Joint Replacements in the VA Compared to Results in a Civilian Hospital
A large study of total knee and total hip replacements is reported by the Veteran’s Administration (the VA). Studies like this have been done in the civilian world many times. This is the first VA study of its kind.
All the patients were veterans treated in VA hospitals. Both men and women were included. Almost 7,000 total hips and 12,000 total knees were followed for 30 days. Both minor and major problems were reported such as infections, blood clots, heart attacks, and death.
Differences between men and women were studied. It seems women were less likely to have a joint replacement done at a VA. When they did, they were more likely than men to have problems. Urinary tract infections and a blood clot to the lungs were more common complications in women.
Increasing age and the presence of other diseases were linked with serious complications during and after the operation. Patients with diabetes, lung disease, previous stroke, and wound infection before the joint replacement had longer hospital stays.
Blacks were more likely to have a longer hospital stay, too. They had more pain and more problems with healing than whites. Hispanics were more likely to have problems with wound healing.
The authors say that the findings in the VA group are similar to patients in civilian hospitals. In fact, complications and readmissions were less in the VA sample compared to private hospitals. They conclude that VA care is as good as the care given in non-VA settings.
Frances Weaver, PhD, et al. Preoperative Risks and Outcomes of Hip and Knee Arthroplasty in the Veterans Health Administration. In The Journal of Arthroplasty. September 2003. Vol. 18. No. 6. Pp. 693-708.