Unplanned hospital readmission following total joint arthroplasty

Total joint arthroplasty (TJA) is a reliable and effective means to treat degenerative conditions of the hip and knee. It has been shown to improve physical function, overall health and quality of life. The utilization of total knee arthroplasty (TKA) and total hip arthroplasty (THA) is predicted to increase exponentially in the United States through 2030 so that the number of the number of TKA increases by 673% for TKA to 3.48 million annually and the number of THA increases by 174% to 572,000 (1). The total gross cost to the American health care system for THA has risen more than 4 fold since 2005, to $13.43 billion, and the gross cost of TKA has risen more than 5 fold, to $40.8 billion (1,2). The Affordable Healthcare Act of 2010 includes pay-for-performance measures enforced by the Centers for Medicare and Medicaid Services (CMS) that are intended to incentivize providers and hospitals to minimize costly complications, reoperations and readmissions (3). As part of these measures, outcomes and complications are used as surrogates for performance and have become publically available leading to an overall increased scrutiny of outcomes following TJA.