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Current Reviews in Musculoskeletal Medicine

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https://www.readbyqxmd.com/read/28421386/technology-assessment-and-cost-effectiveness-in-orthopedics-how-to-measure-outcomes-and-deliver-value-in-a-constantly-changing-healthcare-environment
#1
REVIEW
Jeremy M Burnham, Fabien Meta, Vincent Lizzio, Eric C Makhni, Kevin J Bozic
PURPOSE OF REVIEW: The purpose of this study is to review the basic concepts of healthcare value, patient outcome measurement, and cost-effectiveness analyses as they relate to the introduction of new surgical techniques and technologies in the field of orthopedic surgery. RECENT FINDINGS: An increased focus on financial stewardship in healthcare has resulted in a plethora of cost-effectiveness and patient outcome research. Recent research has made great progress in identifying orthopedic technologies that provide exceptional value and those that do not meet adequate standards for widespread adoption...
April 19, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28417338/accessibility-accountability-affordability-healthcare-policy-in-orthopedic-trauma
#2
REVIEW
Renee C Genova, Rachel L Box, James R Ficke
PURPOSE OF REVIEW: This review provides historical background on trauma care in the USA and summarizes contemporary trauma-related health policy issues. It is a primer for orthopedic surgeons who want to promote improvements in research, delivery, and cost reduction in trauma care. RECENT FINDINGS: As of 2010, funding for trauma research accounted for only 0.02% of all National Institutes of Health research funding. This is disproportionate to the societal burden of traumatic injury, which is the leading cause of death and disability among people aged 1 to 46 years in the USA...
April 18, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28389971/pay-for-performance-in-orthopedics-how-we-got-here-and-where-we-are-going
#3
REVIEW
Ashton H Goldman, Stephen Kates
PURPOSE OF THE REVIEW: Recent health laws have shifted from the traditional fee-for-service model toward a pay-for-performance model. In this changing climate, it is imperative that a provider understands these changes and recognizes the importance of health services research on medicine. RECENT FINDINGS: Increasing the value of care by improving quality and decreasing cost has been the focus of several projects. Preventing complications may be an effective way to increase value...
April 7, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28389970/osteoporosis-a-discussion-on-the-past-5%C3%A2-years
#4
REVIEW
Kyle M Schweser, Brett D Crist
PURPOSE OF THE REVIEW: The purposes of this study are to examine the literature within the past 5 years regarding osteoporosis and offer a discussion on new topics and controversies. RECENT FINDINGS: Patient compliance with therapy remains an issue. The effectiveness of Vitamin D and calcium are being called into question Atypical femur fractures have been associated with bisphosphonate and denosumab use. Treatment is both surgical and pharmaceutical. A multidisciplinary approach to osteoporotic fractures is important and having some form of fracture liaison service (FLS) improves the efficacy of osteoporotic care and decreases secondary fractures...
April 7, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28364146/bundled-payments-in-total-joint-arthroplasty-and-spine-surgery
#5
REVIEW
Rashad Sullivan, Landry D Jarvis, Tadhg O'Gara, Maxwell Langfitt, Cynthia Emory
PURPOSE OF REVIEW: The goal of this manuscript is to provide an overview and analysis of bundled payment models for joint replacement and select spine procedures. Advantages and disadvantages of bundled payment models will be discussed. RECENT FINDINGS: In select populations, bundled payment models have been shown to reduce costs while maintaining satisfactory outcomes. These models have not been tested with complex patient cohorts, such as older adults with fragility hip fractures, and limited data exist with bundled payment analysis in spine procedures...
March 31, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28353143/cervical-disc-replacement-surgery-biomechanical-properties-postoperative-motion-and-postoperative-activity-levels
#6
REVIEW
Alfred Pisano, Melvin Helgeson
PURPOSE OF REVIEW: Cervical disc arthroplasty (CDA) is an evolving technique used in the treatment of cervical disc disease. To remain up to date on studies regarding its efficacy, we sought to answer three questions: What do biomechanical studies demonstrate in regard to the kinematics of CDA? How does CDA affect cervical motion? What are the postoperative activity levels of patients after cervical disc arthroplasty? RECENT FINDINGS: 1) In regard to biomechanics, recent data suggests that CDA maintains motion while possibly altering facet biomechanics...
