Is The Practice of Overlapping Surgery Safe in Total Knee and Hip - PowerPoint PPT Presentation

Is The Practice of Overlapping Surgery Safe in Total Knee and Hip Arthroplasty? 1 Ahmed Al-Mansoori, MD; 2 Juan C. Suarez, MD, 1 Vani J. Sabesan, MD, 3 Wilfredo J. Borroto MD; 1 Jesus M. Villa, MD; 1 Preetesh Patel, MD 1 Levitetz Department of Orthopaedic Surgery, Cleveland Clinic Florida, Weston, FL 2 Department of Orthopaedic Surgery, Baptist Hospital, Miami, FL 3 Ponce School of Medicine and Health Sciences, Ponce PR

Disclosures Juan C. Suarez, MD Consultant - DePuy Royalties - Corin Preetesh Patel, MD Consultant - Stryker

Introduction Overlapping surgeries in the States over the last two decades Growing. Importance in healthcare based on quality and cost.

Introduction The increase correlates with high demand for TJA. Emphasis on volume and productivity to meet demand. Overlapping approach allows the surgeons to do more cases in a more efficient way…Running Two Rooms. Regulatory bodies concern over safety and quality for patients

Objectives Assess how overlapping surgery affect outcomes in TJA

Methods Retrospective Review of 2,833 Consecutive Primary THA/TKA The cohort was divided into two groups: - Overlapping Surgeries (n=1,610; 57%) - Control Group (n=1,223; 43%) Definition of Overlapping Room Time Of ≥ 30 minutes. Sub-analysis for: Obese patients (BMI >30) ASA Class 3 or 4

Methods Outcomes included 90-day: - Readmissions - Reoperations - Complication s

Results The Groups Matched for Demographics Including: age, sex, race, and ethnicity.

Results Outcomes of the entire cohort P=0.104 P= 0.235 P= 1.0 P= 0.140 P= 0.359 P= 1.0

Results - Overlapping Group (n=737) - Control Group (n=541) P=0.366 P= 0.284 P= 1.0 P= 0.379 P= 0.574 P= 1.0

Results - Overlapping Group (n=530) - Control Group (n=412) P=0.424 P= 0.463 P= 0.475 P= 0.308 P= 1.0 P= 1.0

Conclusion From almost 3000 patients we looked at, there was no significant difference in outcomes for overlapping surgery in patients undergoing TJA. Moreover, no significant difference in the difficult or complex cases of high BMI or those with high ASA class.

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