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Comparison of Three Types of Joint Replacements

In this study, researchers from Johns Hopkins University compare death rates, complications, and costs for three types of joint replacements. Hip, knee, and shoulder arthroplasties were included for patients with osteoarthritis (OA). Arthroplasty is the medical term for joint replacement.

Data was taken from Maryland hospital discharge records for the years 1994 to 2001. More than 500 surgeons from 60 hospitals were included. Types of information collected included age, sex, race and insurance type. Length of stay, in-hospital complications, and in-hospital mortality (death rate) were also compared.

They found most patients were Caucasian (white) with an average age of 69 years. However, patients ranged in age from 24 to 94. Patients having a total shoulder arthroplasty (TSA) were older and less likely to use Medicaid insurance.

There were more problems after total hip arthroplasty (THA) or total knee arthroplasty (TKA) compared with TSA. Patients with complications were more likely to be 65 years of older, male, and nonCaucasian. Patients with other health problems were also more likely to have post-operative complications.

Overall the data showed that TSA was safe with half as many complications as the THA or TKA. With shorter hospital stays, costs were less with TSA as well.

References: Kevin W. Farmer, MD, et al. Shoulder Arthroplasty versus Hip and Knee Arthroplasties. In Clinical Orthopaedics and Related Research. February 2007. No. 455. Pp. 183-189.

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