AAHKS Position Statements

These statements are policy expressions of the American Association of Hip and Knee Surgeons. They are not comprehensive subject reviews nor are they intended as medical advice for the treatment of individual patients.
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Removal of TKA from CMS IPO List

In November 2017, the Center for Medicare and Medicaid Services finalized the 2018 Medicare Outpatient Prospective Payment System rule that removed total knee arthroplasty procedures from the Medicare inpatient-only list of procedures. This action has already had significant and unexpected consequences. Full Statement.

 
 

 

CDC Guideline Use of Antibiotics

The Centers for Disease Control and Prevention released their 2017 Guideline for the Prevention of Surgical Site Infection, which recommends against the use of post-operative prophylactic antibiotics – including patients undergoing total joint arthroplasty (TJA). At this time, we do not agree with this recommendation for TJA as it contradicts current international standards of care with limited evidence and study. Full statement.

 

Outpatient Joint Replacement

Hospitals, surgeons and payers have recognized the potential benefits to patients that derive from decreasing the length of inpatient hospital stay after total hip and total knee arthroplasty, and even the potential benefits associated with same-day discharge in the outpatient setting for select patients. This statement contains recommendations for outpatient hip and knee arthroplasty procedures to guide hospitals, surgeons and institutions in appropriate and safe patient care. Full statement.

Opioid Use for the Treatment of Osteoarthritis of the Hip and Knee

How best to manage osteoarthritis pain in the non-operative setting can be challenging and has been the subject of much debate. It is our position that the use of opioids for the treatment of osteoarthritis of the hip and knee should be avoided and reserved for only for exceptional circumstances.  Full Statement.

 

 

Biologics for Advanced Hip and Knee Arthritis

An increasing number of facilities and physicians have begun to offer intraarticular injections of stem cells and platelet rich plasma (PRP) as a therapeutic intervention to patients with advanced hip and knee arthritis. Improvements in joint function, reduction in pain, and an increase in cartilage in the affected joint are often touted as potential benefits. Full statement.