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https://www.readbyqxmd.com/read/28108823/which-clinical-and-patient-factors-influence-the-national-economic-burden-of-hospital-readmissions-after-total-joint-arthroplasty
#1
Steven M Kurtz, Edmund C Lau, Kevin L Ong, Edward M Adler, Frank R Kolisek, Michael T Manley
BACKGROUND: The Affordable Care Act of 2010 advanced the economic model of bundled payments for total joint arthroplasty (TJA), in which hospitals will be financially responsible for readmissions, typically at 90 days after surgery. However, little is known about the financial burden of readmissions and what patient, clinical, and hospital factors drive readmission costs. QUESTIONS/PURPOSES: (1) What is the incidence, payer mix, and demographics of THA and TKA readmissions in the United States? (2) What patient, clinical, and hospital factors are associated with the cost of 30- and 90-day readmissions after primary THA and TKA? (3) Are there any differences in the economic burden of THA and TKA readmissions between payers? (4) What types of THA and TKA readmissions are most costly to the US hospital system? METHODS: The recently developed Nationwide Readmissions Database from the Healthcare Cost and Utilization Project (2006 hospitals from 21 states) was used to identify 719,394 primary TJAs and 62,493 90-day readmissions in the first 9 months of 2013 based on International Classification of Diseases, 9th Revision, Clinical Modification codes...
January 20, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28105502/transfracture-medial-transposition-of-the-radial-nerve-associated-with-plate-fixation-of-the-humerus
#2
Ali Hassan Chamseddine, Amer Abdallah, Hadi Zein, Assad Taha
PURPOSE: The aim of this study was to illustrate safety, feasibility and advantages of transfracture medial transposition of the radial nerve during the lateral approach and lateral plating of humeral fractures located in the mid and distal shaft. METHODS: This was a retrospective review and analysis of medical records and radiographs of 19 patients who underwent a transfracture medial transposition of the radial nerve. Fifteen patients were treated for fresh fracture and four for nonunion...
January 19, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28103747/failure-of-an-uncemented-thumb-carpometacarpal-joint-ceramic-prosthesis
#3
E Kollig, W Weber, D Bieler, A Franke
: Thumb carpometacarpal joint replacement is associated with high rates of loosening and failure. We present our results for an uncemented ceramic-ceramic total joint prosthesis with a reverse ball-and-socket design and bioactive coating. Between 2008 and 2012, 29 prostheses were inserted into 28 patients (mean age 63 years) with advanced osteoarthritis. After a mean period of 33 months (range 9-62), 26 patients (27 implants) were available for follow-up. Six months postoperatively, 50% of the patients had radiological evidence of early loosening...
January 1, 2017: Journal of Hand Surgery, European Volume
https://www.readbyqxmd.com/read/28101590/-minimally-invasive-treatment-of-intra-articular-calcaneal-fractures-with-the-2%C3%A2-point-distractor
#4
G Mattiassich, W Litzlbauer, M Ponschab, R Ortmaier, C Rodemund
OBJECTIVE: Open treatment of calcaneus fractures often has an increased risk of wound healing. Minimally invasive treatment with small incisions reduces complications. INDICATIONS: Calcaneal fractures with malalignment/comminution >1-2 mm; broadening, varus alignment of the calcaneal length axis or shortening; emergency surgery for open fractures or compartment syndrome. CONTRAINDICATIONS: Local or general contraindications. SURGICAL TECHNIQUE: Standardised positioning; restoration of length/axis with 2‑point distractor under fluoroscopic control...
