IRVINE, CA (January 2, 2019) – Hoag Orthopedic Institute, one of the largest
volume orthopedic hospitals in the country, conducts and submits research
to multiple prestigious organizations annually to share its findings with
the medical community to enhance the specialty of orthopedic surgery.
These research projects are a way for Hoag Orthopedic Institute to extend
its reach into the global medical community and improve patient outcomes
on a broader scale. Several of our findings have been selected by The
American Academy of Orthopedic Surgeons for presentation at this coming
year’s annual meeting. Additionally, the American Association of
Hip and Knee Surgeons (AAHKS), which received 1,615 research abstracts
this year, selected Hoag Orthopedic Institute to present two poster presentations
of the 250 that were chosen.
Dr. Travis Scudday (2017-2018 Total Joint Fellow) was selected to present
a poster at AAHKS and a paper at AAOS on the research project titled,
“Successful Outcomes in Enhanced Recovery Program Patients Following
Joint Replacement Surgery.” The study is believed to be the largest
single institution study for early experience with same day discharges
of total hip replacement from an inpatient hospital. The enhanced recovery
program (ERP) does not increase hospital readmission rates and accomplishes
its goal of decreased cost and shorter hospital stays.
“With increased emphasis on value-based care, minimizing hospital
stay and cost while maintaining quality is of paramount importance. Short
stay and outpatient total hip arthroplasty (THA) has been shown to be
safe while the majority of procedures continue to be done at inpatient
facilities,” said Dr. Scudday. “We hypothesize a same day
discharge enhanced recovery protocol (ERP) implemented at an inpatient
orthopedic specialty hospital is safe and cost effective when compared
to a standard inpatient tract.”
Dr. Zachary Thielen (2017-2018 Total Joint Fellow) was selected to present
a poster at AAHKS on the research project titled, “Opioid Use After
Discharge Following Primary THA – How Much Are We Over-prescribing?”
In this prospective cohort study, it was determined that patients were
significantly more narcotics than needed for adequate post-operative pain
control. Unused narcotics are a potential source for abuse and diversion.
Based on our findings we recommend prescribing 300 MME or less for opioid
naïve, routine THA patients.
The study titled “Intraoperative comparison of measured resection
and gap balancing using a force sensor: A prospective, randomized controlled
trial”, by Krishna Cidambi MD, Nicholas Robertson MD, Camille Borges,
BA, Nader Nassif MD, and Steven Barnett MD was published in The Journal
of Arthroplasty’s Vol.33 Issue 7. It demonstrates that gap balancing
resulted in a greater range of femoral component rotation compared to
measured resection and greater variation of thickness of the posterior
condylar cuts. Force sensor data showed a decreased intercompartmental
force difference at full flexion in the balanced group and more similar
forces within the medial compartment between extension and full flexion.