Joint Replacement News

2018

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July 2018


Body implant provides new habitat for bacteria and fungi, study reveals

Previously, doctors and researchers assumed that implants inserted into the body were sterile. However, in a study conducted at the University of Copenhagen, researchers found that more than 70% of the patients with implants had bacteria and fungi on the implants. Interestingly enough, none of the patients showed signs of infection. Moving forward, the authors of the study question whether this is beneficial like the rest of our microbiome or potentially a precursor to future infections.
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Older patients with knee pain may benefit from allograft transplant technique

Active patients over 40 with knee pain have been difficult to treat. However, researchers from the Oregon Health and Science University in Portland found that there might be some benefits to using a fresh osteochondral allograft transplantation to treat common causes of knee pain (i.e. focal cartilage defects) in adults. Osteochondral allograft transplantation surgery or OATS is a process in which the damaged cartilage in the knee is replaced with healthy cartilage from a donor. This process ultimately can lead to relieved pain and restored function and movement in the joint.
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Prolonged opioid use before knee or hip replacement surgery increases risk of poor outcomes

Prescription of opioids are sometimes given to patients who undergo surgical procedures to alleviate some pain. However, one study published in The Journal of Bone & Joint Surgery found that patients who took prescribed opioids for more than 60 days before their joint replacement surgery were at a significantly higher risk of being re-hospitalized and undergoing the same joint replacement surgery compared to patients who did not use opioids before their operation. Researchers noted that physicians should reconsider opioid use as another risk factor for patients undergoing joint arthroplasty.
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Risk factors associated with revision for prosthetic joint infection after hip replacement: a prospective observational cohort study

The risk of prosthetic joint infection can be influenced by patient, surgical and health-care factors. Researchers used data from the National Joint Registry of England and Wales to conduct an observational cohort study on the overall factors that affect the risk of prosthetic joint infection in patients who undergo total hip replacement. The study found that there were several modifiable and non-modifiable factors associated with the risk of prosthetic joint infection: these consisted of male sex, high levels of BMI, smoking, previous joint surgery, and comorbidities such as rheumatoid arthritis and depression. The results of the study suggest the importance of identifying patient factors associated with increased risk of prosthetic joint infection and the need to focus development of interventions in this area.
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June 2018


New telemedicine exercise therapy

Patients who get artificial hip or knee joint replacement surgery spend much of their time in rehabilitation. However, therapy can be delayed and costly due to time constraints for working individuals. The development of a new telemedicine-based exercise therapy may allow patients to organize their rehabilitation more flexibly and ultimately solve this issue. The ReMove-It project consist of videos in which the therapist performs the prescribed exercises and the patients imitate them in front of the screen. These videos are recorded by therapists themselves and are individually tailored toward each patient. The efficacy of this study has been approved and this medical device is expected to be in use by 2019.
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Researchers identify urinary markers that predict bone problems in hip replacement patients

A study published in the Journal of Orthopedic Research found urinary markers that differentiate total hip replacement patients who develop bone tissue destruction (osteolysis) from patients who do not. Researchers found that levels of certain markers helped identify patients at risk for osteolysis almost six years before a diagnosis was made. Researchers are hopeful that the findings of this study will alert surgeons to be especially attentive in following up with high-risk patients.
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Joint replacement rates declined more than half among RA patients</strong

Although the prevalence of rheumatoid arthritis has been increasing, the rate of joint replacement surgery has declined over these past 13 years. During the EULAR Annual Congress, researchers stated that after matching RA patients with controls by age and gender, there was a significant reduction in arthroplasty surgery in RA patients by 51.9%. As other surgical procedures remained higher for RA patients then controls, the researchers predict that this decline in joint replacement surgery is not due to lack of access. Instead, they suggest that it may be due to early diagnosis and improved medical therapy over the last several decades.
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New 3D imaging analysis technique could lead to improved arthritis treatment

A team of engineers, radiologists, and physicians at the University of Cambridge have developed an algorithm to monitor the joints of patients with arthritis. This breakthrough could enable greater understanding of how osteoarthritis develops and provide new, effective treatments without having to do invasive tissue sampling. Known as joint space mapping (JSM), this semi-automated technique analyzes standard computerized tomography images to identify changes in the bones of the patients’ joints. Researchers hope to use this technique to identify osteoarthritis earlier and develop potential treatment plans before the disease becomes debilitating.
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May 2018


Mepivacaine is found to be an effective spinal anesthetic for knee replacement surgery, May 9th, 2018

Mepivacaine, a pain controlling medication that was abandoned decades ago, is being used today as an effective spinal anesthetic for knee replacement. In two studies by Henry Ford Health System, mepivacaine was found to be as effective in managing pain with less side effects than bupivacaine, the more commonly used spinal anesthetic by surgeons. In the study, patients who received mepivacaine had faster recovery and shorter hospital stay.
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DePuy Synthes’ ATTUNE Knee System may improve patient outcomes and reduce hospital stays, May 11th, 2018

DePuy Synthes, part of the Johnson & Johnson Medical Devices Companies, announced clinical findings that outline the potential benefits patients may experience when undergoing knee replacement with the ATTUNE Knee System. ATTUNE Knee system is a new knee replacement system designed to work harmoniously with the patient’s body. One study reports that there was significant improvement in Patient Reported Outcome Measures (PROMS) and knee functioning at six months with the ATTUNE Knee compared to pre-operation. These results provide additional information in regard to the rate of recovery for patients who are considering knee surgery.
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HSS study aims to find if bariatric surgery prior to knee replacement can improve outcomes, May 18th, 2018

A study, known as Surgical Weight-Loss to Improve Functional Status Trajectories Following Total Knee Arthroplasty (SWIFT), aims to answer whether weight loss surgery before knee replacement could improve outcomes or even eliminate the need for joint replacement surgery for overweight patients. To conduct the study, researchers are enrolling patients at a number of hospitals nationwide and follow up with these patients over the course of 5 years. They hypothesis that weight loss resulting from bariatric surgery prior to knee replacement could improve joint replacement outcomes in severely obese patients. Furthermore, they plan to examine if losing a significant amount of weight could enable patients to hold off on knee replacement or postpone it indefinitely.
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Injections for knee osteoarthritis – ‘subtle but significant’ impact of revisions in clinical practice guidelines, May 18th, 2018

