Preoperative predictors of extended hospital length of stay following total knee arthroplasty.


The purpose of this study was to identify the preoperative predictors of hospital length of stay after primary total knee arthroplasty in a patient population reflecting current trends toward shorter hospitalization and using readily obtainable factors that do not require scoring systems. A single-center, multi-surgeon retrospective chart review of two hundred and sixty consecutive patients who underwent primary total knee arthroplasty was performed. The mean length of stay was 3.0 days. Among the different variables studied, increasing comorbidities, lack of adequate assistance at home, and bilateral surgery were the only multivariable significant predictors of longer length of stay. The study was adequately powered for statistical analyses and the concordance index of the multivariable logistic regression model was 0.815.





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Publication Info

Halawi, Mohamad J, Tyler J Vovos, Cindy L Green, Samuel S Wellman, David E Attarian and Michael P Bolognesi (2015). Preoperative predictors of extended hospital length of stay following total knee arthroplasty. J Arthroplasty, 30(3). pp. 361–364. 10.1016/j.arth.2014.10.025 Retrieved from

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Samuel S. Wellman

Associate Professor of Orthopaedic Surgery

My career has primarily focused on clinical care of hip and knee arthritis.  I run a busy Adult Reconstruction (hip and knee replacement) practice.  I am also Chief of the Orthopedic Surgery service at the Durham VA medical center.  In these roles, I work daily with orthopedic residents, and train them to manage these issues both non-operatively and with surgery.   I also mentor residents, fellows,and medical students on their research projects, typically in collaboration with my clinical partner, Michael Bolognesi, MD.  We often have multiple residents working on a variety of projects at once.  My research interests lie mainly with clinical research in hip and knee replacement, including biomechanical studies, outcomes research, and clinical trials. I have also begun collaborating with basic science colleagues on biomarker research


David Edward Attarian

Professor Emeritus of Orthopaedic Surgery

Investigation of value based healthcare markets and transitions. Cost transparency for patients and providers.
Risk management and medicolegal aspects of orthopaedic practice.
Co-management and alignment relationships between clinicians and hospitals/ health systems in evolving healthcare markets.
Clinical outcomes of total hip and knee replacements (primary and revision surgeries, total joint infections, modern bearing surfaces, gait mechanics and balance).
Novel surgical techniques for difficult adult hip and knee reconstruction cases.
Development of quality and efficiency metrics in an Academic practice; correlation of work culture with patient satisfaction and experience.
Development of value based compensation plans for physcians.
Effect of comorbidities on surgical outcomes and complications: anemia, diabetes, smoking, obesity, depression-anxiety


Michael Paul Bolognesi

Virginia Flowers Baker Distinguished Professor of Orthopaedic Surgery

As chief of the adult reconstruction service, the majority of my research effort has been directed toward clinical outcomes, implant survivorship, functional recovery, the biology of hip and knee arthritis and cost effectiveness.

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