Use of off-label devices increased costs and length of stay in TJA

By Casey Tingle

Greater length of stay, admission costs, long-term complications risks and inpatient facility discharge likelihood was found among patients who underwent total hip or knee arthroplasty with an off-label prosthesis, according to results.

Researchers retrospectively queried the Nationwide Inpatient Sample from 2000 to 2010 and identified 2,566,523 primary total hip arthroplasty (THA) and 5,203,340 primary total knee arthroplasty (TKA) cases. The primary outcome measure “was annual trends in the national rate of off-label THA and TKA,” while secondary outcome measures included hospital length of stay, admission cost, perioperative complication rate and inpatient facility discharge rate by label status, according to the researchers.

Overall, 34.8% of cases were categorized as off-label with a prevalence of 30.4% in THA patients and 37% in TKA patients, according to results. Researchers noted that by 2040, at least 86.1% of THAs and 91.5% of TKAs could be off-label.


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