Guidelines for nonsurgical treatment of knee osteoarthritis are continually changing and playing an important role in the ongoing evaluation of medical treatment. Several studies have been conducted to understand the use of steroid and hyaluronic acid injection for patients with osteoarthritis of the knee and considering knee replacement surgery. New findings question the effectiveness of these treatments as researchers say injections given shortly before total knee replacement surgery may even increase the risk of infection. Physicians and researchers hope these studies will give rise to clinical practice guidelines that improve care for patients with knee osteoarthritis.
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April 2018


Boomers are going bionic, and they want joint replacements to let them do it all

According to the American Academy of Orthopedic Surgeons, more Americans are now getting more hip, knee, shoulder, and ankle replacements than they have in the past. The success rates have toped 95 percent and due to improvements in materials and the way they’re treated and sterilized, implants now have a 90 percent chance of lasting two decades. Baby boomers are determined to keep moving no matter the wear and tear, which is fueling this surge in joint replacements. While physical activity obviously plays a role in joint deterioration, physicians say that genetics may be the biggest factor in determining who needs a replacement and when. This explosion in joint replacements plays a role in health care as orthopedic surgeons are having trouble meeting the demands. Researchers believe that technology will have to be part of the solution.
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What is the Best Way to Treat Infected Hip Replacements?

Hip and other joint replacement are very common operations that are effective at providing pain relief and improving mobility. However, infection can sometimes occur following joint replacement. Interestingly, new research finds that treating an infected hip replacement in a single stage procedure is as successful, if not better, than the widely used two-stage procedure.
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Before Joint-Replacement Surgery, Be Prepared for Some Tough Questions

Statistics have shown that as many as 15 to 20 percent of knee replacement patients are less than satisfied post-surgery. Therefore, in the past decade, joint replacement surgeons have been digging deep into the patient’s motivation in order to ensure that the end results of a joint replacement surgery will fit with the patient’s definition of success. The Hospital of Special Surgery (HSS) is now using a new computer-base tool that can predict a patient’s satisfaction rate three to six months after surgery and consider patient characteristics such as age, body mass index, socio-economic status, social history, and overall psycho-social health.
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Thousands Missing Out on Safer Knee Replacements, Say Experts

Each year, around 50,000 patients who undergo full knee replacements may benefit from a simpler surgery. According to a new study by Oxford University, partial replacement may be a safer and easier surgery and should be the preferred method on nearly half the patients who get full-joint surgery. The procedure has shown to be less invasive, allowing for a faster recovery, carrying less post-operative risks and providing better function. In addition, the National Health Service believes this is a cheaper intervention in the short and long term as partial replacements for a high proportion of knee replacements provide better outcomes and are cheaper for the NHS than total replacements.
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March 2018


More Men, Younger Americans having Joint Replacement Surgery

Although hip, knee, and other joint replacement procedures have been among the most common elective operations in the U.S., a recent study shows that the average age of patients undergoing hip replacement surgeries are decreasing and more men are currently undergoing these operations than in the past. Results of the study suggest that the average age of patients undergoing knee replacement surgery has declined from 68 to just under 66. Although seemingly negligible, researchers suggest that this decline in age may possibly be due to an increase in obesity and/or an increase in access to care.

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Managing Pain with Fewer Opioids After Joint Replacement

This article states that rather than using opioid painkillers alone, doctors should prescribe more than one type of medicine for pain management after hip and knee replacement surgery to reduce risks for patients. According to a new study, patients who used two or more pain control methods had fewer respiratory complications, gastrointestinal complications, and shorter hospital stays compared to patients who received opioids alone. Furthermore, as opioid painkillers can cause nausea, vomiting and drowsiness, researchers suggest that this can slow a patient’s recovery from surgery.

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Minimally Invasive Treatment Reduces Knee Pain and Disability from Osteoarthritis

Geniculate Artery Embolization (GAE) has become the first clinical procedure to use image-guided treatment to block key arteries in the knee and reduce inflammation and pain with minimal invasiveness. According to this article, patients with osteoarthritis in the knee have reported significant pain reduction within a few days and up to a month after the discovery of this nonsurgical treatment. This accessible procedure suggests an alternative form of treatment compared to currently used pain medications that have various side effects and risks, as this new procedure may provide accessible treatment for patients looking to improve their quality of life and manage their pain.

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After Knee Replacement, Play On

A small new study finds that knee replacement patients can continue to enjoy high-impact sports without worrying about compromising their new joint. Although historically, patients are advised against high-impact sports, the study finds that sports participation has no significant impact on the longevity of artificial knees. However, other researchers have pointed out that knee replacement patients who participate in high-impact sports are more likely to be strong and non-obese, conditions that assist the longevity of an artificial knee. These results suggest conducting future research with a bigger sample size and a wider range of physical activity.

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February 2018


Aspirin as Good a Clot Buster as Pricey Drugs After Joint Replacement, February 21 2018

The article talks about a new clinical trial that has found that aspirin may be just as effective as newer, more expensive drugs in preventing blood clots in patients after they have hip or knee replacement surgery. The findings suggest that patients would be able to switch to aspirin after day five of their post-surgery recovery.

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Joint Replacement in 23 Hours: Is It Right for You?, February 20 2018

This article discusses how patients today are having the 23-hour joint replacement surgery done for their hip or knee replacement surgery. Although the 23-hour joint replacement surgery has the benefit of a quicker recovery, not all patients are a candidate for this surgery. The article looks into how a 23-hour joint replacement works and states that the best candidates for this surgery are younger and in overall good health i.e. normal weight and don’t smoke.

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Joint Replacement Rates in OA with Diabetes: Effects of COX-2 Inhibitors Plus Metformin, February 14 2018

The article discusses a study that looked into the effect of cyclooxygenase-2 (COX-2) inhibitors and metformin on the rates of joint replacement surgery in patients with osteoarthritis (OA) and type 2 diabetes mellitus (T2DM). The study found that people who have T2DM and OA have lower rates of joint replacement surgery when they take a combination of COX-2 inhibitors and metformin rather than taking COX-2 inhibitors alone.

