Appropriateness criteria and elective procedures--total joint arthroplasty.

@article{Ghomrawi2012AppropriatenessCA,
  title={Appropriateness criteria and elective procedures--total joint arthroplasty.},
  author={Hassan M K Ghomrawi and Bruce R. Schackman and Alvin I. Mushlin},
  journal={The New England journal of medicine},
  year={2012},
  volume={367 26},
  pages={
          2467-9
        }
}
The implementation of appropriateness criteria that help to identify the patients likely to benefit most from a given procedure could help to combat increasing health care costs while enhancing access and quality. Total joint arthroplasty offers a prime example. 

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The present study was undertaken to determine the prevalence rates of TKA surgeries classified as appropriate, inconclusive, and inappropriate in a knee osteoarthritis population in the US.

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It is important to provide clinicians with guidance in determining which patients should undergo total joint replacement surgery, and current appropriateness criteria for elective orthopaedic procedures have important limitations that suggest that they be used cautiously.

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The need for a tool to support decision making for TJA, particularly in the context of increasing surgical demand in younger patients with less severe arthritis, is recognized, and work to develop and test such a decision-support tool is underway.

Length Hip and knee arthroplasty utilization and outcomes in the United States and Canada : an analysis of New York and Ontario administrative data

This retrospective cohort study of patients who underwent primary TKA or THA using administrative data from New York (NY) and Ontario in 2012-2013 compared utilization and short-term outcomes in adjacent regions of Canada and the United States.

Effect of age on cost-effectiveness of unicompartmental knee arthroplasty compared with total knee arthroplasty in the U.S.

Unicompartmental knee arthroplasty is an economically attractive alternative in patients sixty-five years of age or older, and modest improvements in implant survivorship could make it a cost-effective alternative in younger patients.

Outpatient Surgery as a Means of Cost Reduction in Total Hip Arthroplasty: A Case-Control Study

This study demonstrates that appropriately selected patients can undergo total hip arthroplasty in an outpatient setting with no increase in complications and at a substantial savings to the healthcare system.
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