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https://www.readbyqxmd.com/read/28805358/medicare-program-inpatient-rehabilitation-facility-prospective-payment-system-for-federal-fiscal-year-2018-final-rule
#1
(no author information available yet)
This final rule updates the prospective payment rates for inpatient rehabilitation facilities (IRFs) for federal fiscal year (FY) 2018 as required by the statute. As required by section 1886(j)(5) of the Social Security Act (the Act), this rule includes the classification and weighting factors for the IRF prospective payment system's (IRF PPS) case-mix groups and a description of the methodologies and data used in computing the prospective payment rates for FY 2018. This final rule also revises the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM) diagnosis codes that are used to determine presumptive compliance under the "60 percent rule," removes the 25 percent payment penalty for inpatient rehabilitation facility patient assessment instrument (IRF-PAI) late transmissions, removes the voluntary swallowing status item (Item 27) from the IRF-PAI, summarizes comments regarding the criteria used to classify facilities for payment under the IRF PPS, provides for a subregulatory process for certain annual updates to the presumptive methodology diagnosis code lists, adopts the use of height/weight items on the IRF-PAI to determine patient body mass index (BMI) greater than 50 for cases of single-joint replacement under the presumptive methodology, and revises and updates measures and reporting requirements under the IRF quality reporting program (QRP)...
August 3, 2017: Federal Register
https://www.readbyqxmd.com/read/28803816/midterm-adjusted-survival-comparing-the-best-performing-unicompartmental-and-total-knee-arthroplasties-in-a-registry
#2
Stefano A Bini, Guy Cafri, Monti Khatod
BACKGROUND: Recent literature suggests that the difference in revision risk between unicompartmental knee arthroplasty (UKA) and total knee arthroplasty (TKA) can be influenced by surgeon volume and other confounders. We hypothesized that implant selection might decrease the relative risk of revision in an adjusted model. METHODS: We selected the best performing (BP) primary UKAs and TKAs performed for osteoarthritis between January 2001 and December 2012 collected through a joint replacement registry...
June 8, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28793979/outcome-of-prosthesis-matched-and-unmatched-patella-components-in-primary-and-revision-total-knee-replacement
#3
Peter L Lewis, Ai E Gamboa, David G Campbell, Michelle Lorimer
BACKGROUND: Although knee replacements have specifically designed patella prostheses that correspond to the geometry of their femoral components, a patella prosthesis that is unmatched to the femoral component may occasionally be inserted. In revision total knee arthroplasty (TKA), an originally resurfaced patella may be left, but the femoral component revised to one that does not match the patella. Few studies have compared the outcome of matched and unmatched patella components in TKA...
August 6, 2017: Knee
https://www.readbyqxmd.com/read/28782280/orthopaedic-wear-particle-induced-bone-loss-and-exogenous-macrophage-infiltration-is-mitigated-by-local-infusion-of-nf-%C3%AE%C2%BAb-decoy-oligodeoxynucleotide
#4
Tzuhua Lin, Jukka Pajarinen, Akira Nabeshima, Luis A Córdova, Florence Loi, Emmanuel Gibon, Laura Lu, Karthik Nathan, Eemeli Jämsen, Zhenyu Yao, Stuart B Goodman
Excessive production of wear particles from total joint replacements (TJRs) induces chronic inflammation, macrophage infiltration, and consequent bone loss (periprosthetic osteolysis). This inflammation and bone remodeling are critically regulated by the transcription factor NF-κB. We previously demonstrated that inhibition of NF-κB signaling by using the decoy oligodeoxynucleotide (ODN) mitigates polyethylene wear particle-induced bone loss using in vitro and in vivo models. However, the mechanisms of NF-κB decoy ODN action, and in particular its impact on systemic macrophage recruitment, remain unknown...
August 7, 2017: Journal of Biomedical Materials Research. Part A
https://www.readbyqxmd.com/read/28775218/predictive-factors-for-length-of-hospital-stay-following-primary-total-knee-replacement-in-a-total-joint-replacement-centre-in-hong-kong
#5
C K Lo, Q J Lee, Y C Wong
INTRODUCTION: The demand for total knee replacement in Hong Kong places tremendous economic burden on our health care system. Shortening hospital stay reduces the associated cost. The aim of this study was to identify perioperative predictors of length of hospital stay following primary total knee replacement performed at a high-volume centre in Hong Kong. METHODS: We retrospectively reviewed all primary total knee replacements performed at Yan Chai Hospital Total Joint Replacement Centre from October 2011 to October 2015...