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One in five older adults experience brain network weakening following knee replacement surgery, February 7 2018

In a study done at the University of Florida, researchers conducted cognitive and brain imaging tests on patients 60 and older who were undergoing total knee replacement surgery. They found that 23 percent of participants had large decline in activity in at least one brain network 48 hours after surgery. Moreover, 15 percent of participants had a decline across all brain networks. This study aims to call on surgeons and patients to consider and assess cognitive abilities after surgery.

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January 2018


Can Your Hip Replacement Kill You?, January 13 2018

This New York Times article details how the medical device industry is largely unregulated. The FDA does not require the same rigorous testing of medical devices as it does of new medications. There is no standard of testing for many implants and medical devices.

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Tiny antibiotic beads fight infections after joint replacement, January 10 2018

This article looks at the small antibiotic beads that Terry Clyburn, M.D., developed. The antibiotic beads release medicine for several weeks in order to reduce infection risk after joint replacement surgery. The antibiotic microspheres are coated on the implant before placing it in the patient’s joint.

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Black patients less likely to receive knee replacement, despite worse symptoms, January 9 2018

This article discusses the continued racial disparities in the use of knee replacement surgery. Researchers published these findings in the Journal of Clinical Rheumatology. At baseline, black patients exhibit worse pain and function and yet they receive total knee replacements less than white patients.

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December 2017


Take intraoperative steps to reduce joint infection risk, December 29 2017

The article looks at possible intraoperative steps and techniques taken to try and avoid joint infection such as antibacterial surfaces on implants and antibiotic dosages patients should receive. As the number of total knee arthroplasty (TKA) and total hip arthroplasty (THA) procedures have increased in the U.S. so, too, has the rate of failure increased. Infection is a leading cause in revisions of TKA and THA.

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Is It Time For Joint Surgery? Here’s How To Know, December 20 2017

This article details the importance of recognizing your joint pain early and having a conversation with your doctor about it. Surgery is not always the right answer for a patient but the longer you wait for surgery the harder rehabilitation may become. Professor William Jiranek recommends weighing the risks and benefits of the surgery depending on how debilitating their condition may be.

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This procedure repairs joint damage and avoids hip replacement surgery, December 20 2017

This article discusses a procedure by the name of Subchondroplasty is being used by the Ohio State Wexner Medical Center. This procedure helps patients avoid hip replacement surgery by injecting a bone substitute material into the hip joint that fills the lesions in the joint.

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November 2017


Man receives knee surgery using 3D technology, November 27, 2017

An 84-year-old man received knee surgery using 3D print technology. Tantalum pads were individually designed for the patient by computer design and 3D print technology. It was the first surgery of its kind worldwide.

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Do Education and Poverty Affect Knee Surgery Success? November 22, 2017

A study done by Arthritis Care & Research found that individuals in poor communities that did not attend college attain lower 2-year WOMAC scores after knee replacement surgery than those individuals who had some college. Education had no impact on total knee arthroplasty in wealthy communities.

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Click here for the Arthritis Care & Research Abstract

A New Way to Reduce Surgery Complications Stemming from High Blood Sugar, November 16, 2017

Researchers at Thomas Jefferson University discovered a different blood-sugar marker to track patient’s glycemic levels. The marker could improve outcomes after joint surgery for diabetic and non-diabetic patients by predicting which patients have highest risk of complications more accurately.

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Adhering to TNFi Therapy May Reduce Joint Replacement Rates in Rheumatoid Arthritis, November 9, 2017

The National Institute for Health and Care Excellence (NICE) did a recent study on tumor necrosis factor inhibitor (TNFi) therapies and found an association between this treatment and reduced rates of total knee replacement in RA patients in England and Wales.

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October 2017


Patients using less opioids after hip, knee replacement surgery, October 23, 2017

A study conducted by the University of Massachusetts Medical School found that more hip and knee replacement patients are using a variety of pain management methods rather than receiving opioids as the sole treatment for their pain.

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Outcomes and Predictors of Success for Arthroscopic Lysis of Adhesions for the Stiff Total Knee Arthroplasty, October 23, 2017

Authors did a retrospective review of 18 patients who had arthroscopic lysis of adhesions for stiff total knee arthroplasty. The authors found that time to lysis of adhesions, age, weight, and body mass index were significant predictors for the range of motion in patients’ post-lysis of adhesions.

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Bigger Waistline Limits Mobility After Hip/Knee Replacement: High BMI also ups risk of death before age 85 in those undergoing total joint replacement, October 13, 2017

A prospective study of women aged 65 to 79 years old found that those who were obese or overweight at baseline had 4 times the risk of mobility limitation at age 85 as that of normal-weight women. The study found that abdominal obesity, overweight, and general obesity were risk factors after total joint replacement for survival to age 85.

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Click here for the Arthritis Care Research Article

After Joint Replacement, Why Physical Therapy Is Key, October 2, 2017

After joint replacement, proper rehabilitation is a critical factor in the new joint’s success. Physical therapy can assist with mobility after joint replacement and help prevent life-threatening complications, such as blood clots. Patients who do not undergo rehabilitation may experience prolonged pain, stiffness and swelling in the joint.

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September 2017


Joint replacements increase by 20,000 in a year, says NJR report, September 26, 2017

Joint replacements increased by 20,000 in the UK from 2016 to 2017 and they are continuing to see impressive long-term outcomes. These good clinical outcomes are in part due to physiotherapists playing a central role in orthopedic teams. Physiotherapy programs help to delay revision surgery for younger patients.

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How You Can Have a Faster Recovery After Joint Replacement, September 26, 2017

Due to technological advances in joint replacement procedures, it is now possible to have a far shorter stay in the hospital after surgery and, in some cases, it can be done as an outpatient procedure. Shorter incisions are able to be made due to development of smaller instruments. Better pain management has been achieved by using a short-acting spinal anesthetic and a long-acting local anesthetic around the surgical site. Not everyone is a viable patient for this minimally invasive procedure, however, so consult with your doctor before considering this surgery.

