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https://www.readbyqxmd.com/read/27926675/improvement-in-total-joint-replacement-quality-metrics-year-one-versus-year-three-of-the-bundled-payments-for-care-improvement-initiative
#1
John M Dundon, Joseph Bosco, James Slover, Stephen Yu, Yousuf Sayeed, Richard Iorio
BACKGROUND: In January 2013, a large, tertiary, urban academic medical center began participation in the Bundled Payments for Care Improvement (BPCI) initiative for total joint arthroplasty, a program implemented by the Centers for Medicare & Medicaid Services (CMS) in 2011. Medicare Severity-Diagnosis Related Groups (MS-DRGs) 469 and 470 were included. We participated in BPCI Model 2, by which an episode of care includes the inpatient and all post-acute care costs through 90 days following discharge...
December 7, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27926380/out-of-hours-workload-management-bayesian-inference-for-decision-support-in-secondary-care
#2
Iker Perez, Michael Brown, James Pinchin, Sarah Martindale, Sarah Sharples, Dominick Shaw, John Blakey
OBJECTIVE: In this paper, we aim to evaluate the use of electronic technologies in out of hours (OoH) task-management for assisting the design of effective support systems in health care; targeting local facilities, wards or specific working groups. In addition, we seek to draw and validate conclusions with relevance to a frequently revised service, subject to increasing pressures. METHODS AND MATERIAL: We have analysed 4 years of digitised demand-data extracted from a recently deployed electronic task-management system, within the Hospital at Night setting in two jointly coordinated hospitals in the United Kingdom...
October 2016: Artificial Intelligence in Medicine
https://www.readbyqxmd.com/read/27925637/risk-factors-for-perimegaprosthetic-infections-after-tumor-resection
#3
Marco De Gori, Giorgio Gasparini, Rodolfo Capanna
Periprosthetic joint infection remains one of the most challenging and pervasive complications following megaprosthetic replacement after tumor resection. The authors conducted a systematic review of the literature for clinical studies that reported a risk factor analysis for perimegaprosthetic joint infections. The search included English-language studies published up to July 2015. Eight studies fulfilled the inclusion criteria. Identified factors mostly related to both surgical procedure and hospitalization...
December 7, 2016: Orthopedics
https://www.readbyqxmd.com/read/27925193/systemic-and-local-adipose-tissue-in-knee-osteoarthritis
#4
REVIEW
Elisa Belluzzi, Hamza El Hadi, Marnie Granzotto, Marco Rossato, Roberta Ramonda, Veronica Macchi, Raffaele De Caro, Roberto Vettor, Marta Favero
Osteoarthritis is a common chronic joint disorder affecting older people. The knee is the major joint affected. The symptoms of osteoarthritis include limited range of motion, joint swelling, and pain causing disability. There are no disease modifying drugs available, and treatments are mainly focused on pain management. Total knee replacement performed at the end stage of the disease is considered the only cure available. It has been found that obese people have an increased risk to develop not only knee but also hand osteoarthritis...
December 7, 2016: Journal of Cellular Physiology
https://www.readbyqxmd.com/read/27922951/anatomic-and-ultrasonographic-evaluation-of-the-knee-sensory-innervation-a-cadaveric-study-to-determine-anatomic-targets-in-the-treatment-of-chronic-knee-pain
#5
Jorge M Orduña Valls, Ricardo Vallejo, Pablo López Pais, Eliezer Soto, Daniel Torres Rodríguez, David L Cedeño, Carlos Tornero Tornero, Maximino Quintáns Rodríguez, Aurora Baluja González, Julián Álvarez Escudero
BACKGROUND AND OBJECTIVES: Osteoarthrosis is a main cause of knee pain in the elderly. Pain associated with this condition is often refractory to conservative treatment. Total knee replacement may be the best option for severe pathologies; however, the occurrence of a chronic pain state after knee replacement has been well documented in the literature. The previous descriptions of the genicular nerves have been considered somewhat inaccurate. This innervation is complex and exhibits significant interindividual variability...
