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https://www.readbyqxmd.com/read/28224441/does-medicaid-insurance-confer-adequate-access-to-adult-orthopaedic-care-in-the-era-of-the-patient-protection-and-affordable-care-act
#1
Joseph T Labrum, Taylor Paziuk, Theresa C Rihn, Alan S Hilibrand, Alexander R Vaccaro, Mitchell G Maltenfort, Jeffrey A Rihn
BACKGROUND: A current appraisal of access to orthopaedic care for the adult patient receiving Medicaid is important, since Medicaid expansion was written into law by the Patient Protection and Affordable Care Act (PPACA). QUESTIONS/PURPOSES: (1) Do orthopaedic practices provide varying access to orthopaedic care for simulated patients with Medicaid insurance versus private insurance in a blinded survey? (2) What are the surveyed state-by-state Medicaid acceptance rates for adult orthopaedic practices in the current era of Medicaid expansion set forth by the PPACA? (3) Do surveyed rates of access to orthopaedic care in the adult patient population vary across practice setting (private vs academic) or vary with different Medicaid physician reimbursement rates? (4) Are there differences in the surveyed Medicaid acceptance rates for adult orthopaedic practices in states that have expanded Medicaid coverage versus states that have foregone expansion? METHODS: Simulated Patient Survey: We performed a telephone survey study of orthopaedic offices in four states with Medicaid expansion...
February 21, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28222067/designation-and-validation-of-a-posterior-anatomical-plate-for-the-anterior-column-of-the-acetabulum
#2
Lifeng Zhang, Chuangxin Lin, Shenglu Cao, Yiran Wang, Geng Peng, Yongqiang Xu, Yongzeng Feng, Gang Wang
BACKGROUND Surgical treatment of acetabular fractures is one of the greatest challenges for orthopedic surgeons. Fixation of most displaced fractures requires extensive exposure, which may lead to complications, including blood loss, neural or vascular injury, postoperative infection, wound healing problems, and heterotopic bone formation. MATERIAL AND METHODS This study was conducted to certify an anatomic plate with an anterior column lag screw guiding device to repair the posterior acetabulum. Complete pelvic spiral computed tomography (CT) scan data were collected from 56 patients...
February 21, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28203578/supersized-atheroma-causing-acquired-coarctation-of-aorta-leading-to-heart-failure
#3
Sajin Karakattu, Ghulam Murtaza, Sharma Dinesh, Kamesh Sivagnanam, Jeffrey Schoondyke, Timir Paul
Calcified atheromatous aortic lesion causing significant narrowing of the aorta is an uncommon clinical entity. This calcified atheroma leads to obstruction of the lumen of the aorta simulating acquired coarctation of aorta causing impaired perfusion of lower limbs, visceral ischemia, and hypertension. We report a case of 58-year-old patient who presented with dyspnea on exertion, orthopnea, paroxysmal nocturnal dyspnea, 25-lb weight gain, lower extremity edema, and chest pain. Extensive workup including computed tomography and magnetic resonance imaging revealed a large calcific mass in the aortic arch causing his presenting symptoms...
January 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/28188484/estimation-of-attachment-regions-of-hip-muscles-in-ct-image-using-muscle-attachment-probabilistic-atlas-constructed-from-measurements-in-eight-cadavers
#4
Norio Fukuda, Yoshito Otake, Masaki Takao, Futoshi Yokota, Takeshi Ogawa, Keisuke Uemura, Ryota Nakaya, Kazunori Tamura, Robert B Grupp, Amirhossein Farvardin, Mehran Armand, Nobuhiko Sugano, Yoshinobu Sato
PURPOSE: Patient-specific musculoskeletal biomechanical simulation is useful in preoperative surgical planning and postoperative assessment in orthopedic surgery and rehabilitation medicine. A difficulty in application of the patient-specific musculoskeletal modeling comes from the fact that the muscle attachment regions are typically invisible in CT and MRI. Our purpose is to develop a method for estimating patient-specific muscle attachment regions from 3D medical images and to validate with cadaver experiments...
