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Sunday, May 18, 2008

Twice he was given last rites: Staph infection from a knee replacement

Robert Besse's painful journey began when he checked into a Cincinnati hospital a year ago to get his right knee replaced. The 60-year-old retired pharmacist had worn down the joint skiing and hiking and working on his feet for years.

Ten days after leaving the hospital, his knee was still oozing bits of fluid. "The pain was off the scale," he said. One of his surgeons took a look and immediately had him admitted to a different hospital, where he declined rapidly. Twice during the first night he was given last rites. But he survived until the morning when the surgeon opened up his knee again and found a raging staph infection that took two rounds of surgery to clean up. He spent the next several months on infused antibiotics and pain medication. He was barely able to celebrate his 60th birthday with his family in Breckenridge, Colorado.

He might have fared better at a specialty hospital – one of 200 centers in the U.S. that focuses on the care of a particular body part like the heart, spine, or joints, or a specific disease such as cancer. A study by the University of Iowa on thousands of Medicare patients found that rates of bleeding, infections, or death ("complications") are 40% lower for hip and knee surgeries at specialty hospitals than at big community hospitals. A study funded by Medicare in 2006 found that mortality rates for orthopedic surgery, e.g., knee replacements, are 75% lower for orthopedic patients in specialty hospitals than for other hospitals.

Advice to patients about to have surgery: Consider having the surgery at a specialty hospital.

Read another knee replacement story.

Thanks to David Whelan for the source article in the March 10 issue of Forbes magazine.

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