A.S. Chitnis's research while affiliated with Brunswick and other places
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Publications (90)
Introduction:
The impact of robotic-assisted total knee arthroplasty (rTKA) vs. traditional, manual TKA (mTKA) on hospital costs is not well documented and is analyzed herein.
Research design and methods:
Patients in the Premier billing Healthcare Database undergoing elective rTKA or mTKA ("index") in the in- or outpatient setting for knee osteo...
Background
Spinal fusion surgery (SFS) is one of the most common operations in the United States, >450,000 SFSs are performed annually, incurring annual costs >$10 billion.
Objectives
We used a nationwide longitudinal database to accurately assess incidence and payments associated with management of postoperative infection following SFS.
Methods...
Background
Computer-assisted hexapod ring fixation systems (HRF) are used for multiple conditions and in very diverse patient populations. This study analyzes perioperative outcomes following HRF application based on patient etiology and clinical presentation.
Methods
Data from patients in the Premier Hospital Billing Database between 2007–2019 un...
Introduction
The clinical and economic burden of clavicle fractures in England is not well documented. This study evaluated rates of surgical treatment, post-surgical complications, reoperations and costs in patients with clavicle fractures using the Clinical Practice Research Datalink (CPRD) database.
Methods
CPRD data were linked to National Hea...
Abstract Background Multiplanar external fixation systems that employ software-assisted deformity correction consist of rings connected by angled struts, defined as hexapod ring fixators (HRF). Costs and outcomes associated with the application of HRFs are not well documented. This study was designed to provide a nationwide baseline understanding o...
Background
Surgical site infection posthysterectomy has significant impact on patient morbidity, mortality, and health care costs. This study evaluates incidence, risk factors, and total payer costs of surgical site infection after hysterectomy in commercial, Medicare, and Medicaid populations using a nationwide claims database.
Methods
IBM Market...
Objective
This study evaluated the rates and patterns of intramedullary nail (IMN) breakage and mechanical displacement for proximal femur fractures and the factors associated with their occurrence.
Patients and Methods
Patients with subtrochanteric, intertrochanteric, or basicervical femoral neck fractures treated with IMN from 2016 to 2019 were...
Background
Treatment of large segmental defects in skeletal long bones is challenging. Heterogeneity in patient presentation further increase the difficulty in designing and running randomized trials, hence the paucity of published data with large patient numbers. This study was designed to help understand patient presentation, costs and outcomes,...
Aim
To estimate 2-year healthcare resource utilization (HCRU) and costs of dislocation following primary total hip arthroplasty (THA).
Materials and methods
This retrospective evaluation used medical claims from the US Medicare database. Patients were eligible if they were ≥65 years old, underwent a primary elective inpatient THA between 1 January...
Background:
Colorectal surgical procedures place substantial burden on health care systems because of the high complication risk, of surgical site infections in particular. The risk of surgical site infection after colorectal surgery is one of the highest of any surgical specialty.
Objective:
The purpose of this study was to determine the incide...
Objective:
Patients that undergo total hip replacement (THA) are at risk of revision surgery. This study evaluated the cumulative incidence of revision following a medial collared, triple tapered (MCTT) primary hip stem versus other implants in real-world settings using electronic medical records.
Methods:
This was a retrospective cohort study that...
Objectives
Determine the impact of infections on direct costs and healthcare resource use in England for patients undergoing intramedullary nailing (IMN) for tibial shaft fractures.
Design
Non-concurrent cohort based on retrospectively collected data with 2-year follow-up.
Setting
England.
Participants
The study population included adult patient...
Aim: To examine the time-to-total knee replacement (TKR) surgery among patients with high-concentration nonavian high-molecular-weight hyaluronan injection (HMW-HA) compared with those without HA injections. Materials & methods: Using MarketScan ® Commercial claims all patients aged 18–64 who underwent TKR surgery between 2008 and 2017 were identif...
Background
This study evaluated treatment patterns for long bone fractures and factors that contribute to use of intramedullary nails (IMN).
Methods
Patients from IBM MarketScan® Research Commercial and Medicare Databases with femoral/tibial/humeral fractures during inpatient admission between January 2016-July 2019 were identified. Patients were...
Aim: To evaluate the rates of infection and nonunion and determine the impact of infections on healthcare resource use and costs following open and closed fractures of the tibial shaft requiring open reduction internal fixation. Methods: Healthcare use and costs were compared between patients with and without infections following pen reduction inte...
Objective: To evaluate the impact of using different readmissions definitions among patients undergoing open reduction and internal fixation (ORIF) of the femur, tibia, and fibula in claims databases.
Methods: Patients from the IBM MarketScan® Research Commercial and Medicare Databases receiving inpatient ORIF between 1/1/2010-1/31/2017 (index) wer...
Aim: To estimate rates of fracture-related infection (FRI) and nonunion and assess the healthcare burden associated with FRI among patients with open reduction and internal fixation (ORIF) for Type III open tibial shaft fractures (TSFs). Methods: Patients with type III TSF requiring ORIF were identified using MarketScan® Database. Healthcare utiliz...
This study assessed the impact of intraoperative and early postoperative periprosthetic hip fractures (PPHFx) after primary total hip arthroplasty (THA) on health care resource utilization and costs in the Medicare population.