February 10, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28188003/current-status-of-simulation-based-training-tools-in-orthopedic-surgery-a-systematic-review
#5
Michael Morgan, Abdullatif Aydin, Alan Salih, Shibby Robati, Kamran Ahmed
OBJECTIVE: To conduct a systematic review of orthopedic training and assessment simulators with reference to their level of evidence (LoE) and level of recommendation. DESIGN: Medline and EMBASE library databases were searched for English language articles published between 1980 and 2016, describing orthopedic simulators or validation studies of these models. All studies were assessed for LoE, and each model was subsequently awarded a level of recommendation using a modified Oxford Centre for Evidence-Based Medicine classification, adapted for education...
February 7, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28178636/comparison-of-three-corrosion-inhibitors-in-simulated-partial-lead-service-line-replacements
#6
Aki Kogo, Sarah Jane Payne, Robert C Andrews
Partial lead service line replacements (PLSLR) were simulated using five recirculating pipe loops treated with either zinc orthophosphate (1mg/L as P), orthophosphate (1mg/L as P) or sodium silicate (10mg/L). Two pipe loops served as "inhibitor-free" (Pb-Cu) and "galvanic free" (Pb-PVC) controls. Changes in water quality (CSMR [0.2 or 1], conductivity [≈330mS/cm or ≈560mS/cm], chlorine [1.4mg/L]) were not observed to provide a significant impact on lead or copper release, although galvanic corrosion was shown to be a driving factor...
January 23, 2017: Journal of Hazardous Materials
https://www.readbyqxmd.com/read/28157719/preclinical-safety-and-efficacy-evaluation-of-biocas-bioactive-calcium-sulfate-bone-cement
#7
Sony Sandhya, Parayanthala Valappil Mohanan, Arumugan Sabareeswaran, Hari Krishna Varma, Manoj Komath
A new bioactive calcium sulfate-based formulation (named 'BioCaS') has been developed for bone filler applications. This is a self-setting injectable cement where the preset form comprises bassanite obtained from the uniform submicron-sized precursor crystals of gypsum, modified with hydrogen orthophosphate ions. The results of the safety and efficacy evaluation of BioCaS cement, done as per the International Standards and guidelines, are presented in this paper. The study plan consisted of in vitro screening tests of cytotoxicity and haemolysis and in vivo biocompatibility evaluation, including an acute systemic toxicity test (in mice), an intracutaneous reactivity test (in rabbits), a pyrogen test (in rabbits) and a maximization sensitization test (in guinea pigs)...
February 3, 2017: Biomedical Materials
https://www.readbyqxmd.com/read/28153385/video-review-as-a-tool-to-improve-orthopedic-residents-performance-of-closed-manipulative-reductions
#8
Nickul S Jain, Ran Schwarzkopf, John A Scolaro
OBJECTIVE: Orthopedic residents commonly perform closed manipulative reductions as a part of their training. Traditionally, this skill is taught early in training but difficult to simulate. Proficiency is achieved through repetition and experience; faculty observation and instruction is unfortunately often limited. Direct resident teaching has been shown to increase competency, comfort, and long-term skill retention. We hypothesize that video review of closed fracture reductions will provide an inexpensive and valuable tool for resident education and improve skill performance...
January 30, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28152443/diamond-like-carbon-coatings-with-zirconium-containing-interlayers-for-orthopedic-implants
#9
Dipankar Choudhury, Juergen Lackner, Robert A Fleming, Josh Goss, Jingyi Chen, Min Zou
Six types of diamond-like carbon (DLC) coatings with zirconium (Zr)-containing interlayers on titanium alloy (Ti-6Al-4V) were investigated for improving the biotribological performance of orthopedic implants. The coatings consist of three layers: above the substrate a layer stack of 32 alternating Zr and ZrN sublayers (Zr:ZrN), followed by a layer comprised of Zr and DLC (Zr:DLC), and finally a N-doped DLC layer. The Zr:ZrN layer is designed for increasing load carrying capacity and corrosion resistance; the Zr:DLC layer is for gradual transition of stress, thus enhancing layer adhesion; and the N-doped DLC layer is for decreasing friction, squeaking noises and wear...
