I'm going to have a total knee replacement. What's better: having it done at our local hospital where I'll be close to home or going to a big medical center 100 miles away?

Researchers are studying this question. In fact, Medicare is starting to pilot some regional centers for total hip and knee replacements.

Doctors from six large medical centers took a look at the results of their Medicare patients after total knee replacement. They found patients had fewer problems at a large, high-volume hospital. They counted number of deaths and rates of infection, pneumonia, and blood clots. Everyone in the study was followed for 90 days.

According to the authors of the study, doctors who do TKRs more often have better results. The best option may be a large center where the same surgeon does many joint replacements. More research is needed to find out long-term results.

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