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Acupuncture & Electrotherapy May Help Patients after Total Knee Arthroplasty, September 18, 2017

A review and meta-analysis performed by Dr. Dario Tedesco and colleagues found that patients who have acupuncture and/or electrotherapy could have a decreased or delayed need for opioid treatment after total knee arthroplasty. The aim of their review was to determine effective postoperative non-pharmacological interventions for total knee arthroplasty patients. The researchers discovered evidence that acupuncture delayed opioid use and electrotherapy reduced opioid use but these interventions showed low evidence for improving pain relief.

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Click here for the JAMA Surgery review

Demand for Revision Total Knee Arthroplasty Is on the Rise, September 15, 2017

Revision total knee arthroplasty is expected to rise 600% in the next five to ten years due to increasing rates of obesity in the US and increased knee replacements in younger populations. Both of these populations put increased demand on their knee replacements leading to premature failure and the need for revision total knee arthroplasty. The article stresses the need for preoperative behavior modifications in order to decrease the need for reoperation.

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Healthcare industry split on CMS’ proposal to allow inpatient joint replacement surgeries, September 14, 2017

The Centers for Medicare & Medicaid Services has proposed a rule to allow outpatient facilities and surgery centers to perform knee and hip replacement surgeries rather than solely perform these surgeries at inpatient settings. Healthcare providers employed by hospitals are against this proposal and are pushing for these surgeries to remain inpatient. Surgical centers are behind the proposal. Those against the proposal feel that it is a threat to patients’ safety and those who support site that it will save healthcare dollars giving Medicare beneficiaries more options.

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August 2017


 

1st outpatient total joint bundles in NC to be performed at Surgical Center of Greensboro, August 29, 2017

A group of doctors in Greensboro, NC plan to implement a bundled payment program for total joint replacement surgeries performed at the new Surgical Care Affiliates surgery center. They created a management company that handles negotiations between the center and the payers, and in doing so they provide a 15 to 20 percent discount on the average amount spent for the total episode of care. In addition, the surgeons assume all costs for care within the 90 days after surgery, which includes any infections, complications or return visits. Their first total joint replacement surgery at the center will be at the end of August.

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6 Myths About Total Hip and Knee Replacement Surgery, August 23 2017

This article discusses 6 myths and stereotypes around joint replacement surgery and explains why these are erroneous.

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Aging for Amatures: Protect your joints, August 21 2017

This is a general article on join well-being and how to protect your joints. This article discusses what are called ‘joint protection techniques’.

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Joint replacement model mandatory areas slashed in CMS proposal, August 16, 2017

 

This article looks at research which demonstrates that patients who are included in the Centers for Medicare & Medicaid Services’ (CMS) Comprehensive Joint Replacement (CJR) bundle program remain at most risk for readmission during the first 30 days of discharge. It also discusses the need to pay more attention to the reasons for readmission and on more attention to questions like which post-acute care members to include within networks.
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CMS Proposes Joint Replacement Coverage at ASCs, August 16 2017

This article look at CMS and their consideration of whether to provide coverage for hip and knee replacement surgeries at outpatient surgery centers.

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July 2017


New Study Finds Improvement in Outcomes Following Metal-on-Metal Hip Revision Surgery, July 5, 2017

A new study reviewing metal-on-metal hip revision surgery, which is performed for abnormal reactions to metal, has found that outcomes have improved since initial reports 5 years ago. Outcomes are now similar to those of patients with other types of hip replacement who undergo revision surgery. The study also identifies factors that surgeons can modify during the revision surgery that can potentially improve patients’ outcomes even more.

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Obese Patients Don’t Have to Lose Weight Before Joint Replacement: Study, July 19, 2017

 

A new study conducted by the University of Massachusetts Medical School finds that joint replacement candidates do not need to lose weight before having joint replacement surgery. The study reports that obese patients have similar functional outcomes and pain relief as those reported by non obese patients. Researchers did emphasize, though, that losing weight can help in preventing post surgery infection.
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New Survey Says Too Many Women Wait Too Long In Pain Before Getting Knee/Hip Replacement, July 23, 2017

 

A survey conducted by Edelman Intelligence for the DePuy Synthes Companies surveyed over 500 American women who have had or plan to have knee or hip replacement surgery. The survey discovered that 4 out of 5 women spend more time in pain than necessary because they consider getting knee or hip replacement surgery as a last resort. Nearly all of the women who underwent surgery, however, would now encourage others to not delay in speaking with their doctors about their options.

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June 2017


MHRA Updates Alert on Metal-on-Metal Hip Implants, June 29, 2017

The Medicines and Healthcare Products Regulatory Agency updated their recommendations for long term follow up for patients with metal on metal hip replacements. MHRA has revised their recommendations to state that all female patients that have had hip resurfacing, male patients with <48mm head implants, and all patients with large stemmed total hip replacements should be screened annually. This is the best way to prevent possible soft tissue reactions related to their implant.

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Questions to ask your orthopedic surgeon before joint replacement, June 30, 2017

Sherry Booz, an orthopedic nurse practitioner, and Kurtis Staples, an orthopedic hip and knee trauma surgeon, provide advice on what questions to ask your doctor before undergoing joint replacement surgery. Preparing questions before meeting with the orthopedic surgeon will help determine the best treatments and provide a successful surgery result.

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New medication guidelines for rheumatic disease patients having joint replacement, June 17, 2017

A panel of orthopedic surgeons and rheumatologists created guidelines to decrease the risk of infection after joint replacement. The American Association of Hip and Knee Surgeons and the American College of Rheumatology sponsored the development of these guidelines. The aim of the guidelines is to bring consensus amongst rheumatologists and orthopedic surgeons on perioperative management of anti-rheumatic medication in patients undergoing total hip or knee replacement.

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‘Cool’ New Knee Procedure Eases Arthritis Pain Without Surgery, June 13, 2017

A new, non-invasive knee treatment was recently approved by the Food and Drug Administration called “cooled radio frequency ablation”. This is an alternative to surgery for people with moderate to severe osteoarthritis. The procedure is outpatient and takes about 40 minutes. Coolief, as it is known on the market, can reduce pain for about 6 to 12 months. It is slowly becoming available in pain centers across the country. It should be stated that although this new treatment can delay knee replacement, it may still be necessary at some point for many patients.

