Demographic, Comorbidity, and Episode-of-Care Differences in Primary Total Knee Arthroplasty

Abstract

The overall patient health status improved from 2008 to 2018, with improvement in the modifiable comorbidities of smoking status, malnutrition, hypertension, and anemia; the functional status; and the overall morbidity and mortality probability, with no clinically relevant change in patient age; patient BMI; percentage of patients with BMI of >40 kg/m2; or patients with diabetes mellitus, chronic obstructive pulmonary disease, congestive heart failure within 30 days, or acute renal failure. Our findings may be a reflection of a global shift toward value-based care focusing on patient optimization prior to arthroplasty, quality of care, and improved outcomes. The results of our study highlight the potential increase in TKA procedural value, which is paramount for health-care policy changes in today's incentivized, value-based, health-care environment.