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Total joints in view: to tilt at or to toss

Cap Today—July 19, 2017

Cap Today featured HSS pathologists Edward F. DiCarlo, MD and Michael J. Klein, MD in an article exploring the question of if surgeons should submit hip and knee specimens for pathological exams when performing total joint arthroplasties. One study stated that routine pathologic exams boost costs but rarely alter patient management.

Dr. Klein argued that there are benefits to pathologic exams of total arthroplasty specimens and does not agree with orthopedic literature stating otherwise. "The orthopedic literature often neglects to point out reasons other than cost-effectiveness for doing these exams, including quality assurance, risk management, and, of course, patient care," he said.

The article noted that Dr. Klein and Dr. DiCarlo undertook their own study and assessed total joint replacement specimens over a 10 year period. The study did not provide cost analysis, but Dr. Klein concluded that pathologic examinations are important for surgeons in making correct diagnoses. According to the article, degenerative joint disease was the most common diagnosis among surgeons and pathologist, but it was also the most over-diagnosed condition.

Dr. Klein noted to not abandon histologic exams because of cost-effectiveness. "Cost-effectiveness isn’t the reason we do pathology," he said.

Read the full article at captodayonline.com


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