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Hip, Knee Arthroplasty Compared in NY and Ontario

Arthritis Rheumatol; ePub 2017 Dec 29; Cram, Landon, et al

Ontario has higher total joint arthroplasty (TJA) utilization than New York, but a smaller percentage of hospitals performing these procedures, according to a recent study that compared utilization and short-term outcomes of primary total knee and total hip arthroplasty (TKA and THA) in adjacent regions of Canada and the US. In addition, patients are more likely to be discharged home and less likely to be readmitted in Ontario. In this retrospective cohort study of patients who underwent primary TKA or THA using administrative data from NY and Ontario in 2012-2013, researchers compared TKA and THA patient demographics, per-capita utilization, and short-term outcomes between jurisdictions. They found:

  • A higher percentage of NY hospitals performed TKA compared to Ontario (75.7% vs 42.1%) and mean hospital volume was lower in NY (179 vs 327).
  • After direct standardization, utilization was significantly lower in NY compared to Ontario for both TKA (16.2 TKAs per 10,000 population per-year in NY vs 21.4 in Ontario) and THA (10.5 in NY vs 11.5 in Ontario).
  • For TKA, Ontario hospitals’ length of stay was significantly longer compared to NY (3.7 vs 3.4 days).


Cram P, Landon BE, Matelski J, et al. Hip and knee arthroplasty utilization and outcomes in the United States and Canada: An analysis of New York and Ontario administrative data. [Published online ahead of print December 29, 2017]. Arthritis Rheumatol. doi:10.1002/art.40407.

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