An institution that performs more than 2, 000 total hip and knee replacements annually, putting it—in terms of volume—among the top 20 hospitals nationwide, is opening a new Center for Advanced Joint Replacement. The Christiana Care Health System has created the Center, which features 30 private rooms and a new therapy gym, on the 7th floor of Wilmington Hospital.
Top Rated (#1!) Knee Hospital Announces Major Expansion

Christiana Care is one of only 128 hospital health systems in the nation—and the only hospital health system in Delaware—to earn the highest rating for knee surgery in Consumer Reports current issue on hospital surgery ratings. Officials at Christiana Care believe that their team-based approach to patient care results in clinical outcomes that are among the best in the nation.
“Through our new joint center, we are partnering with our neighbors to significantly enhance the patient- and family-centered experience when they are under our expert care, ” said Brian Galinat, M.D., chair of the Department of Orthopedic Surgery at Christiana Care. “Our patients can feel confident knowing that they will receive expert help through our innovative and effective systems of care.”
The opening of the Center for Joint Replacement is part of the Wilmington Hospital Transformation Project, which, by 2014, will create a one million-square foot medical center. Christiana Care Health System ranks as the 21st leading hospital in the nation and 11th on the East Coast in terms of admissions. It includes two hospitals with 1, 100 patient beds and an extensive range of outpatient services.

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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