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Knee Replacement SurgeriesAccording to a new study, the total number of knee replacement surgeries performed in the United States shows a significant increase. The study published in the Journal of Bone and Joint Surgery (JBJS) (June 2014 edition) found that the total knee replacements (TKR) had tripled during 1993 – 2009, while hip replacement surgeries doubled during the same period. A higher prevalence of overweight and obesity in the US accounted for about 95 percent increase in these orthopedic surgical procedures, particularly with younger patients being affected to a greater extent.

Data suggests that excess body weight appears to be more damaging to the knee than to the hip. Researchers observed that the number of knee surgeries far outpaced the hip procedures. Previous studies have found that a strong link exists between higher body mass index (BMI) and knee osteoarthritis.

As part of this study, researchers analyzed about 10 years of national data on total knee and hip procedures performed till 2009. They observed the total number of procedures in detail, type of procedures performed, in-hospital deaths, how long patients stayed in the hospital and other workforce trends.

The main findings of this study are mentioned below

  • Knee arthroplasty is more common among patients who are obese and overweight.
  • Patients in the age group 18 to 64 years showed a rapid increase in overweight and obesity when compared to patients above 64 years of age.
  • From 1993-2009, the number of patients aged between 18 to 64 years, undergoing knee surgery rose to 56%, when compared to just 35% for hip procedure.
  • The length of hospital stay and in-hospital deaths related to knee and hip replacements showed a decline during 1993- 2009.

Further, the study signifies that even though the physician reimbursement for hip surgery is higher, this procedure is not performed as much as knee replacement surgery.

Knee replacement surgery is reimbursed. Orthopedic surgeons performing these procedures must use the correct CPT codes for medical billing purposes.

CPT codes for Knee Arthroplasty

  • 27445 – Arthroplasty, knee, hinge prosthesis (e.g., Walldius type)
  • 27446 – Arthroplasty, knee, condyle and plateau; medial OR lateral compartment
  • 27447 – Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
  • 27486 – Revision of total knee arthroplasty, with or without allograft; 1 component
  • 27487 – Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component

CPT codes for Hip Arthroplasty

  • 27120 – Hip Acetabuloplasty
  • 27122 – Hip Acetabuloplasty; resection, femoral head
  • 27125 – Hip Hemiarthroplasty, hip, partial
  • 27130 – Hip Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft
  • 27132 – Hip Conversion of previous hip surgery to total hip arthroplasty, with or without autograft or allograft
  • 27134 – Hip Revision of total hip arthroplasty; both components, with or without autograft or allograft
  • 27137 – Hip Revision of total hip arthroplasty; acetabular component only, with or without autograft or allograft
  • 27138 – Hip Revision of total hip arthroplasty; femoral component only, with or without allograft

If the rates of overweight and obesity continue to accelerate, it will directly affect the total number of orthopedic surgical procedures performed annually in the US. Moreover, this knowledge can impact future policy decisions related to healthcare costs, surgical workforce training and allocation of preventive health resources.