December 5, 2016: Regional Anesthesia and Pain Medicine
https://www.readbyqxmd.com/read/27922946/patient-reported-outcome-measurement-for-patients-with-total-knee-arthroplasty
#6
Stephen Lyman, Kaitlyn L Yin
Total knee arthroplasty is a large contributor to Medicare costs. In an effort to lower costs and improve outcomes, the Centers for Medicaid and Medicare Services has implemented the Comprehensive Care for Joint Replacement model, which incentivizes surgeons to submit both general health and joint-specific patient-reported outcome measures (PROMs). However, in addition to using PROMs for reporting purposes, surgeons should also consider incorporating PROMs into clinical practice. Currently, PROMs are not widely implemented in the clinical setting despite their value in measuring factors such as patients' expectations and mental state, which impact outcomes...
December 5, 2016: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/27920813/densitometric-evaluation-of-bone-prosthetic-counterface-in-hip-and-knee-arthroplasty-with-modern-implants
#7
Andrea Cozzi Lepri, Marco Giorgini, Carla Signorini, Christian Carulli, Roberto Civinini, Maria Luisa Brandi, Massimo Innocenti
INTRODUCTION: Recent acquisitions of the complex mechanisms of osseointegration between implants and host bone have gained attention, accordingly to the methods of evaluation of these interactions. DEXA analysis is considered an useful tool to assess such phenomena, in order to analyse in a quantitative manner the local metabolic activity of the bone, and to evaluate over the time the integration between host bone and prosthetic components. The purpose of the present study is to report about a preliminary experience in the analysis of osseointegration processes of patients undergoing a primary Total Hip Arthroplasty (THA) or a revision Total Knee Arthroplasty (rTKA)...
May 2016: Clinical Cases in Mineral and Bone Metabolism
https://www.readbyqxmd.com/read/27919671/supracondylar-femoral-osteotomy-and-knee-joint-replacement-during-the-same-surgical-procedure-in-a-type-a-haemophiliac-patient-with-knee-flexion-deformity-and-ankylosis
#8
Jose Luis Osma Rueda, Alejandra Oliveros Vargas, Cristian David Sosa
BACKGROUND: Haemophilia A is the cause of diverse musculoskeletal disorders such as ankylosis, arthritis and associated angular deformity. There are few reported cases in patients with haemophilia A in which simultaneous supracondylar femoral osteotomy and knee joint replacement has been performed to treat knee angular deformity and ankylosis. Here we present the case of an 18year old male patient, with an evolution of two years, who was unable to walk due to the presence of an untreated supracondylar fracture in the left femur and ipsilateral haemophilic arthropathy which led him to develop an ankylosis in flexion close to 70°...
December 2, 2016: Knee
https://www.readbyqxmd.com/read/27919580/variation-in-diagnoses-for-hip-arthroplasty-among-new-york-state-hospitals-implications-for-the-comprehensive-care-for-joint-replacement-model
#9
John A Buza, Jeffrey M Jancuska, James D Slover, Richard Iorio, Joseph A Bosco
BACKGROUND: The Comprehensive Care for Joint Replacement model is designed to minimize costs and improve quality for Medicare patients undergoing joint arthroplasty. The cost of hip arthroplasty (HA) episode varies depending on the preoperative diagnosis and is greater for fracture than for osteoarthritis. Hospitals that perform a higher percentage of HA for OA may therefore have an advantage in the Comprehensive Care for Joint Replacement model. The purposes of this study are to (1) determine the variability in underlying diagnosis for HA in New York State hospitals, and (2) determine hospital characteristics, such as volume, associated with this...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27918885/mutant-ccl2-protein-coating-mitigates-wear-particle-induced-bone-loss-in-a-murine-continuous-polyethylene-infusion-model
#10
Akira Nabeshima, Jukka Pajarinen, Tzu-Hua Lin, Xinyi Jiang, Emmanuel Gibon, Luis A Córdova, Florence Loi, Laura Lu, Eemeli Jämsen, Kensuke Egashira, Fan Yang, Zhenyu Yao, Stuart B Goodman
Wear particle-induced osteolysis limits the long-term survivorship of total joint replacement (TJR). Monocyte/macrophages are the key cells of this adverse reaction. Monocyte Chemoattractant Protein-1 (MCP-1/CCL2) is the most important chemokine regulating trafficking of monocyte/macrophages in particle-induced inflammation. 7ND recombinant protein is a mutant of CCL2 that inhibits CCL2 signaling. We have recently developed a layer-by-layer (LBL) coating platform on implant surfaces that can release biologically active 7ND...
