In a recent editorial, Dr. Gerald McGwin, Jr., professor and vice chair in the department of epidemiology at the University of Alabama at Birmingham, collaborating with Dr. Thomas R. Vetter, professor and vice chair in UAB’s department of anesthesiology, commented on the rising incidence of overweight-obesity, diabetes, osteoarthritis (OA), and lower extremity joint arthroplasty in both developed and developing countries. They pointed out that the majority of individuals with obesity reside in developing countries, with percentages increasing at substantially different rates across age ranges and time periods as well as national and regional locations, and that there is expected to be a higher prevalence of diabetes in adults living in developing countries through the next one and a half decades. Over this same period, the surgical reconstruction or replacement of knee joints — which already far exceeds the number of similar surgeries performed on hip joints — is projected to continue to grow dramatically. Both knee and hip OA rank as significant factors causing disability-adjusted life-years, per the Global Burden of Disease 2010 study.
The authors note that implementing perioperative strategies, including fast-track surgery (which is shown to improve a number of surgical outcomes) and pay-for-performance programs (which provide incentives to health care providers to make improvements that optimize patient outcomes), promotes standardization and quality of health care, which contribute to increased patient satisfaction and added efficiency and safety.
“Fast Food Nation and Fast-Track Arthroplasty: Can We Have Our Cake and Eat It Too?” was published online in January in the journal Anesthesia & Analgesia.