January 18, 2017: Operative Orthopädie und Traumatologie
https://www.readbyqxmd.com/read/28100946/management-of-young-patients-with-temporomandibular-joint-ankylosis-a-surgical-and-anesthetic-challenge
#5
REVIEW
Devalina Goswami, Sweta Singh, Ongkila Bhutia, Dalim Baidya, Chhavi Sawhney
Temporomandibular joint ankylosis is a unique disease where fracture of the mandibular condyle or any other cause leading to ankylosis of the joint can lead to multiple problems if not detected and treated early. If affected in early years of life, it may cause facial dysmorphism, restricted mouth opening, and difficulty in eating, speech, and sleep. Early surgery and physiotherapy can restore the joint function to a great extent. Anesthetizing a pediatric patient with this disorder is a definite challenge which needs expertise in difficult airway management...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100234/arthroscopic-reduction-and-fixation-of-coronoid-fractures-with-an-exchange-rod-a-new-technique
#6
Kan Ouyang, Daping Wang, Wei Lu, Jianyi Xiong, Jian Xu, Liangquan Peng, Haifeng Liu, Hao Li, Wenzhe Feng
BACKGROUND: The ulnar coronoid process plays a central role in maintaining elbow stability. Some of its fractures were often combined with injury of bone and ligament. Arthroscopy enables perfect visualization to allow anatomical repair. METHODS: From January 2012 to December 2013, six patients (four males, two females) with a mean age of 26.6 years were treated. The left and right ulnas were involved in two and four patients, respectively. All patients suffered from ipsilateral subluxation of the elbow without associated radial fracture...
January 18, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28100198/mr-imaging-for-detection-of-trampoline-injuries-in-children
#7
E Hauth, H Jaeger, P Luckey, M Beer
BACKGROUND: The recreational use of trampolines is an increasingly popular activity among children and adolescents. Several studies reported about radiological findings in trampoline related injuries in children. The following publication presents our experience with MRI for detection of trampoline injuries in children. METHODS: 20 children (mean 9.2 years, range: 4-15 years) who had undergone an MRI study for detection of suspected trampoline injuries within one year were included...
January 18, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28097386/biomechanical-analysis-of-clavicle-hook-plate-implantation-with-different-hook-angles-in-the-acromioclavicular-joint
#8
Li-Kun Hung, Kuo-Chih Su, Wen-Hsien Lu, Cheng-Hung Lee
PURPOSE: A clavicle hook plate is a simple and effective method for treating acromioclavicular dislocation and distal clavicle fractures. However, subacromial osteolysis and peri-implant fractures are complicated for surgeons to manage. This study uses finite element analysis (FEA) to investigate the post-implantation biomechanics of clavicle hook plates with different hook angles. METHODS: This FEA study constructed a model with a clavicle, acromion, clavicle hook plate, and screws to simulate the implantation of clavicle hook plates at different hook angles (90°, 95°, 100°, 105°, and 110°) for treating acromioclavicular joint dislocations...
January 18, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28094419/postoperative-computed-tomography-and-low-field-magnetic-resonance-imaging-findings-in-dogs-with-degenerative-lumbosacral-stenosis-treated-by-dorsal-laminectomy
#9
Martin Rapp, Charles J Ley, Kerstin Hansson, Lennart Sjöström
OBJECTIVES: To describe postoperative computed tomography (CT) and magnetic resonance imaging (MRI) findings in dogs with degenerative lumbosacral stenosis (DLSS) treated by dorsal laminectomy and partial discectomy. METHODS: Prospective clinical case study of dogs diagnosed with and treated for DLSS. Surgical and clinical findings were described. Computed tomography and low field MRI findings pre- and postoperatively were described and graded. Clinical, CT and MRI examinations were performed four to 18 months after surgery...