November 24, 2016: Biomaterials
https://www.readbyqxmd.com/read/27914722/poor-expectations-of-knee-replacement-benefit-are-associated-with-modifiable-psychological-factors-and-influence-the-decision-to-have-surgery-a-cross-sectional-and-longitudinal-study-of-a-community-based-sample
#11
Daniel L Riddle, Gregory J Golladay, Amanda Hayes, Hassan M K Ghomrawi
BACKGROUND: Total knee arthroplasty (TKA) is a highly effective surgery, but is underutilized by some patient groups. This study determined factors associated with a person's expectations with respect to pain and walking function following a TKA procedure, should they elect to undergo a TKA. METHODS: A total of 3542 people were studied with or at risk of knee osteoarthritis and enrolled in the community-based Osteoarthritis Initiative (OAI). Multivariable logistic regression analyses identified demographic, socioeconomic, osteoarthritis-related, joint replacement awareness, and psychological correlates as poor outcome expectations...
November 30, 2016: Knee
https://www.readbyqxmd.com/read/27914627/comparison-of-in-vivo-measured-loads-in-knee-hip-and-spinal-implants-during-level-walking
#12
Philipp Damm, Ines Kutzner, Georg Bergmann, Antonius Rohlmann, Hendrik Schmidt
Walking is a task that we seek to understand because it is the most relevant human locomotion. Walking causes complex loading patterns and high load magnitudes within the human body. This work summarizes partially published load data collected in earlier in vivo measurement studies on 9 patients with telemeterized knee endoprostheses, 10 with hip endoprostheses and 5 with vertebral body replacements. Moreover, for the 19 endoprosthesis patients, additional simultaneously measured and previously unreported ground reaction forces are presented...
November 28, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/27913813/-rehabilitation-after-hip-and-knee-endoprosthetic-treatment-in-the-elderly
#13
H Bork
Due to current demographic developments with a continuous increase in average life expectancy and improved medical treatment, the number of elderly patients with joint replacement of the lower extremities also has increased in recent years. Most of these patients have not only one but several chronic diseases requiring treatment and medication. Drug-drug interaction and functional restrictions of the elderly additionally reduce the postoperative psychophysical capacity; therefore, special knowledge in rehabilitative treatment and pain management is necessary...
December 2, 2016: Der Orthopäde
https://www.readbyqxmd.com/read/27913542/new-therapies-for-hemophilia
#14
Steven W Pipe
Individuals with severe hemophilia have benefitted from 5 decades of advances that have led to widespread availability of safe and efficacious factors VIII and IX, a multidisciplinary integrated care model through a network of specialized hemophilia treatment centers, and aggressive introduction of prophylactic replacement therapy to prevent bleeding and preserve joint health. Yet, there are remaining challenges and treatment gaps which have prevented complete abrogation of all joint bleeding, and progressive joint deterioration may continue in some affected individuals over the course of a lifetime...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27912929/survival-failure-modes-and-function-of-combined-distal-femur-and-proximal-tibia-reconstruction-following-tumor-resection
#15
F Sevelda, W Waldstein, J Panotopoulos, C Stihsen, A Kaider, P T Funovics, R Windhager
BACKGROUND: Tumor spread to the knee joint or skip metastasis to the adjacent bones of the knee require reconstruction with combined distal femur and proximal tibia replacements. The literature on implant survival and failure modes with this type of reconstruction is sparse. The goals of this study were to determine the implant survival, the different failure modes and the functional outcome of this megaendoprosthetic reconstruction. PATIENTS AND METHODS: Thirty-nine patients with combined distal femur and proximal tibia reconstruction were retrospectively reviewed...