This retrospective observational cohort study used health care claims from the United States Centers for Medicare and Medic...
Aims: To assess rates of surgical treatment, post-surgical complications, reoperations, and reimbursement in patients with clavicle fractures and acromioclavicular (AC) dislocations.
Materials and methods: This US retrospective study used data from patients with ≥1 diagnosis of clavicle fracture or AC dislocation (index) between 2012-2016. Surgical...
Background:
The frequency of primary and revision total knee and hip replacements (pTKRs, rTKRs, pTHRs, and rTHRs, respectively) is increasing in the United States due to demographic changes. This study evaluated the impact of preoperative patient and clinical factors on the risk of surgical site infection (SSI) within the 90-day period after prim...
Objective: This study evaluated the frequency of reoperation within one year of initial intramedullary fixation for patients with pertrochanteric hip fracture and compared one-year healthcare resource utilization and cost burden for patients with and without reoperation.
Methods: This is a retrospective evaluation of medical claims from the United...
Objective: A prior study found that hyaluronic acid (HA) treatment may help reduce pain medications use (such as steroids, NSAIDs, and opioids) among knee osteoarthritis (OA) patients in the real-world setting. This study aims to update the prior study results to include only the high concentration non-avian high molecular weight hyaluronan (HMW-HA...
Background
The objective of our study was to compare resource use and clinical outcomes among atrial fibrillation (AF) patients who underwent catheter ablation versus antiarrhythmic drug (AAD) treatment.
Methods
A retrospective cohort design using the Clinical Practice Research Data-Hospital Episode Statistics linkage data from England (2008–2013)...
Aims: The anterior approach (AA) for total hip arthroplasty (THA) is associated with more rapid recovery when compared to traditional approaches. The purpose of this study was to benchmark healthcare resource utilization and costs for patients with THA via AA relative to matched patients.
Materials and Methods: We queried Medicare claims data (2012...
Citations
... R-TKA remains costly, with prices ranging from USD 400 thousand to more than USD one million depending on the device and the contract. Average three-month health-related costs may be similar [77] or increased [78] compared to C-TKA, although the supply cost might not be mitigated even with hundreds of cases. Recent studies suggest that the initial capital investment could be paid off thanks to reduced postoperative pain and opioid intake, shorter length of stay, higher home discharge, and inferior readmission rates at short-term follow-up. ...
Reference: Robotic Total Knee Arthroplasty: An Update
... 31,32 Health economic data across the US literature are variable, with estimates of the cost of SSI treatment per case ranging from US$16 242 1 to US$93 741; 33 this range reflects the competing financial interests between federal and private health care institutions and insurance programs. 33,34 The 2018 cost estimate of Barnacle and colleagues 29 represents the most recent health economic data specific for treating spine SSIs, without dilution costs, in a public health care model comparable to that in Canada. 35,36 ...
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... The higher rate of implant removal in women may support this hypothesis. The prebending method proposed by the authors may reduce skin irritation from the plates and patient discomfort, potentially reducing the need for implant removal surgeries [8]. ...
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... spent in the 12-months following post-index surgery for those aged <17 with congenital deformity. Reid, et al., found this group of 168 patients, with an average duration of care similar to ours at 149.5 days, also had an average 22.26 outpatient physical therapy appointments and average 8.94 outpatient imaging procedure [14]. ...
... Previous studies have reported implant breakage rates of 0.66-7.2% [6,[11][12][13], suggesting that the lower breakage rate observed in our study could be attributed to potential advancements in implant technology. No breakages occurred in the implants' main body. ...
... The prevalence of non-union is between 2% and 30% for long bone fractures [7]. The treatment is often time-consuming and costly [8]. Bones of the leg are affected in a high number of cases, resulting in a loss of mobility. ...
... Instability following total hip arthroplasty (THA) can be a devastating complication. Recurrent dislocations can lead to high patient and societal costs due to increased admissions and revision surgeries, as well as overall reduced patient satisfaction [1,2]. While modern dislocation rates in THA are relatively low at~1% [3,4], with approximately~400,000 primary THAs performed annually in the United States, this incidence rate still creates a significant healthcare burden [5]. ...
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... Failure of surgical wound healing can be largely attributed to mechanical failure or to patient-related issues, and can result in SSI, dehiscence and/or incisional hernia. SSI is especially concerning after colorectal surgery, with rates around 24%; and up to 31.8% of colorectal patients develop incisional hernia 2 years after standard mass closure [5,6]. SSI and incisional hernia have multiple causes; ...
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... Chitnis et al. reported on their results using the MCTT stem in 1200 patients, extracted from a retrospective database. They found a lower revision rate at 3 years as compared to conventional hip stems (1.03% vs. 2.63%) [20]. The recent American Joint Replacement Registry (AJRR) data from 2020 also showed that the MCTT stem had the lowest revision rate at three years among all stems analyzed [21]. ...
... 10-fold longer LOS is described [1,4,5,7,17,22]. Our findings add to previous literature because it reports on LOS in patients with and without FRI and demonstrated that there is a fivefold increase of LOS in FRI patients. ...
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