March 28, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28342025/social-media-physicians-to-physicians-education-and-communication
#7
EDITORIAL
Keith A Fehring, Ivan De Martino, Alexander S McLawhorn, Peter K Sculco
PURPOSE OF REVIEW: Physician to physician communication is essential for the transfer of ideas, surgical experience, and education. Social networks and online video educational contents have grown exponentially in recent years changing the interaction among physicians. RECENT FINDINGS: Social media platforms can improve physician-to-physician communication mostly through video education and social networking. There are several online video platforms for orthopedic surgery with educational content on diagnosis, treatment, outcomes, and surgical technique...
March 24, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337733/bias-in-cervical-total-disc-replacement-trials
#8
REVIEW
Kristen Radcliff, Sean Siburn, Hamadi Murphy, Barrett Woods, Sheeraz Qureshi
PURPOSE OF REVIEW: Cervical disc replacement (CDR) has emerged as a motion-preserving alternative to anterior cervical discectomy and fusion in selected cases. Despite favorable literature, CDR is not universally accepted because of concerns regarding bias in the existing literature. The purpose of this review is to identify the possible biases in the disc replacement literature. RECENT FINDINGS: Recent studies that compare CDR and ACDF have demonstrated equivalent or superior outcomes, lower rates of secondary surgery, and equivalent safety at medium- and long-term follow-up...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337732/medicare-reimbursement-and-orthopedic-surgery-past-present-and-future
#9
REVIEW
R Carter Clement, Suneel B Bhat, Meredith E Clement, James C Krieg
PURPOSE OF REVIEW: This paper reviews the history and structure of Medicare reimbursement with a focus on aspects relevant to the field of orthopedic surgery. Namely, this includes Parts A and B, with particular attention paid to the origins of Diagnosis Related Groups (DRG) and the physician fee schedule, respectively. We then review newer policies affecting orthopedic surgeons. RECENT FINDINGS: Recent Medicare reforms relevant to our field include readmission penalties, the evolution of bundled payments including the mandatory Comprehensive Care for Joint Replacement (CJR) and Surgical Hip and Femur Fracture Treatment (SHFFT) programs, and the new mandatory Merit-based Incentive Payment System (MIPS) pay-for-performance program...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337731/arthroplasty-registries-around-the-world-valuable-sources-of-hip-implant-revision-risk-data
#10
REVIEW
Richard E Hughes, Aditi Batra, Brian R Hallstrom
PURPOSE OF REVIEW: National and regional arthroplasty registries have proliferated since the Swedish Knee Arthroplasty Register was started in 1975. Registry reports typically present implant-specific estimates of revision risk and patient- and technique-related factors that can inform clinical decision-making about implants and techniques. However, annual registry reports are long and it is difficult for clinicians to extract comparable revision risk data. Since implants may appear in multiple registry reports, it is even more difficult to gather relevant data for clinical decision-making about implant selection...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337730/current-concepts-of-shared-decision-making-in-orthopedic-surgery
#11
REVIEW
Kevin Klifto, Christopher Klifto, James Slover
PURPOSE OF REVIEW: The Shared Decision Making (SDM) model, a collaborative decision making process between the physician and patient to make an informed clinical decision that enhances the chance of treatment success as defined by each patient's preferences and values, has become a new and promising tool in the healthcare process; however, minimal data exists on its application in the orthopedic surgical specialty. Increasing evidence has demonstrated that this once novel idea can be implemented successfully in the orthopedic setting to improve patient outcomes...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28337729/adjacent-level-disease-background-and-update-based-on-disc-replacement-data
#12
REVIEW
I David Kaye, Alan S Hilibrand
PURPOSE OF REVIEW: The precise etiology of adjacent segment disease following cervical spine surgery is controversial. Theories for development include inevitable changes secondary to the natural progression of the degenerative cascade and changes secondary to altered biomechanics of the fused cervical spine. Motion preserving techniques, such as cervical disc arthroplasties (CDA), have been introduced with the hopes of reducing the rates of adjacent segment pathology. Recently, 7-year data from the investigational device exemption (IDE) studies have been published...
March 23, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28332140/interspinous-implants-are-the-new-implants-better-than-the-last-generation-a-review
#13
REVIEW
Michael Pintauro, Alexander Duffy, Payman Vahedi, George Rymarczuk, Joshua Heller
PURPOSE OF REVIEW: Interspinous process devices (IPDs) are used in the surgical treatment of lumbar spinal stenosis. The purpose of this review is to compare the first generation with the next-generation devices in terms of complications, device failure, reoperation rates, symptom relief, and outcome. RECENT FINDINGS: Thirty-seven studies were included from 2011 to 2016. Device failure occurred at a mean of 3.7%, with a lower tendency to happen with next-generation IPDs...
