Patients who took a standardized medical evaluation process before their joint replacement surgery experienced 32% fewer postoperative complications than did patients who were not evaluated, according to a Business Wire report.
Pre-Surgery Evaluation Cuts Complications

A study of nearly 700 total knee and total hip replacement patients, conducted by John Muir Health, found that the pre-operation project improves the process for patients by identifying potential risk factors and reducing those risks.
The evaluation was administered by a nurse practitioner in a new, dedicated pre-operation clinic. Results were compared to a control group of patients who underwent the same types of surgery in the year immediately prior to the new clinic opening.
“The process produces a standardized medical history and current physical condition and, if appropriate, the process can generate pre- and post-operative order set changes, such as medications and dosages, to minimize the chance of post-surgical complications, ” said Doug Lange, M.D., orthopedic surgeon at John Muir Health.
“Nationally, more than one million patients annually suffer from serious post-surgical complications, ” said Lange. “These complications range from simple urinary tract infections to heart attacks, serious infections and death. The toll in patient suffering is staggering as is the unnecessary cost to the health care system.”
Among patients in the control group, the complication rate was 12.40%. Patients going through the new pre-operation clinic process had a 32% reduction in perioperative complications—from 12.40% to 8.45%.
“The new process reduces complications and improves surgical outcomes, ” said Dawn Knight, senior vice president of quality at John Muir Health. “Our work is supported by national trends in the emerging science of perioperative medicine, where there has been a tremendous surge in new information on how to better evaluate and enhance quality of care for patients.”

Discussion
This is a fascinating development. In my practice we've seen similar outcomes with the revised protocol. The key differentiator seems to be patient selection criteria. Has anyone else noticed the correlation with BMI thresholds?
Great point. I'd push back slightly on the conclusion, the sample size in the cited study is too small to draw population-level inferences. That said, the directional signal is compelling and worth a larger RCT.
We implemented a similar approach last year. Early results are promising but we're still gathering 12-month follow-up data. Happy to share our protocol if anyone is interested.
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