patients for demographic data, Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores and Medical Outcomes Study Short Form 36 (SF-36) scores at baseline and at 3-month and 1-year follow-up. We assessed patient satisfaction at 1 year with a single survey question. RESULTS Community hospital patients (n = 269) were significantly older and had greater comorbidity than academic hospital patients (n = 202; p < 0.05). We found no difference in WOMAC scores, SF-36 scores or in patient satisfaction between hospitals at 1-year follow-up (p > 0.05). Adjusted analysis showed that patients undergoing surgery in an academic or community hospitals have the same functional outcomes. CONCLUSION There is no significant difference in the functional outcomes of joint-replacement surgery between academic and community hospitals. Further work will involve evaluating cost of care differences between these types of hospitals.