Vital Times 2017 - 61

I Need a Total Knee, but...
By	Keith	Chamberlin,	MD,	MBA,	FASA,	|	Practice	Management	Chair

Y

es, I need a total knee. But, if you heard all the
Surgical Site Infection (SSI) talks at the ASA in
Boston recently, you might well understand why I still
NEED a total knee yet do not HAVE a total knee. Yes, I
know the chance of infection is low, but frankly not low
enough for my knee. I listened to the SSI lectures as a
patient and as a physician-anesthesiologist. The patient
part of me was appalled.
Have you ever seen a total knee get infected? Of
course, you have. Do we have a role in preventing these
infections? Of course we do! And did I believe that
before going to six hours of SSI lectures at the ASA? Of
course not! Do I believe it now? You bet I do! Is it an
annoying disruption to our workflow to do all the things
we need to do to help with SSIs? Yes. Heck YES.
SSIs have our attention every day in every OR in this
country, and is a major improvement initiative of every
state and national regulatory agency. Infection rates are
posted publicly to assist patients in making wise choices.
Most likely, your hospital's infection control department
has data on SSIs for every surgeon and procedure. It
is projected that by the year 2030 the total number of
primary total knee arthroplasty (TKA) procedures in the
United States will reach 3.48 million per year, a 673%
increase over the number of procedures in 2005. And
the cost of TKA revisions for SSIs is projected to exceed
$1.62 billion by 2020. (That is only two years away...)1
So the scrutiny of the OR environment will only get
more intense. AORN is concerned about OR attire.
So is the American College of Surgeons, and the ASA.
I went to lectures about surgical attire, masks, shoes
(continued)

Annual	Publication	2017	|	 	61



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