Readmission and Length of Stay After TKA in a National Medicare Sample 2002-2007

Introduction: Evaluation of hospital readmissions after total knee arthroplasty (TKA) may provide an opportunity for improved patient safety and cost reduction. Despite the established effectiveness of TKA for treatment of arthritis, it is a very costly procedure. Thus, it is of great interest to find ways of reducing costs while ensuring that patient safety and outcomes are not compromised. The equipment, personnel and facilities needed for TKA comprise some of the costs, but the postoperative hospital stay is a significant contributor. Factors contributing to the length of hospital stay after TKA include preoperative, intra-operative as well as postoperative variables. Some of these causes of increased postoperative stay are more modifiable that others. Previous studies of risk factors associated with prolonged hospital stay after TKA have described female gender, increasing age, comorbidities, obesity, higher American Society of AnesthesiologistsPhysical Status scores, longer incisions, longer operative time, the need for transfusion and postoperative complications as having significant associations with increased stay.