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May 2017


Surgery won’t help degenerative knee problems, experts say, May 12 2017

A panel of international experts released guidelines, which were published in the British Medical Journal, recommending against arthroscopic surgery. The panel of surgeons, patients, clinicians, and physical therapists analyzed data from 13 randomized control trials involving 1,668 patients. They drew the conclusion that surgery doesn’t cure chronic knee pain, a torn meniscus, “clicking” or “locking” Instead, physical therapy, anti-inflammatory medications, and cortisone injections work as well, if not better than surgery.

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Click here for the full paper

Research from Mercy Health Physician confirms that simple treatment can lessen infection risk for joint replacement patients, May 11, 2017

Dr. Gallagher, a physician at Mercy Health in Cincinnati, found a treatment that could help joint replacement patients regain their infection-fighting systems and lower their rates of complications following surgery. Dr. Gallagher treated 489 total hip and knee replacement patients who had elevated glucose levels (hyperglycemia) after undergoing joint replacement surgery with a simple insulin protocol. After treatment, no one on the protocol developed an infection or needed hospital readmission for wound complications.

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Rodents with trouble walking reveal potential treatment approach for most common joint disease, May 11, 2017

NYU Langone Medical Center produced a study that found that maintenance of high levels of adenosine in rats with damaged anterior cruciate ligaments (ACLs) prevented these rats from developing osteoarthritis. The researchers also discovered that lower levels of the protein on the surface of chondrocytes, which receive and pass on adenosine’s signal, drive reductions in the number of cartilage producing cells and greater risk for osteoarthritis. The team applied adenosine packaged lipid bubbles to the rats’ ACL injuries and found that this excess of adenosine prevented development of osteoarthritis. These findings lead researchers to conclude that adenosine replacement therapy could have the potential of delaying the onset of osteoarthritis and the need for joint replacements.

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April 2017


Total joint replacement patients face increased future risk of needing second procedure: 4 study insights, April 28, 2017

A study recently published in The Journal of Bone & Joint Surgery found that total joint replacement patients face increased risk of needing a second procedure in the future. Based on these findings, the researchers believe patients undergoing joint replacement surgery should be made aware of an up to 45 percent chance of a second surgical procedure within 20 years of the initial replacement surgery.

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After Knee or Hip Replacement, No Place Like Home, April 24, 2017

A number of recent studies have found that the majority of patients who undergo a joint replacement surgery and go home directly from the hospital and engage in outpatient rehabilitation recover equally as well and may experience fewer complications as patients who spend a few days or weeks in a rehab facility. This even extends to patients who live alone. Since at least half of the cost of total joint replacements is incurred in the postoperative period, being discharged right after surgery can reduce costs while maintaining an equivalent recovery.

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Women more sensitized than men to metal used in joint replacement, April 19, 2017

 According to a study published in The Journal of Bone & Joint Surgery, findings show that women on average had an increased rate of hypersensitivity to the metals contained in the joint implants. This may be a contributing factor to why women are at higher risk of complications after total hip or knee replacement surgery.

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Could 3-D Printing Enhance Your Joint Replacement Surgery? April 13, 2017

3-D printing is now being used in orthopedic surgeries, particularly to customize joint replacement surgeries for patients with significant anatomical abnormalities or deformities. This can be due to a fracture or when there is significant erosion of the bone causing the alignment of the knee to be off. There are two ways 3-D printing can be used in joint replacement surgeries: a 3-D printed cutting guide is created from pre-operative MRI or CT scans, where the guide is used to help cut the bone so that a standard implant fits better; or, less commonly, the knee implant itself is customized from a 3-D printed wax mold.

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March 2017


DePuy Synthes knee system shown to be beneficial for economics and patient reported outcomes, March 15, 2017

Depuy Synthes – which is part of the Johnson & Johnson Family of Companies – released a report that analyzes the ATTUNE Knee System’s clinical and economic data. The report found that the value of a knee replacement implant is measured through patient reported outcomes and the economic benefits of the procedure, in addition to how long the implant lasts. Based on the report’s analysis, the ATTUNE Knee has demonstrated favorable survivorship, improved patient reported outcomes, and potential economic benefits.

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Bariatric surgery impacts joint replacement outcomes in very obese patients, March 14, 2017

Hospital for Special Surgery produced a study that found that bariatric surgery performed in morbidly obese patients prior to a total hip or knee joint replacement can reduce in-hospital and 90-day postoperative complications and improve patient health. Because bariatric surgery has a major impact on the metabolic system, clinicians’ opinions differed between whether the surgery would have a negative impact on total joint replacement or a positive one. The authors state, however, that based on their data, bariatric surgery prior to total joint replacement is not a harmful recommendation.

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UMMS study of patient-reported joint replacement outcomes cited for clinician-engaged learning: Patricia Franklin, MD, co-authored National Academy of Medicine paper featuring FORCE-TJR, March 13, 2017

The National Academy of Medicine recently released a discussion paper on the University of Massachusetts Medical School’s study of patient-reported outcomes following total joint replacement surgery, called FORCE-TJR. The paper discusses how actionable, timely and relevant knowledge generation depends on three things: fully engaged clinicians, patients and health care data. The authors state that using the knowledge of clinicians who interact with patients the most is critical to attaining the best outcomes, and cites FORCE-TJR as a program that meets those objectives.

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February 2017


Some Hospitals May Overcharge for Hip, Knee Replacements: Study, February 28, 2017

New research suggests that some US hospitals may be charging private insurers twice as much for hip and knee replacements as the implants generally cost. This raises questions regarding the fact that insurers are not told how much the implants cost the hospital. The findings from this study only involved one insurer, however, so it is therefore difficult to make conclusions as to why the discrepancy exists.

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After joint replacement surgery, smokers at increased risk of reoperation for infection, February 16, 2017

A study published in The Journal of Bone & Joint Surgery reported that smoking is associated with an 80% increase in risk of infectious complications among patients undergoing joint replacement surgery. Furthermore, each additional pack-year significantly contributed to total reoperations for infectious complications. The results indicate that it may be wise to engage patients in a smoking cessation program prior to joint replacement surgery.

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Before getting a joint replacement, consider these factors, February 3, 2017

Knee and hip replacements are among the most common operations in the United States, with about 1 million done each year. There isn’t, however, consensus among surgeons regarding the choice of prosthetic, the operating procedure and other factors, and the variation from one surgeon or hospital to the next can have an impact on outcomes. The Washington Post has put together a list of factors to consider before getting a joint replacement.