November 23, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27912242/deciphering-the-origin-of-dogs-from-fossils-to-genomes
#16
Adam H Freedman, Robert K Wayne
Understanding the timing and geographic context of dog origins is a crucial component for understanding human history, as well as the evolutionary context in which the morphological and behavioral divergence of dogs from wolves occurred. A substantial challenge to understanding domestication is that dogs have experienced a complicated demographic history. An initial severe bottleneck was associated with domestication followed by postdivergence gene flow between dogs and wolves, as well as population expansions, contractions, and replacements...
November 28, 2016: Annual Review of Animal Biosciences
https://www.readbyqxmd.com/read/27906096/biological-and-functional-evaluation-of-a-novel-pyrolytic-carbon-implant-for-the-treatment-of-focal-osteochondral-defects-in-the-medial-femoral-condyle-assessment-in-a-canine-model
#17
Samantha L Salkeld, Laura P Patron, Joan C Lien, Stephen D Cook, Deryk G Jones
BACKGROUND: Osteochondral defects continue to be a clinical treatment challenge, and when left untreated, may cause pain and functional impairment. Pyrolytic carbon is a unique isotropic biomaterial used in heart valve and small joint replacements due to its excellent wear properties and biocompatibility with bone and articular cartilage. Therefore, a proposed solution is to utilize a focal pyrolytic carbon hemiarthroplasty implant as an alternative resurfacing treatment strategy for isolated cartilage lesions...
December 1, 2016: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/27906065/dystrophin-deficient-dogs-with-reduced-myostatin-have-unequal-muscle-growth-and-greater-joint-contractures
#18
Joe N Kornegay, Daniel J Bogan, Janet R Bogan, Jennifer L Dow, Jiahui Wang, Zheng Fan, Naili Liu, Leigh C Warsing, Robert W Grange, Mihye Ahn, Cynthia J Balog-Alvarez, Steven W Cotten, Monte S Willis, Candice Brinkmeyer-Langford, Hongtu Zhu, Joe Palandra, Carl A Morris, Martin A Styner, Kathryn R Wagner
BACKGROUND: Myostatin (Mstn) is a negative regulator of muscle growth whose inhibition promotes muscle growth and regeneration. Dystrophin-deficient mdx mice in which myostatin is knocked out or inhibited postnatally have a less severe phenotype with greater total mass and strength and less fibrosis and fatty replacement of muscles than mdx mice with wild-type myostatin expression. Dogs with golden retriever muscular dystrophy (GRMD) have previously been noted to have increased muscle mass and reduced fibrosis after systemic postnatal myostatin inhibition...
April 4, 2016: Skeletal Muscle
https://www.readbyqxmd.com/read/27904793/current-concepts-in-treatment-of-patellofemoral-osteochondritis-dissecans
#19
Chris Juneau, Russ Paine, Eric Chicas, Emily Gardner, Lane Bailey, James McDermott
: Identification, protection, and management of patellofemoral articular cartilage lesions continue to remain on the forefront of sports medicine rehabilitation. Due to high-level compression forces that are applied through the patellofemoral (PF) joint, managing articular cartilage lesions is challenging for sports medicine specialists. Articular cartilage damage may exist in a wide spectrum of injuries ranging from small, single areas of focal damage to wide spread osteoarthritis involving large chondral regions...
December 2016: International Journal of Sports Physical Therapy
https://www.readbyqxmd.com/read/27903963/cdh1-regulates-e2f1-degradation-in-response-to-differentiation-signals-in-keratinocytes
#20
Randeep K Singh, Lina Dagnino
The E2F1 transcription factor plays key roles in skin homeostasis. In the epidermis, E2F1 expression is essential for normal proliferation of undifferentiated keratinocytes, regeneration after injury and DNA repair following UV radiation-induced photodamage. Abnormal E2F1 expression promotes nonmelanoma skin carcinoma. In addition, E2F1 must be downregulated for proper keratinocyte differentiation, but the relevant mechanisms involved remain poorly understood. We show that differentiation signals induce a series of post-translational modifications in E2F1 that are jointly required for its downregulation...
November 26, 2016: Oncotarget
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