| Title: |
Team Approach: Perioperative Optimization for Total Joint Arthroplasty |
| Authors: |
Feng, James E.; Novikov, David; Anoushiravani, Afshin A.; Wasterlain, Amy S.; Lofton, Holly F.; Oswald, William; Nazemzadeh, Milad; Weiser, Sherri; Berger, Jeffery S.; Iorio, Richard |
| Source: |
JBJS Reviews ; volume 6, issue 10, page e4-e4 ; ISSN 2329-9185 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2018 |
| Description: |
* With the shift toward value-based patient care, greater emphasis has been placed on improving patient outcomes, reducing complications, and minimizing hospital costs. Optimal care therefore requires a multidisciplinary approach for perioperative patient optimization and episode management. * Here we review the case of a 48-year-old woman with symptomatic osteoarthritis of the left hip and multiple medical comorbidities. We present appropriate optimization guidelines from a panel of multidisciplinary experts in their respective specialties. * Continued clinical research is critical with regard to perioperative optimization and disease episode management as part of population health initiatives and will enable us to better identify at-risk patients early in the process. This will promote the development of improved evidence-based screening criteria and guidelines allowing for the optimization of patient outcomes, safety, and satisfaction following total joint arthroplasty. * Historically, surgical risk stratification methods have emphasized the appraisal of non-modifiable risk factors. Consequently, this has incentivized surgeons to operate on healthy, low comorbidity burden patients, while avoiding surgical intervention on unhealthy, high-comorbidity patients. Only recently has the medical optimization of high-risk candidates undergoing total joint arthroplasty demonstrated improved outcomes by reducing hospital readmissions when patients undergo total joint arthroplasty after optimization. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.2106/jbjs.rvw.17.00147 |
| Availability: |
https://doi.org/10.2106/jbjs.rvw.17.00147; https://journals.lww.com/01874474-201810000-00003 |
| Accession Number: |
edsbas.FEF4B0A4 |
| Database: |
BASE |