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January 2017


SMH Highest Reporting for Hip and Knee Replacement, January 13, 2017

Sarasota Memorial Hospital has been ranked by Modern Healthcare as the highest performing safety net hospital for hip and knee replacements in America. Using data from CMS, it was found that SMH demonstrated the best safety in treatment and the least amount of readmission’s after hip and knee replacements. It was also the only hospital in Florida to receive 5 stars from the CMS for overall care.

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Study Finds Inpatient vs. Home; Outpatient Care Drives Post Surgery Spending, January 13th 2017

A new study out of the University of Michigan has found that variation in location and facility of where patients receive post-surgical care impacts the cost of that patient’s care. This article discusses how decisions regarding where post-surgical care should occur must be based on what is best for the patient’s individual needs. This will possibly improve quality of care and reduce overall cost, even if the patient needs a more intensive follow up. Improving patient education and knowledge about options, as well as understanding each patient’s available social support will improve the decision making process around treatment options.

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Art of Aging: Hip Replacement Recovery, January 12, 2017

This article discusses the use of CAT scan imaging and how it may improve outcomes for a hip replacement surgery. The scan is used to map out the process for the surgery beforehand, providing as much information as possible to everyone on the operating team before the replacement surgery is undertaken. In this article patients and clinicians discusses how such imaging can, and may continue to reduce recovery time, improve pain management, and enhance quality of care for the patients who have experienced these imagining protocols prior to their surgery.

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Stepping Out After Knee Replacement Surgery, January 9, 2017

Gary Granza, one recent knee replacement patient, has used yoga to credit his recovery from his surgery. After years of pain management from yoga, Gary received his knee replacement and was up and doing modified versions of the exercise on the same day as his surgery. He credits continued yoga for his recovery, and says that many fear trying the exercises due to lack of trust in their new knee. He has offered a sample plan for how to employ yoga in the recovery period of a knee replacement.

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December 2016


Hip, knee orthopedic surgical implants market to $33B by 2022 – 12/9/16

As demand for hip and knee replacement and implants rise, surgical technique and devices are making advances in quality, efficacy, and safety. This is seen in particular with implants, as the type of implant can now be chosen based on the patient’s specific needs and expertise of the surgeon. Patients of hip or knee replacements have experienced decreased post-operative pain, fewer readmissions to hospitals, and faster recoveries if implants are used. Reduced insurance payments have increased the cost of providing care, incentivizing surgeons to join Accountable Care Organizations (ACOs). When the ACO purchases a device it has more power in setting the cost, which combined with fewer device providers has reduced some of the costs of the implant devices. Despite this, rising demand overall particularly in the elderly population has lead to significantly higher profit margins in the last five years for insurance companies.

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Morton Grove Patients Climb Stairs…..30 Minutes After Hip Replacements! –  12/12/16

At Illinois Bone and Joint Institute’s offices in Morton Grove, Lincolnwood, and Des Plaines, Dr. Ritesh Shah has been practicing “Rapid Recovery Reality,” a form of hip replacement surgery that combines better patient preparation, improved anesthetic techniques, reduced narcotic use, and physical therapy 45 minutes after surgery to significantly reduce recovery time. Dr. Shah uses a three inch incision, careful lighting, and gentle retractions to keep the wound small, minimize muscle damage, and reduce invasiveness. After inserting a femoral stem and hip cup, Dr. Shah ensures that the hip’s alignment and leg length are perfect. Near immediate and continued physical therapy and reduced narcotics are also keys to success, ultimately saving costs by limiting the length of a hospital stay and recovery time.

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9th Annual Winter Hip & Knee Course

From January 12th to the 15th the 9th Annual Winter Hip & Knee Course will take place. Virtually every aspect of joint replacement will be examined through case-based panel discussions, video vignettes, and audience interaction focusing on the latest, cutting-edge procedures and technology for hip & knee arthroplasty. Issues like surgical environment, thrombosis, wound and pain management, blood conversion, quality, management and economics will be discussed as well.

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November 2016


Exercise program after knee replacement need not be intensive, 11/22/2016

A randomized trail out of the University of Sydney found that, when comparing standard post replacement rehabilitation, no significant differences occurred in activity ability, speed, strength, range of motion, or adverse events. While many did experience reduced pain, it was noted that to truly build up muscle strength exercise is needed for more than a year after a replacement.

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Men and Women show sex- specific improvements after hip replacement, may benefit from unique rehab approaches, 11/13/2016

Researchers at the university of Illinois at Chicago have found the outcomes, including pain, function, range of motion, and strength after hip replacements differ between men and women. Though the exact cause of this difference has not been determined, these findings may lead to the development of separate rehabilitation programs for men and women after hip replacements.

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Towards better hip replacements, 11/2/2016

A mechanical  engineer at McGill University has developed a hip implant that is porous, while still maintaining its strength. The implant would connect the femoral head to the artificial hip joint. This is believed to have an increased longevity and reduced adverse effects in patients as it mimics real bones, resulting in less breakdown of the living femur.

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AJRR announces 2016 annual report of hip, knee arthroplasty data, 11/11/16

This article summarizes and discusses the American Joint Replacement Registry Annual Report which was released this year. It discusses key information data on hip and knee joint replacements from across the country and shares information on the methods that were used to collect data, to conduct analysis and to disseminate findings through the report.

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Joint Replacement Numbers to Know, 11/11/16

This article, like the above one, shares details about The American Joint Replacement Registry Annual Report. It discusses results and findings from key demographic fields in joint placement procedures and related patient populations. It also provides a link for those interested in accessing the full report.

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October 2016


Nanofiber coating prevents infections of prosthetic joints, 10/24/2016

Scientists at Johns Hopkins University discovered a novel coating made with antibiotic-releasing nanofibers that can potentially better prevent serious bacterial infections related to total joint replacement surgery.

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Research finds no change in patient’s physical activity after hip replacement surgery, 10/24/2016

A study conducted at the University of East Anglia shows that patients are not engaging in more physical activity post-operation as compared to pre-operation, which suggests that patients may need to be encouraged by health professionals to be more physically active.