March 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28324328/interspinous-implants-to-treat-spinal-stenosis
#14
REVIEW
Raj J Gala, Glenn S Russo, Peter G Whang
PURPOSE OF REVIEW: Lumbar spinal stenosis has historically been treated with open decompressive surgery which is associated with significant morbidity and may give rise to various complications. Interspinous spacers (ISS) have been developed as a less invasive strategy which may serve to avoid many of these risks. The two current spacers that are FDA approved and commercially available are the Coflex and Superion devices. The goal is to review these two implants, their indications, and patient selection...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28324327/lumbar-disc-replacement-surgery-successes-and-obstacles-to-widespread-adoption
#15
REVIEW
Stephan N Salzmann, Nicolas Plais, Jennifer Shue, Federico P Girardi
PURPOSE OF REVIEW: Lumbar disc replacement has been a surgical alternative to fusion surgery for the treatment of lumbar degenerative disc disease (DDD) for many years. Despite enthusiasm after the approval of the first devices, implantation rates have remained low, especially in the USA. The goal of this review is to provide a general overview of lumbar disc replacement in order to comprehend the successes and obstacles to widespread adoption. RECENT FINDINGS: Although a large amount of evidence-based data including satisfactory long-term results is available, implantation rates in the USA have not increased in the last decade...
March 21, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28321806/patient-satisfaction-in-musculoskeletal-medicine
#16
REVIEW
Matthew J Smith, Theodore J Choma
PURPOSE OF REVIEW: This is a literature review of the measurement of patient satisfaction in musculoskeletal medicine. Its purpose is to better understand the motivation for such measurements, the potential confounders, and the potential physician behaviors that may modulate such measures. RECENT FINDINGS: There have been studies documenting that physician conveyance of empathy, the extent to which patients' expectations for pain control and timeliness of care are met, as well as patient demographics and health status all affect the current measures of patient satisfaction...
March 20, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28316056/temporary-stabilization-of-unstable-spine-fractures
#17
REVIEW
Aaron P Danison, Darrin J Lee, Ripul R Panchal
PURPOSE OF REVIEW: We will review the recent literature concerning the necessity of supplemental fusion to spinal instrumentation and discuss if temporal spinal fixation is a viable option for the treatment of unstable spine fractures. Advancements in minimally invasive techniques offer an alternative approach to traditional open stabilization for unstable spine fractures. The use of minimally invasive surgery offers many advantages concerning operative morbidly; fusion is not utilized and instrumentation can be removed in a delayed fashion...
March 18, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28251560/scaphoid-fractures-in-the-athlete
#18
REVIEW
Mark J Winston, Andrew J Weiland
Scaphoid fractures are a common wrist injury, especially in athletes. Clinicians should have a high index of suspicion for a scaphoid fracture in any patient complaining of radial-sided wrist pain after a fall on an outstretched hand. Advanced imaging, including CT and MRI scans, may be useful in diagnosis and classification of fracture patterns. Treatment varies based on the fracture location, stability of the fracture, and predictability of the fracture to heal. Treatment involves either non-operative management with a thumb spica cast or brace, or operative fixation with a headless compression screw, k-wires, or scaphoid-specific plates...
March 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28220354/zone-ii-and-iii-fifth-metatarsal-fractures-in-athletes
#19
REVIEW
Michael Le, Robert Anderson
PURPOSE OF REVIEW: This study aimed to review indications, complications, and outcomes of zone II and III fifth metatarsal fractures based on recent literature. RECENT FINDINGS: High rates of nonunion, delayed union, and refracture in athletes treated non-operatively. The standard of care is operative treatment in athletes with intramedullary fixation. Operative treatment of zone II and III fractures in athletes will decrease the risk of nonunion and refracture while leading to an earlier return to play...
March 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28194638/achilles-tendon-injuries
#20
REVIEW
Anthony C Egger, Mark J Berkowitz
PURPOSE OF REVIEW: The purpose of this study is to review the current literature of Achilles tendon injuries, specifically chronic tendinopathy and acute ruptures in regard to etiology, diagnosis, treatment options, and outcomes. RECENT FINDINGS: The incidence of Achilles tendon injuries is increasing, but the necessity for surgical intervention is decreasing due to improved conservative therapies, which may provide comparable outcomes without the implied surgical risk...
March 2017: Current Reviews in Musculoskeletal Medicine
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