Abstract The purpose of this study was to evaluate concordance between administrative and clinical diagnosis and procedure codes for revision total joint arthroplasty (TJA). Concordance between ...administrative and clinical records was determined for 764 consecutive revision TJA procedures from 4 hospitals. For revision total hip arthroplasty, concordance between clinical diagnoses and administrative claims was very good for dislocation, mechanical loosening, and periprosthetic joint infection (all κ > 0.6), but considerably lower for prosthetic implant failure/breakage and other mechanical complication (both κ < 0.25). Similarly, for revision total knee arthroplasty diagnoses, concordance was very good for periprosthetic fracture, periprosthetic joint infection, mechanical loosening, and osteolysis (all κ > 0.60), but much lower for implant failure/breakage and other mechanical complication (both κ < 0.24). Concordance for TJA-specific procedure codes was very good only for revision total knee arthroplasty patellar component revisions and tibial insert exchange procedures. Total (all-component) revisions were overcoded for hips (00.70) and undercoded for knees (00.80). Improved clinical documentation and continued education are needed to enhance the value of these codes.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
Abstract Understanding patients' perceived health status, as measured by health state utility, is important when evaluating the societal impact of hip osteoarthritis (OA) and total hip arthroplasty ...(THA). The purpose of this study was to measure health state utility in patients with hip OA and THA. A total of 231 patients from 2 institutions were enrolled into 1 of 6 cohorts: chronic hip OA, successful and failed primary THA, successful and failed revision THA, and infected THA. Average health state utilities were calculated using the time-trade-off method. Health state utilities were highest for primary THA (0.96) and lowest for infected THA (0.46). Our data demonstrate that THA results in substantial improvement in perceived health status in patients with chronic hip OA. However, health state utility is significantly worse after revision THA than primary THA, and failed primary or revision THA results in substantially reduced health state utility, similar to or worse than chronic OA.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
