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Electronic medical records for appropriate timing of arthroplasty


Mr Kari Tirkkonen, Department of Orthopaedics and Traumatology, Turku University Hospital, Luolavuorentie 2, PO Box 28, FI-20701 Turku, Finland.


Objective  The objective of this study was to analyse whether electronic medical records (EMRs) of total hip and knee arthroplasty can be used to manage the optimal time of surgery.

Design  Retrospective registry study.

Setting  Data on waiting time for operation, age, gender, body mass index (BMI), operable condition pre-operatively and the functional scores at 3 and 12 months after arthroplasty were obtained from EMRs and from an electronic implant database.

Participants  The participants of the study were 162 arthroplasty patients.

Results  An increase in waiting time of hip patients decreased significantly the change in functional scores at 3 months (P = 0.006, n = 56). The score reductions of older patients were more marked than of younger patients and of patients of normal weight compared with overweight patients. In patients undergoing knee arthroplasty, the association between a longer waiting time and profound change in functional score was statistically significant after 1 year (P = 0.03, n = 75). After adjustment of the results for pre-operative scores, age group, BMI class, American Society of Anesthesiologists class and gender, the waiting time turned out to affect only the scores of patients undergoing hip arthroplasty at 3 months post-operatively.

Conclusions  Data from electronic patient entries complemented with data of the operable condition can be used for defining the optimal operation time with regard to the pre-operative condition of the patients. The implication of prolonged waiting times was not very profound, but elderly patients benefit from a short waiting time.