Approximately seven million orthopaedic surgeries [1] are carried out in the US every year, with total knee arthroplasty (TKA) and total hip arthroplasty (THA) among the most common procedures [2] outside of drainage/injection and venipunctures.
Orthopaedic surgery is often the last resort for patients unable to reap the benefits of other forms of treatment such as physical therapy, massage therapy, medication, or lifestyle changes. Chronic pain and immobility as a result of broken bones or fractures are the leading reasons for patients requiring surgical intervention.
Despite having a success rate of up to 98% [3] in the US, orthopaedic surgery can pose a wide range of adversities for patients that can lead to ongoing pain and discomfort, ultimately delaying patients reaching a full recovery.
Edema and the risks in recovery
Edema (swelling) is a common physical reaction that occurs following orthopaedic surgery. As the body begins to heal the surgical wound, extra fluid builds up around the affected area in the tissue to promote healing, prevent infection and help the tissues recover. Although it is a natural component of the recovery process, edema itself can contribute to further pain and limit mobility.
Some patients may experience edema up to six months [4] (and longer) following the procedure, impacting their ability to resume life as normal. Patients experiencing edema should be conscious of the risks associated with swelling, and understand that – although common – it could be an indication of a more serious condition such as an infection or deep vein thrombosis (DVT). Without relevant prophylaxis, approximately 80% [5] of orthopaedic surgical patients will develop DVT, and between 10% – 20% will develop pulmonary embolism (PE), which can be life threatening. Understanding the recovery process is therefore vital in preventing serious complications.
The financial burden of orthopaedics
Orthopaedic surgery can place a financial burden on the healthcare system and many families in the US, with TKA costing $19,995 [6] without health insurance and more complicated procedures such as a total hip replacement surgery costing up to $40,000 [7] for an uninsured patient. The average length of stay following orthopaedic surgery is approximately three days [8], which can cost around USD $8,226 [9] on average, indicating the proportion of costs associated with hospital recovery.
The level of 30-day hospital readmissions or unplanned return to operating room (UROR) in the US following orthopaedic surgery is reported between 4 and 7% [10]. Patients can be readmitted with serious medical or surgical complications of the original hospitalization, which can be costly and harmful. In other cases, patients may return to hospital if they are not recovering as well or quickly as they should. For 90-day readmissions for THA and TKA, payments can range from ~$7,000 to ~$15,000 [11] depending on Center for Medicare and Medicaid Services (CMS) complications. One in ten patients return to ED within 90 days of total joint arthroplasty
(TJA), incurr