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S hearer and colleagues attempt to isolate the areas with the greatest impact on cost and long-term effectiveness of THA. This is a commendable effort. The authors showed that a 10% reduction in periprosthetic joint infections (PJI) may have a greater net monetary benefit to society than equivalent (10%) improvements in aseptic loosening or hospital readmissions. Reductions in readmissions resulted in lower costs, but ultimately failed to have an impact on quality of life. This supports some concepts that on the surface may cut against the grain, but that we believe are important: Not all readmissions are bad, and unsophisticated or isolated analyses of readmission as a putative quality benchmark may have more to do with system-level efforts to contain costs than with actual quality. Gorodeski et al. [4] showed how mortality may be inversely related to readmissions. We also published a study that

CORR Insights®: Short-term Complications Have More Effect on Cost-effectiveness of THA than Implant Longevity