Outcomes of total joint arthroplasty in academic versus community hospitals.

Background: Most joint-replacement surgeries are currently performed in community hospitals. We sought to determine whether the functional outcomes of joint-replacement surgery differ between academic and community hospitals.

Methods: We surveyed 471 patients for demographic data, Western Ontario McMaster University Osteoarthritis Index (WOMAC) scores and Medical Outcomes Study Short Form 36 (SF-36) scores at baseline and at 3-month and 1-year follow-up. We assessed patient satisfaction at 1 year with a single survey question.

Results: Community hospital patients (n = 269) were significantly older and had greater comorbidity than academic hospital patients (n = 202; p < 0.05). We found no difference in WOMAC scores, SF-36 scores or in patient satisfaction between hospitals at 1-year follow-up (p > 0.05). Adjusted analysis showed that patients undergoing surgery in an academic or community hospitals have the same functional outcomes.

Conclusion: There is no significant difference in the functional outcomes of joint-replacement surgery between academic and community hospitals. Further work will involve evaluating cost of care differences between these types of hospitals.