January 20, 2017: Journal of the Mechanical Behavior of Biomedical Materials
https://www.readbyqxmd.com/read/28152274/fe-3-seo42-dual-doped-nano-hydroxyapatite-a-novel-material-for-biomedical-applications
#10
Ammar Z Alshemary, Ahmet Engin Pazarceviren, Aysen Tezcaner, Zafer Evis
Dual ions substituted hydroxyapatite (HA) received attention from scientists and researchers in the biomedical field owing to their excellent biological properties. This paper presents a novel biomaterial, which holds potential for bone tissue applications. Herein, we have successfully incorporated ferric (Fe(3+) )/selenate (SeO42-) ions into the HA structure (Ca10-x-y Fey (PO4 )6-x (SeO4 )x (OH)2-x-y Oy ) (Fe-SeHA) through a microwave refluxing process. The Fe-SeHA materials were characterized by X-ray diffraction (XRD), Fourier transform infrared (FTIR) spectroscopy, and field emission scanning electron microscopy (FESEM)...
February 2, 2017: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
https://www.readbyqxmd.com/read/28142354/the-use-of-three-dimensional-printing-technology-in-orthopaedic-surgery
#11
Tak Man Wong, Jimmy Jin, Tak Wing Lau, Christian Fang, Chun Hoi Yan, Kelvin Yeung, Michael To, Frankie Leung
Three-dimensional (3-D) printing or additive manufacturing, an advanced technology that 3-D physical models are created, has been wildly applied in medical industries, including cardiothoracic surgery, cranio-maxillo-facial surgery and orthopaedic surgery. The physical models made by 3-D printing technology give surgeons a realistic impression of complex structures, allowing surgical planning and simulation before operations. In orthopaedic surgery, this technique is mainly applied in surgical planning especially revision and reconstructive surgeries, making patient-specific instruments or implants, and bone tissue engineering...
January 2017: Journal of Orthopaedic Surgery
https://www.readbyqxmd.com/read/28137325/interhospital-comparison-of-surgical-site-infection-rates-in-orthopedic-surgery
#12
Jozica Skufca, Jukka Ollgren, Mikko J Virtanen, Kaisa Huotari, Outi Lyytikäinen
OBJECTIVE To investigate whether comparison by deep or adjusted deep surgical site infection (SSI) rates in orthopedic surgeries are a better basis for feedback to Finnish hospitals than overall SSI rates DESIGN Retrospective cohort study SETTING Hospitals conducting surveillance of hip arthroplasties (HPROs) and knee arthroplasties (KPROs) in the Finnish Hospital Infection Program METHODS We analyzed surveillance data for 73,227 HPROs and 56,860 KPROs performed in 18 hospitals during 1999-2014. For each hospital, the overall, deep, and adjusted deep SSI rates with 95% confidence intervals (CIs) were calculated, and the hospital ranks were simulated in the Bayesian framework...
January 31, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28119007/evidence-for-organic-phosphorus-activation-and-transformation-at-the-sediment-water-interface-during-plant-debris-decomposition
#13
Wenqiang Zhang, Xiaolei Zhu, Xin Jin, Xin Meng, Wenzhong Tang, Baoqing Shan
The processes and mechanisms through which phosphorus (P) is released from sediment and organic P is transformed, induced by the decomposition of plant (duckweed (Lemma minor L.)) debris, were studied experimentally. In the simulation experiments, the dissolved oxygen concentration, pH, and oxidation-reduction potential at the water-sediment interface first decreased rapidly. The lowest oxidation-reduction potential reached was 225.4mV, and the solution became weakly acidic (pH5.14) and anoxic (dissolved oxygen concentration 0...
January 22, 2017: Science of the Total Environment
https://www.readbyqxmd.com/read/28116977/feasibility-of-detecting-orthopaedic-screw-overtightening-using-acoustic-emission
#14
Rhys Pullin, Bryan J Wright, Richard Kapur, John P McCrory, Matthew Pearson, Sam L Evans, Davide Crivelli
A preliminary study of acoustic emission during orthopaedic screw fixation was performed using polyurethane foam as the bone-simulating material. Three sets of screws, a dynamic hip screw, a small fragment screw and a large fragment screw, were investigated, monitoring acoustic-emission activity during the screw tightening. In some specimens, screws were deliberately overtightened in order to investigate the feasibility of detecting the stripping torque in advance. One set of data was supported by load cell measurements to directly measure the axial load through the screw...