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Enhanced-recovery-after-surgery (ERAS) programs help patients prepare for surgery and recover faster, 10/24/2016

ERAS programs at healthcare centers across the country are helping patients better prepare for surgery and recuperate faster afterward. These programs employ a variety of methods to ease the effects of surgery and fast track patient recovery, which have a focus on pain control and patient education.

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Elective surgeries on Fridays are safe, 10/18/2016

A Canadian study sought to investigate the “weekday effect” whereby there is speculation that surgeons who operate on Fridays may be less experienced and inexperience may translate to worse outcomes. The study found that patients’ risk of death within 30 days of surgery was similar, no matter what weekday the procedure took place.

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September 2016


How 10 hospitals took their total joint replacement programs to the next level, 9/29/2016

Becker’s Hospital Review, a magazine for hospital business that highlights best practices and legal guidance regarding decision making, have released a list of 10 hospitals and health systems that have recently updated their joint replacement programs with new initiatives.

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How to control costs if you’re having hip replacement or knee replacement surgery, 9/15/16

Hip and knee replacement surgeries can prove too costly procedures that range from $16,500 to $33,000 based on geographic location. Bankrate, a consumer financial services company, has compiled a list of 6 helpful tips designed to control the costs of arthroplasty surgery.

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Is It Safe to Hit the Tennis Court with a New Hip? 9/20/16

Physicians are reporting seeing a wave of younger patients coming in for joint replacement surgery and returning to high impact sports. While these are possibilities, doctor’s point out that it is important for patients to consider their own contexts and what effects this might have on their arthroplasty outcome

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New NJR report highlights that patient factors can have major impact on revision of hip replacements, 9/13/2016

The National Joint Registry, a British governmental health agency, recently released its annual report that highlights patient factors affect how long an implant will last, with younger patients facing increased risks of having revisions.

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Who’s holding the knife? Growing number of surgeons expected to use robotic tools, 9/10/16

Who’s holding the knife? Growing number of surgeons expected to use robotic tools, 9/10/16Robotic-assisted technology is starting to move into specialty centers and hospitals around Minnesota. People who have used them report quicker recovery times and more predictable results.

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August 2016


Total knee replacement, 8/31/2016

A British orthopedic surgeon discusses and explains indications for total knee replacement surgery, post-surgical outcomes and complications that may arise.

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Medical tourism growing, but obstacles hamper trend in U.S. hospitals, 8/30/2016

Medical tourism, the process by which patients travel to other countries to receive treatments, is experiencing a huge growth. For patients in need of hip or knee replacement, medical tourism has become a popular option for obtaining a new joint at a much lower price.

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The American Joint Replacement Registry reaches half a million procedures, 8/25/2016

The American Joint Replacement Registry, a non-profit organization established to collect data to improve arthroplasty patient care, has announced that it has almost reached its goal of collecting data on all hip and knee replacement surgeries taking place in the United States.

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Clinical Studies Demonstrate ConforMIS iTotal CR Customized Knee Implants Provide Superior Outcomes and Potential for Economic Savings, 8/15/16

ConfoMIS, INc, a medical technology company that develops joint replacement devices that are customized based upon a patient’s specific anatomical structures, announced the test results from their latest device. According to their report, patients who were outfitted with the new device were discharged within 24-hours of their procedure and experienced a greater range of motion.

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Will ‘Unloading’ Shoes Help Your Arthritic Knees?, 8/12/2016

Many arthritis patients seek special footwear to minimalize the forces placed upon the affected knee in order to relieve pain. A recent study out of Australia investigated the benefits of modified footwear compared to traditional lace-up footwear on arthritic knees.

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Lara Spencer discusses hip replacement surgery on Good Morning America, 8/11/2016

Joint replacement surgery is commonly seen as a procedure for the elderly. However, Good Morning America’s host Lara Spencer recently underwent hip replacement surgery at 47 and is speaking about her experiences as a younger patient.

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How Common Procedures Became 20 Percent Cheaper for Many Californians, 8/8/2016

In 2011, the California Public Employees’ Retirement System (Calpers) implemented a policy that saw the prices for certain procedures, which included knee replacements, drop nearly 20%. This business model has the potential to save consumers more money while giving them the opportunity to “shop” around.

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Minorities less likely to have knee replacement surgery, more likely to have complications, 8/3/2016

According to a recent study, total knee replacements (TKR) surgeries have more than doubled since 1997, however minority populations are less likely to undergo TKR. For those who do, a greater risk of experiencing complications was reported.

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July 2016


Increased BMI, anxiety associated with higher total knee replacement-related costs, 7/22/2016

Arthroplasty surgery can be a costly process. A recent study found that people with a higher body mass index (BMI), younger age and elevated anxiety faced increased costs related to their replacement.

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Super-hard metal that is four times tougher than titanium could mean hip replacements will last forever, 7/22/2016

Titanium is an incredibly durable metal and the preferred metallic substance used in hip and knee replacements. However, scientists at Rice University, in Houston, Texas, have created a new metal that is four times harder than titanium and could last forever.

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Stem cells could replace hip replacements, 7/19/2016

Scientists at Washington University School of Medicine have successfully used stem cells to grow new cartilage on a model hip. These implications mean that a patient’s own cells might someday be used to repair a damaged joint.

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Hoag Orthopedic Institute Joins World Health Leaders In London to Drive Implementation of International Standards for Orthopedic Outcomes Measurement, 7/15/2016

The Hoag Orthopedic Institute, one of the largest providers of orthopedic care in the US, recently attended an international conference and proposed a set of standards for the measurement of hip and knee osteoarthritis outcomes.

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Researchers discover new genetic mutation linked to osteonecrosis of the hip, 7/14/2016

Scientists at McGill University Health Centre have discovered a genetic mutation linked to bone death in the hip. The implications of these findings may help doctors identify and treat the disease, which may reduce the need for hip replacements.

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Liposomal Bupivacaine After TKA Reduces Hospital Stay 7/12/2016

For patients undergoing arthroplasty, hospital stay and rehabilitation are important parts of the post-surgical process. However, a recent research study suggests that the injection of a particular post-surgical anesthetic may reduce time spent in the hospital and decrease the likelihood for rehab.