January 17, 2017: Veterinary and Comparative Orthopaedics and Traumatology: V.C.O.T
https://www.readbyqxmd.com/read/28094191/functional-results-of-bilateral-reverse-total-shoulder-arthroplasty
#10
Chris R Mellano, Robert Thorsness, Peter N Chalmers, Terrence F Feldheim, Patrick O'Donnell, Brian J Cole, Nikhil N Verma, Anthony A Romeo, Gregory P Nicholson
BACKGROUND: The purpose of this study was to analyze a population of patients with bilateral reverse total shoulder arthroplasty (RTSA) to evaluate their ability to perform activities of daily living and personal hygiene tasks. METHODS: At a minimum 2-year follow-up, we retrospectively reviewed 50 patients (100 shoulders) with a mean age of 72 years who underwent staged bilateral RTSA. The average follow-up period was 61 months (range, 24-121 months), with a minimum 2-year follow-up after the second surgical procedure...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28094189/medicaid-payer-status-is-linked-to-increased-rates-of-complications-after-treatment-of-proximal-humerus-fractures
#11
Vani J Sabesan, Graysen Petersen-Fitts, Daniel Lombardo, Daniel Briggs, James Whaley
BACKGROUND: Low socioeconomic status and Medicaid insurance as a primary payer have been associated with major disparities in resource utilization and risk-adjusted outcomes for patients undergoing total joint arthroplasty. With the expansion of Medicaid through the Affordable Care Act in 2014, examination of these disparities has become increasingly relevant for the treatment of proximal humerus fracture (PHF). METHODS: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to identify patients who were treated for PHF from 2002 to 2012...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28089259/prosthetic-replacement-for-coronoid-deficiency-report-of-three-cases
#12
Enrico Bellato, Shawn W O'Driscoll
BACKGROUND: Persistent elbow instability associated with coronoid deficiency is a difficult condition to treat. Several surgical techniques have been described for coronoid reconstruction, but the resulting outcomes have been unpredictable. We hypothesized that a coronoid prosthesis could restore elbow stability. METHODS: A nonanatomically shaped metallic coronoid prosthesis was custom designed for each of 3 patients. Each had a chronic fracture-subluxation with persistent instability, deficiencies of the coronoid, and compromise of the radial head...
January 11, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28087283/benefits-of-using-the-ultrasonic-bonescalpel%C3%A2-in-temporomandibular-joint-reconstruction
#13
Rebeka Silva, Rishi Gupta, Gianluca Tartaglia, Stephen Connelly
PURPOSE: The main objective of this retrospective study is to analyze and report on our operative experiences and outcomes using the ultrasonic BoneScalpel™ (BoneScalpel) versus a conventional reciprocating saw (RecipSaw) for the purpose of completing the osteotomies in total temporomandibular joint reconstruction (TJR) surgery. MATERIALS AND METHODS: 23 consecutive patients presented with a diagnosis of either degenerative joint disease (n = 23), a failing autogenous TJR (n = 1), heterotrophic bone formation (n = 1) or a subcondylar fracture (n = 1) for a total of 26 joints that received a TJR...
December 19, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28079741/management-of-pediatric-open-tibia-fractures-with-supracutaneous-locked-plates
#14
Veerappa N Radhakrishna, Vrisha Madhuri
We evaluated the novel application of supracutaneous locked plates in pediatric open tibia fractures. Pediatric open tibia fractures stabilized with a locked supracutaneous plate from January 2011 to December 2014 were reviewed. Twenty-eight children, mean age 8.9 years, with 29 open tibia fractures were included. Nine of these children who had metaphyseal or metadiaphyseal fractures did not require joint spanning. The mean follow-up duration was 13.5 months. The mean time to uneventful union was 11.46 weeks, with no unacceptable malunion...
January 10, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28079306/open-dislocation-of-ankle-without-fracture-treated-with-an-external-fixator
#15
Emrah Sayit, Asli Tanrivermis Sayit, Elcin Zan
Ankle dislocations are orthopedic emergencies that require immediate treatment to avoid neurovascular impairment. They are usually accompanied by one or more comminuted fractures of the ankle mortis. In rare circumstances, such as high-energy trauma, the ankle dislocations may not be accompanied by concomitant malleolar fractures and, thus, are named "pure ankle dislocations". We presented a very rare and interesting case of an open medial dislocation of the ankle without associated fracture in an 18-year-old man with no known predisposing risk factors...
