SURGEON WORK INPUT AND RISK IN PRIMARY VERSUS REVISION TOTAL JOINT ARTHROPLASTY

One hundred twenty stratified nonselected cases of primary and revisio n total joint arthroplasties performed between 1990 and 1992 in which complete financial and clinical data were available were reviewed. All cases were performed at a single university hospital. Compared with p rimary total joint arthroplasty, revision surgery involved significant ly more operative time, greater blood loss, increased length of stay, and a much higher complication rate. The actual physician reimbursemen t was not significantly more than for primary procedures. Physician re imbursement constituted 18% of the total fees collected compared with 24% for the actual prosthesis cost. Surgeons performing revision surge ry devote significantly more time and are at a higher liability than w hen performing primary total joint arthroplasty.