August 4, 2017: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/28774129/two-level-micro-to-nanoscale-hierarchical-tio%C3%A2-nanolayers-on-titanium-surface
#6
Elena G Zemtsova, Andrei Yu Arbenin, Ruslan Z Valiev, Evgeny V Orekhov, Valentin G Semenov, Vladimir M Smirnov
Joint replacement is being actively developed within modern orthopedics. One novel material providing fast implantation is bioactive coatings. The synthesis of targeted nanocoatings on metallic nanotitanium surface is reported in this paper. TiO₂-based micro- and nanocoatings were produced by sol-gel synthesis using dip-coating technology with subsequent fast (shock) drying in hot plate mode at 400 °C. As a result of shock drying, the two-level hierarchical TiO₂ nanolayer on the nanotitanium was obtained...
December 13, 2016: Materials
https://www.readbyqxmd.com/read/28773989/bacterial-infection-and-implant-loosening-in-hip-and-knee-arthroplasty-evaluation-of-209-cases
#7
Ulrike Dapunt, Stephanie Radzuweit-Mihaljevic, Burkhard Lehner, Gertrud Maria Haensch, Volker Ewerbeck
The aim of this study was to evaluate bacteria species detected in a large number of patients treated for prosthetic joint infection of the hip and knee at a single specialized center. Furthermore, the rate of implant loosening was investigated in a time-dependent manner for the most frequently detected bacteria species. A retrospective analysis of patients (n = 209) treated for prosthetic joint infection of the hip and knee was performed. The following parameters were evaluated: C-Reactive Protein (CRP) concentration, microbiological evaluation of tissue samples, loosening of the implant, the time that had elapsed since the primary prosthetic joint replacement, and the duration since the last surgical intervention...
October 26, 2016: Materials
https://www.readbyqxmd.com/read/28773240/metallic-biomaterials-current-challenges-and-opportunities
#8
REVIEW
Karthika Prasad, Olha Bazaka, Ming Chua, Madison Rochford, Liam Fedrick, Jordan Spoor, Richard Symes, Marcus Tieppo, Cameron Collins, Alex Cao, David Markwell, Kostya Ken Ostrikov, Kateryna Bazaka
Metallic biomaterials are engineered systems designed to provide internal support to biological tissues and they are being used largely in joint replacements, dental implants, orthopaedic fixations and stents. Higher biomaterial usage is associated with an increased incidence of implant-related complications due to poor implant integration, inflammation, mechanical instability, necrosis and infections, and associated prolonged patient care, pain and loss of function. In this review, we will briefly explore major representatives of metallic biomaterials along with the key existing and emerging strategies for surface and bulk modification used to improve biointegration, mechanical strength and flexibility of biometals, and discuss their compatibility with the concept of 3D printing...
July 31, 2017: Materials
https://www.readbyqxmd.com/read/28773102/raman-and-photoemission-spectroscopic-analyses-of-explanted-biolox-%C3%A2-delta-femoral-heads-showing-metal-transfer
#9
Paola Taddei, Eleonora Pavoni, Saverio Affatato
Biolox(®) delta has been widely used in joint replacements thanks to its high strength and wear resistance. In this study, eleven Biolox(®) delta femoral head retrievals affected by metal transfer (MT) were analysed by Raman spectroscopy to estimate the tetragonal to monoclinic zirconia phase transformation, whose occurrence may compromise ceramic chemical stability and mechanical strength. The residual stress state was evaluated by both Raman and photoemission spectroscopy. Vm monoclinic zirconia contents were higher near the centre of the articulating surface and in the MT area than in the border control area of the retrievals...
July 3, 2017: Materials
https://www.readbyqxmd.com/read/28772532/influence-of-substrate-heating-and-nitrogen-flow-on-the-composition-morphological-and-mechanical-properties-of-sinx-coatings-aimed-for-joint-replacements
#10
Charlotte Skjöldebrand, Susann Schmidt, Vicky Vuong, Maria Pettersson, Kathryn Grandfield, Hans Högberg, Håkan Engqvist, Cecilia Persson
Silicon nitride (SiNx) coatings are promising for joint replacement applications due to their high wear resistance and biocompatibility. For such coatings, a higher nitrogen content, obtained through an increased nitrogen gas supply, has been found to be beneficial in terms of a decreased dissolution rate of the coatings. The substrate temperature has also been found to affect the composition as well as the microstructure of similar coatings. The aim of this study was to investigate the effect of the substrate temperature and nitrogen flow on the coating composition, microstructure and mechanical properties...