January 12, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28074463/importance-of-fixation-of-posterior-malleolus-fracture-in-trimalleolar-fractures-a-retrospective-study
#16
Sinan Karaca, Meriç Enercan, Güzelali Özdemir, Sinan Kahraman, Mutlu Çobanoğlu, Metin Küçükkaya
BACKGROUND: The aim of this retrospective study was to evaluate treatment effect and importance of posterior malleolus (PM) fixation in surgically treated trimalleolar fractures. METHODS: A total of 57 cases of ankle joint fracture involving PM and treated with open reduction and internal fixation technique between 2004 and 2011 were evaluated. PM fixation was performed with cannulated screws in 46 cases, and in 11 cases, PM plate was used. All patients were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score, American Academy of Orthopedic Surgeons (AAOS) foot and ankle questionnaire, and Visual Analog Score (VAS) pain scale...
November 2016: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28074258/the-treatment-options-for-posterior-malleolar-fractures-in-tibial-spiral-fractures
#17
Jialiang Guo, Lei Liu, Zongyou Yang, Zhiyong Hou, Wei Chen, Yingze Zhang
PURPOSE: The posterior malleolar fracture (PMF) in tibial spiral fractures are a common type of complication that occurs in tibial fractures. However, the indication of fixation for posterior fractures is still under debate and varies between different surgeons'. It is not unusual to find the smaller PMF (<25%), which could be treated conservatively within guidelines, treated with internal fixation in clinic. The aim of this study is to evaluate the clinical outcomes of tibial spiral fractures with PMF and provide proper guidance for the treatment of this special fracture...
January 10, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28073653/rare-lateral-dislocation-of-the-first-metatarsophalangeal-joint-a-case-report-and-review-of-the-literature
#18
Amir Reza Vosoughi, Pascal F Rippstein
Traumatic lateral dislocations of the first metatarsophalangeal (MTP) joint are very rare. A 44-year-old male was referred after a motorcycle to car accident because of an exposed head of the left first metatarsal through a laceration on the medial aspect of the first MTP joint. Radiographs showed a lateral dislocation of the first MTP joint, with concomitant fractures of the neck of the second metatarsal and the base of the third and fourth metatarsal bones. The dislocation was reduced in the emergency department with the patient under conscious sedation after thorough irrigation...
January 7, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28073376/treatment-and-outcome-prognosis-of-patients-with-high-energy-transsyndesmotic-ankle-fracture-dislocation-the-logsplitter-injury
#19
Zhe Wang, Xin Tang, Shenglong Li, Xiuhui Wang, Liangfeng Gong, Tao Zhong, Kunzheng Wang
BACKGROUND: This study aimed to retrospectively review the clinical efficacy of open reduction and internal fixation (ORIF) for treatment of high-energy transsyndesmotic ankle fracture dislocation-the "Logsplitter" injury. METHODS: Between December 2006 and December 2014, 41 patients (29 males and 12 females; mean age, 41.46 ± 13.42 years) with Logsplitter injury were treated by ORIF procedure. Patients were grouped as typical injury (mainly vertical axial stress) and untypical injury (mainly rotational stress) according to the injury mechanism and the degree of the talus wedged into the distal tibiofibular joint...
January 10, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28071874/medicare-program-advancing-care-coordination-through-episode-payment-models-epms-cardiac-rehabilitation-incentive-payment-model-and-changes-to-the-comprehensive-care-for-joint-replacement-model-cjr-final-rule
#20
(no author information available yet)
This final rule implements three new Medicare Parts A and B episode payment models, a Cardiac Rehabilitation (CR) Incentive Payment model and modifications to the existing Comprehensive Care for Joint Replacement model under section 1115A of the Social Security Act. Acute care hospitals in certain selected geographic areas will participate in retrospective episode payment models targeting care for Medicare fee-forservice beneficiaries receiving services during acute myocardial infarction, coronary artery bypass graft, and surgical hip/femur fracture treatment episodes...
3, 2017: Federal Register
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