January 1, 2017: Proceedings of the Institution of Mechanical Engineers. Part H, Journal of Engineering in Medicine
https://www.readbyqxmd.com/read/28103852/stiffness-of-the-locking-compression-plate-as-an-external-fixator-for-treating-distal-tibial-fractures-a-biomechanics-study
#15
Wei Liu, Lihui Yang, Xiaochuan Kong, Likun An, Gang Hong, Zicheng Guo, Lei Zang
BACKGROUND: Locking compress plate, as external fixator, is an attractive technique for distal tibial fracture treatment. But it still remains unclear whether the external LCP has sufficient stiffness. Thus, the present study aims to make a comprehensive evaluation of the stiffness of external locking compress plate when it is used as an external fixator in distal tibial fractures treatment. METHODS: Composite tibia was used to simulate distal tibia fracture (Orthopedic Trauma Association type 43 A3 fracture)...
January 19, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28097386/biomechanical-analysis-of-clavicle-hook-plate-implantation-with-different-hook-angles-in-the-acromioclavicular-joint
#16
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/28094763/measuring-the-effect-of-femoral-malrotation-on-knee-joint-biomechanics-for-total-knee-arthroplasty-using-computational-simulation
#17
K-T Kang, Y-G Koh, J Son, O-R Kwon, C Baek, S H Jung, K K Park
OBJECTIVES: Malrotation of the femoral component can result in post-operative complications in total knee arthroplasty (TKA), including patellar maltracking. Therefore, we used computational simulation to investigate the influence of femoral malrotation on contact stresses on the polyethylene (PE) insert and on the patellar button as well as on the forces on the collateral ligaments. MATERIALS AND METHODS: Validated finite element (FE) models, for internal and external malrotations from 0° to 10° with regard to the neutral position, were developed to evaluate the effect of malrotation on the femoral component in TKA...
November 2016: Bone & Joint Research
https://www.readbyqxmd.com/read/28062353/indentation-across-interfaces-between-stiff-and-compliant-tissues
#18
Oliver E Armitage, Michelle L Oyen
Bone-tendon, bone-ligament and bone-cartilage junctions are multi-tissue interfaces that connect materials that differ by two orders of magnitude in mechanical properties, via gradual variations in mineral content and matrix composition. These sites mediate load transfer between highly dissimilar materials and are consequently a primary site of injury during orthopedic failure. Given the large incidence rate and the lack of suitable surgical solutions for their regeneration or repair, characterization of their natural structure and subsequent replication through tissue engineering is important...
January 3, 2017: Acta Biomaterialia
https://www.readbyqxmd.com/read/28057631/ultimate-fracture-load-of-cadaver-proximal-humeri-correlates-more-strongly-with-mean-combined-cortical-thickness-than-with-areal-cortical-index-dexa-density-or-canal-to-calcar-ratio
#19
J G Skedros, C S Mears, W Z Burkhead
OBJECTIVES: This investigation sought to advance the work published in our prior biomechanical study (Journal of Orthopaedic Research, 2016). We specifically sought to determine whether there are additional easy-to-measure parameters on plain radiographs of the proximal humerus that correlate more strongly with ultimate fracture load, and whether a parameter resembling the Dorr strength/quality characterisation of proximal femurs can be applied to humeri. MATERIALS AND METHODS: A total of 33 adult humeri were used from a previous study where we quantified bone mineral density of the proximal humerus using radiographs and dual-energy x-ray absorptiometry (DEXA), and regional mean cortical thickness and cortical index using radiographs...
January 2017: Bone & Joint Research
https://www.readbyqxmd.com/read/28056127/use-of-robotic-manipulators-to-study-diarthrodial-joint-function
#20
Richard E Debski, Satoshi Yamakawa, Volker Musahl, Hiromichi Fujie
Diarthrodial joint function is mediated by a complex interaction between bones, ligaments, capsules, articular cartilage, and muscles. To gain a better understanding of injury mechanisms and to improve surgical procedures, an improved understanding of the structure and function of diarthrodial joints needs to be obtained. Thus, robotic testing systems have been developed to measure the resulting kinematics of diarthrodial joints as well as the in situ forces in ligaments and their replacement grafts in response to external loading conditions...
February 1, 2017: Journal of Biomechanical Engineering
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