February 13, 2017: Materials
https://www.readbyqxmd.com/read/28770427/testing-the-efficacy-of-antimicrobial-peptides-in-the-topical-treatment-of-induced-osteomyelitis-in-rats
#11
Pavel Melicherčík, Václav Čeřovský, Ondřej Nešuta, David Jahoda, Ivan Landor, Rastislav Ballay, Petr Fulín
Joint replacement infections and osteomyelitis are among the most serious complications in orthopaedics and traumatology. The risk factors for these infections are often bacterial resistance to antimicrobials. One of the few solutions available to control bacterial resistance involves antimicrobials, which have a different mechanism of action from traditional antibiotics. Antimicrobial peptides (AMP) appear to be highly promising candidates in the treatment of resistant infections. We have identified several AMP in the venom of various wild bees and designed analogues that show potent antimicrobial activity and low toxicity against eukaryotic cells...
August 2, 2017: Folia Microbiologica
https://www.readbyqxmd.com/read/28768780/activity-levels-and-return-to-work-following-total-knee-arthroplasty-in-patients-under-65-years-of-age
#12
C E H Scott, G S Turnbull, D MacDonald, S J Breusch
AIMS: Little is known about employment following total knee arthroplasty (TKA). This study aims to identify factors which predict return to work following TKA in patients of working age in the United Kingdom. PATIENTS & METHODS: We prospectively assessed 289 patients (289 TKAs) aged ≤ 65 years who underwent TKA between 2010 and 2013. There were 148 women. The following were recorded pre-operatively: age, gender, body mass index, social deprivation, comorbidities, indication for surgery, work status and nature of employment, activity level as assessed by the University of California, Los Angeles (UCLA) activity score and Oxford Knee Score (OKS)...
August 2017: Bone & Joint Journal
https://www.readbyqxmd.com/read/28768430/multi-and-univariate-analyses-of-the-weekend-effect-for-elective-lower-limb-joint-replacements
#13
Wte Briggs, Blt Guevel, A W McCaskie, S M McDonnell
Introduction The weekend effect is a perceived difference in outcome between medical care provided at the weekend when compared to that of a weekday. Clearly multifactorial, this effect remains incompletely understood and variable in different clinical contexts. In this study we analyse factors relevant to the weekend effect in elective lower-limb joint replacement at a large NHS multispecialty academic healthcare centre. Materials and Methods We reviewed the electronic medical records of 352 consecutive patients who received an elective primary hip or knee arthroplasty...
August 3, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28766055/non-synonymous-wnt16-polymorphisms-alleles-are-associated-with-different-osteoarthritis-phenotypes
#14
Carmen García-Ibarbia, Sara Neila, Carlos Garcés, Maria A Alonso, María T Zarrabeitia, Carmen Valero, Fernando Ortiz, José A Riancho
Hereditary factors have a strong influence on osteoarthritis (OA). The Wnt pathway is involved in bone and cartilage homeostasis. Hence, we hypothesized that allelic variations of WNT16 could influence the OA phenotype. We studied 509 Caucasian patients undergoing joint replacement due to severe primary OA. Radiographs were used to classify the OA as atrophic or hypertrophic. Two nonsynonymous polymorphisms of WNT16 (rs2707466 and rs2908004) were analyzed. The association between the genotypes and the OA phenotype was analyzed by logistic regression and adjusted for age and body mass index...
August 1, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28765504/does-early-return-to-theatre-add-value-to-rates-of-revision-at-3-years-in-assessing-surgeon-performance-for-elective-hip-and-knee-arthroplasty-national-observational-study
#15
Alex Bottle, Helen E Chase, Paul P Aylin, Mark Loeffler
BACKGROUND: Joint replacement revision is the most widely used long-term outcome measure in elective hip and knee surgery. Return to theatre (RTT) has been proposed as an additional outcome measure, but how it compares with revision in its statistical performance is unknown. METHODS: National hospital administrative data for England were used to compare RTT at 90 days (RTT90) with revision rates within 3 years by surgeon. Standard power calculations were run for different scenarios...
