MANAGED CARE January 2011. ©MediMedia USA
Other countries have demonstrated the benefits of a national tracking and monitoring registry for surgical implants, but the United States has been lagging.
Now a medical device registry set up by Kaiser Permanente that tracked 85,000 joint surgeries is helping clinicians provide better care and lower costs, as the incidence of replacing the devices can be lowered.
Robert S. Namba, MD, an attending physician and coauthor of the study, says, “We wanted to see what factors were associated with early failures or re-operations on total hips or total knee replacements.”
The researchers categorized the factors affecting re-operation into patient and surgical factors. For total knee replacement, a patient was more likely to have a second operation on the surgically repaired knee if he was younger than 55.
“Knee replacement was designed for patients 65 and older, but the procedure became more common and successful so patients had the surgery at younger and younger ages. Many patients who are younger and more active tend to have arthritic knees. But these patients are at high risk for failures, or re-operations,” says Namba.
Creating registries can be a major benefit to managed care, says Namba. “Being able to follow patients who are being treated within your organization is very valuable. With the proliferation of electronic medical records, it facilitates the access to integrated databases so that we can know what other medical conditions our patients might have, or how our patients are doing compared to others.”
Registries don’t have to be set up for unique or difficult-to-treat conditions, he says.
“The ability to track any common procedures or medical conditions will pay dividends to those who develop them.”