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June 2016


After joint replacement surgery, physical therapy is a necessity, 6/30/2016

Patients have many questions concerning physical therapy (PT) following joint replacement surgery. The following article explains that PT is a “necessity” and explores its benefits in depth.

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Your Risk of Infection After Knee Replacement Depends on Your Hospital, 6/29/2016

Many patients have questions and concerns prior to knee replacement surgery. Consumer Reports has released 8 critical questions to ask before surgery to ensure optimal outcomes and improve safety and care.

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Metal ions released by implant wear can damage progenitors of bone-forming cells, 6/22/2016

Patients have expressed their trepidations over metal on metal implant devices. According to the following article, researchers in Berlin found metal ions from devices could reach the bone marrow and inhibit bone cell growth.

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Jury still out on mortality benefits of knee replacement in OA, 6/15/2016

Patients undergo knee replacement surgery to relieve pain and increase mobility, the following articles suggests that patients might also benefit from a reduced mortality rate, however determining those benefits remains difficult.

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Introducing a Toolkit for Knee and Hip Replacement Patients, 6/9/2016

The National Blood Clot Alliance has released a toolkit for perspective arthroplasty patients with information about risks associated with these procedures so that patients can take necessary steps to prevent and treat blood clots.

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Ways to prevent, treat knee and hip joint pain, 6/8/2016

The following article describes ways to reduce joint and hip pain which may reduce immediate need for arthroplasty surgery.

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Patients with RA had better perioperative outcomes after THA, TKA vs controls, 6/3/2016

This article summarizes a research study from the Journal of Clinical and Experimental Rheumatology that suggests patients with rheumatoid arthritis who underwent Total hip and knee replacement surgeries experienced better outcomes opposed to those without RA.

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Artificial hip joints and obesity: Risk of complications rises with BMI but benefits predominate, 6/2/2016

This article summarizes a discussion by the European Federation of National Associations of Orthopedics and Traumatology (EFFORT) that explored the benefits of hip arthroplasty in obese patients along with special considerations that will improve their outcomes and experience.

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May 2016


Antioxidants may help total joint replacements last longer, 5/24/2016

This article summarizes a recently-released research study that suggests incorporating antioxidants into the surface of joint replacement devices may help them last longer and reduce destruction to the surrounding bone.

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Arthroscopic hip surgery on the rise, but study shows it may not be the best choice for patients with arthritis, 5/19/2016

While minimally invasive procedures are preferred over joint replacement, this article suggests that it may not be the best option for patients over 60 with arthritis.

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High incidence of pain common 1 year following TKA, 5/18/2016

This article describes pain experienced by total knee replacement patients after one year.

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Patients may not need to wait two weeks to shower following knee replacement surgery, 5/12/2016

This article discusses post-surgical wound care and avoiding infection in connection with showering guidelines for patients who have undergone knee replacement surgery.

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Ease the pain for National Arthritis Month, 5/10/2016

This is a brief article that discusses when joint replacement surgery may become necessary (hip and knee), what are other non-surgical interventions that may be suggested and what some life style changes may include to alleviate pain associated with joint inflammation.

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Joint replacement therapy: What to know, 5/2/2016

This article provides a brief summary of basic information to know about joint replacement including when it may become a necessary course of action for the patient.

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April 2016


Knee, hip replacements getting easier with 3D models, technology, 4/21/2016

Informative article about how new technology and 3D modelling and robotic surgery is making surgery more precise and recovery much faster.

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Why Medical Devices Aren’t Safer?, 4/18/2016

This article was published in the New York Times and raises important questions about why there is a lack of information regarding safety of medical devices and the importance of access to information about the same.

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Physical Therapy Underused for Knee Osteoarthritis, 4/14/2016

Informative article about the benefits of physical therapy for knee osteoarthritis and the underuse of therapy in favor of corticosteroid injections and surgery to address pain.

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New Medicare rules for hip, knee replacements take effect in Collier, 4/11/2016

This article discusses the potential implications of the new Medicare payment plan on patients who may need to undergo hip or knee surgery.

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March 2016


Health Report: Total Joint Replacement, 3/30/2016

Informative article, including a short video on the surgical procedure, improvements in the procedure and recovery time and issues for total joint replacement.

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An innovative Patient-Centered Total Joint Replacement Program, 3/28/2016

This article describes and discusses a program for joint replacement to address issues such as unmet patient expectations, patient satisfaction and decision making and the pre-authorization process.

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Bundled payments improve care for Medicare patients undergoing joint replacement, 3/2/2016

This article explains what ‘bundled payment plans’ comprise, and discusses the findings of a pilot program that examined the relation between bundled payments for total joint replacement and patient outcomes and quality of care.

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Halting or reducing opioids prior to hip or knee replacement surgery linked to fewer complications, improved outcomes and reduced post-surgical opioid use, 3/4/2016

This article examines the link between opioid use and patient outcomes based on research findings and studies.

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Survey: Most Hospitals Unprepared for Orthopedic Bundled Payments, 3/14/2016

This article discusses the importance of data analysis and patient reported outcomes data in understanding issues around cost and quality of care for the bundled payment system.

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February 2016


 

Burden of Joint Pain on the Rise –Dramatic increases in emergency visits and admissions, 2/22/2016

This article examines why emergency room visits by patients who are coping with Arthritis have dramatically increased and specifically with a lens on Nebraska.

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Patients benefit from one-on-one counseling session prior to knee or hip replacement surgery, 2/22/2016

This article discusses the benefits patients may accrue, from education about pre-operative and post-operative care in connection with hip and join replacement surgery in terms of outcomes. This article is a result of a study done by Hospital of Special Surgery (HSS)

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Healthy over 60: Knee, hip replacement surgery skyrockets, 2/16/2016

This article discusses the increase in the past few years in the rates of hip and knee arthroplasties. The article also talks about the evolution of surgical techniques and about implant devices.

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November 2015


 

CMS: New Model for Hip, Knee Replacement Payments, 11/17/2015

This article discusses the changes in pay structure implemented by Medicare to ensure and move toward better quality of care.

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Why patient-generated health data is critical to the process of care, 11/11/2015

This article discusses the importance of patient generated data and patient reported outcomes research in improving patient care.

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