August 1, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28760738/characteristics-associated-with-joint-replacement-in-early-symptomatic-knee-or-hip-osteoarthritis-6-year-results-from-a-nationwide-prospective-cohort-study-check
#16
Alex N Bastick, Jurgen Damen, Rintje Agricola, Reinoud W Brouwer, Patrick Je Bindels, Sita Ma Bierma-Zeinstra
BACKGROUND: Many patients with osteoarthritis (OA) of the knee and/or hip undergo total joint replacement (TJR) because of severely progressed symptoms. AIM: To determine patient and disease characteristics associated with undergoing TJR in participants with recent-onset knee and/or hip OA. DESIGN AND SETTING: Participants with hip or knee pain from the nationwide prospective Cohort Hip and Cohort Knee (CHECK) study were included. METHOD: The outcome measure was total hip arthroplasty (THA) or total knee arthroplasty (TKA) during 6 years of follow-up...
July 31, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28760710/the-impact-of-preoperative-bacteriuria-on-the-risk-of-periprosthetic-joint-infection-after-primary-knee-or-hip-replacement-a-retrospective-study-with-a-one-year-follow-up
#17
Meeri Honkanen, Esa Jämsen, Matti Karppelin, Reetta Huttunen, Heini Huhtala, Antti Eskelinen, Jaana Syrjänen
OBJECTIVES: Patients who undergo elective joint replacement are traditionally screened and treated for preoperative bacteriuria in order to prevent periprosthetic joint infection (PJI). More recently, this practice has been questioned. The purpose of this study was to determine whether preoperative bacteriuria is associated with an increased risk of PJI. METHODS: Patients who had undergone a primary hip or knee replacement in a tertiary care hospital between September 2002 and December 2013 were identified from the hospital database (23 171 joint replacements, 10 200 hips, and 12 971 knees)...
July 28, 2017: Clinical Microbiology and Infection
https://www.readbyqxmd.com/read/28755167/surgery-for-greater-trochanteric-pain-syndrome-after-total-hip-replacement-confers-a-poor-outcome
#18
Eve Robertson-Waters, James R Berstock, Michael R Whitehouse, Ashley W Blom
PURPOSE: Surgery for greater trochanteric pain syndrome (GTPS) may be indicated for cases refractory to conservative measures. We aim to evaluate patient reported outcomes and adverse events following surgery. METHODS: Postal questionnaires were used to evaluate a consecutive series of 61 bursectomy and gluteal fascia transposition (GFT) procedures. Study outcomes were Oxford hip score, satisfaction score, visual analogue score, pain lying on the affected side, and the duration of pain relief after surgery...
July 28, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28754533/benefits-and-harms-of-treatment-of-asymptomatic-bacteriuria-a-systematic-review-and-meta-analysis-by-the-european-association-of-urology-urological-infection-guidelines-panel
#19
Bela Köves, Tommaso Cai, Rajan Veeratterapillay, Robert Pickard, Thomas Seisen, Thomas B Lam, Cathy Yuhong Yuan, Franck Bruyere, Florian Wagenlehner, Riccardo Bartoletti, Suzanne E Geerlings, Adrian Pilatz, Benjamin Pradere, Fabian Hofmann, Gernot Bonkat, Björn Wullt
People with asymptomatic bacteriuria (ABU) are often unnecessarily treated with antibiotics risking adverse effects and antimicrobial resistance. We performed a systematic review to determine any benefits and harms of treating ABU in particular patient groups. Relevant databases were searched and eligible trials were assessed for risk-of-bias and Grading of Recommendations, Assessment, Development and Education quality. Where possible, a meta-analysis of extracted data was performed or a narrative synthesis of the evidence was presented...
July 25, 2017: European Urology
https://www.readbyqxmd.com/read/28751437/enhanced-recovery-after-surgery-for-hip-and-knee-arthroplasty-a-systematic-review-and-meta-analysis
#20
Shibai Zhu, Wenwei Qian, Chao Jiang, Canhua Ye, Xi Chen
OBJECTIVES: To collect data of randomised controlled trials (RCTs) and clinical controlled trials (CCTs) for evaluating the effects of enhanced recovery after surgery on postoperative recovery of patients who received total hip arthroplasty (THA) or total knee arthroplasty (TKA). METHODS: Relevant, published studies were identified using the following key words: arthroplasty, joint replacement, enhanced recovery after surgery, fast track surgery, multi-mode analgesia, diet management, or steroid hormones...
July 27, 2017: Postgraduate Medical Journal
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