(6) Age, gender, preoperative walking distance, gait aid, community support, home caregiver However, to meet the goal of increasing the productivity of joint replacement surgeons, tools must predict accurately meaningful clinical outcomes and be generalizable widely. The financial savings associated with decreasing LOS have been documented extensively. These tools may also allow for early planning of discharge and postoperative care, potentially reducing hospital length of stay (LOS). Such tools may facilitate efficient resource utilization by helping select better candidates for TJA, anticipating resource-intensive intensive care unit (ICU) monitoring, and encouraging timely planning for patient transition to an extended care facility.
Numerous clinical tools have been developed to predict a variety of TJA patient outcomes ( Table 1 ). The capacity to predict patient outcomes and needs preoperatively allows more efficient delivery of care, which increases the ability of joint replacement surgeons to meet this demand. The United States health care system’s ability to meet the rapidly growing demand will be predicated on safe and efficient delivery. The predicted shortage of qualified arthroplasty surgeons in relation to the increasing demand represents an additional challenge. TKA and THA are considered safe, long-term, cost-effective treatments for osteoarthritis and it is therefore desirable that the growing demand be met. Hospital costs associated with total joint arthroplasty (TJA) were estimated at $30 billion in 2004, and are expected to increase as demand increases. Demand for THA and TKA revision procedures is likewise expected to experience a large increase in demand of 147% and 601% by 2030, respectively. Kurtz and colleagues projected the demand for primary THA to grow 174% to 572,000, and primary TKA to grow by 673% to 3.48 million procedures per year by 2030. The demand for total knee arthroplasty (TKA) and total hip arthroplasty (THA) in the United States is growing rapidly.
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