joint replacement

Comprehensive care program helped reduce some racial disparities after hip and knee replacement

Newswise — April 18, 2022 – A “bundled care” Medicare program to improve care for patients undergoing hip or knee replacement surgery has led to reductions in some outcome disparities for Black compared with White patients, suggests a study in The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

The introduction of Medicare’s Comprehensive Care for Joint Replacement (CJR) Model coincided with a reduction of racial differences in hospital readmission rates after hip or knee replacement surgery, according to new research by Calin Moucha, MD, Jashvant Poeran, MD, PhD, and other colleagues at the Icahn School of Medicine at Mount Sinai, New York.

Despite gains, racial differences persist in patient characteristics and outcomes

With use of nationwide Medicare claims data, the researchers analyzed disparities between Black and White patients undergoing total hip or knee replacement surgery, before and after rollout of the CJR Model in 2016. Under the CJR Model, health-care organizations receive a single “bundled” payment for all services throughout an episode of care – from the initial hospitalization to 90 days postoperatively – providing incentives to reduce costs while improving quality of care.

The study included data on nearly 1.5 million hip or knee replacement surgeries performed from 2013 to 2018. About 5% of patients were Black.

The analysis showed substantial racial differences in patient characteristics, outcomes, and Medicare payments, both before and after implementation of the CJR Model. As a group, Black patients had higher rates of other health problems, received more blood transfusions, spent more days in the hospital, and were more likely to be discharged to an institution (such as a skilled nursing facility), rather than being sent directly home.

The CJR program led to improvements in several key outcomes, some of which differed by race. After adjustment for other factors, White patients who were managed under the CJR approach had reductions in length of hospital stay, complication rate, risk of hospital readmission within 90 and 180 days, discharge to institutional care, and Medicare payments to skilled nursing facilities.

Some of the improvements were greater among Black patients. In particular, Black patients had larger reductions in 90-day and 180-day hospital readmission rates, as well as in Medicare payments related to outpatient care.

The greater benefits among Black compared to White patients suggest that the CJR program has improved some pre-existing racial differences. “These observed racial differences may represent true ‘disparities’ as some may not be attributable to clinical factors and may be directly associated with poorer outcomes,” the researchers write.

Dr Moucha comments, “This is an important finding as it provides insights on how to effectively reduce these disparities that we know are widespread, not just on orthopaedics, but in medicine in general.”

Dr. Poeran adds, “These results indeed seem promising, but we do have to consider alternative perspectives and explanations of our results. For example, although the effects on readmission rates are promising, the difference in payments for outpatient care – where we saw lower Medicare payments for Black patients – may also indicate potential under-utilization of postdischarge care in certain subgroups.”

Together with some previous reports of outcomes after introduction of the CJR Model, the new findings “support the notion of adapting and leveraging the bundled payment program design to reduce disparities in [total hip and knee replacement] care and outcomes,” the researchers write. They note that their study could not demonstrate a causal relationship between the CJR Model and the observed improvements in patient outcomes.

“A first step toward reducing racial differences that represent disparities […] is to understand the sources of these disparities,” Dr. Poeran and colleagues conclude. They call for further studies to evaluate the potential of bundled payment models to reduce racial disparities, and the mechanisms by which they do so.

Click here to read “Racial Differences in Care and Outcomes After Total Hip and Knee Arthroplasties: Did the Comprehensive Care for Joint Replacement Program Make a Difference? “

DOI: 10.2106/JBJS.21.00465

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About The Journal of Bone & Joint Surgery

The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.

About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2020 annual revenues of €4.6 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,200 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

For more information, visit www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

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Originally Appeared Here

“Smart knee” technology allows knee replacement patients to actively engage in their care

As intelligent, connected technology becomes more prevalent in every aspect of our daily lives, it’s probably no surprise that apps and digital feedback are becoming a part of the high-tech world of orthopaedic surgery.

Vail-Summit Orthopaedics & Neurosurgery is currently offering a one-of-a-kind, interconnected pair of all-new tech tools which promise to significantly and proactively improve the outcome of knee replacement patients.

Dr. Nathan Cafferky, a well-respected total joint surgeon and partner in VSON, is one of the first surgeons in the country to use the Persona IQ® “smart knee,” an FDA-approved knee replacement prosthetic that has been very subtly implanted with a data-sharing unit.

Dr. Nathan Cafferky uses technology, such as the smart knee or robotics systems routinely in his surgical procedures, to help him and VSON stay on the cutting edge of patient-focused care.

When used in conjunction with the mymobility® app that many of VSON’s patients already use on their smartphones to prepare for and recover from knee surgery, Cafferky says the combination allows patients to more accurately gauge their success and set goals for themselves throughout their recovery.

“The smart knee appeared in the last six or months or so, and it’s a game-changer, especially for those who are super-into new technology,” Cafferky says. “It gives you real-time feedback on your recovery: your steps, your biometrics and range of motion.”

mymobility, he explains, still works very well as a tool for patients to understand the stages of their pre- and post-surgical progress, but it tends to simply provide passive information. The smart knee, equipped with a tiny RF-frequency transmitter, delivers data on strain, stride, strength and other biometric details to a HIPAA compliant cloud-based platform that can only be accessed by you and your healthcare team. It does not collect data on your location– Cafferky jokes that he cannot use the implant to see if you are at Wal-Mart.

That data can be used to track recovery and help patients set goals for themselves. “But it can also point out other important issues,” he adds. “For example, it can tell us if the implant is not working because of infection, loosening of components or failure.”

**The smart knee is a game-changer in healthcare. It gives you real-time feedback on your recovery: your steps, your biometrics and range of motion.**

While total joint surgery has become a very common procedure in recent years, Cafferky says VSON’s objective is better outcomes for everyone. Technology, such as the smart knee or the robotics systems he routinely uses in his surgical procedures, help him and VSON stay on the cutting edge of patient-focused care.

In the case of the new smart knee, Cafferky says the instantaneous nature of its digital feedback can be an invaluable tool to help patients monitor their progress and see how an active post-surgical regimen will contribute to their recovery.

“The implant software even uses predictive analysis and artificial intelligence to tell the patients that if they take 500 steps today, there’s a 90% chance of them being much improved in two months,” he notes. “It helps point out trends to help people stay on the right path, and it gives more patients the confidence in their care.”

Those affirmations are part of VSON’s overall objectives for its patients, and Cafferky says the interconnected tools represent another aspect of the organization’s mission of helping patients comfortably and quickly return to their normal routines.

Cafferky admits the smart knee concept is not for everyone, but he says that patients who’ve embraced everything from self-driving cars to a range of home high-tech devices have been very excited by Persona IQ and other similar biotech looming on the horizon.

“This technology is sort of like a pacemaker for the knee, but we get to be connected to the patient every step of the way. This is how we get healthcare innovation.”

So far, Cafferky has had two patients implanted with the prosthetic, and plenty more signed up – of the 100 or so smart knee surgeries done in the US so far, most have been in Colorado, he says.

“New ideas like this generate more excitement, and as always, the goal is to help patients thrive, succeed and feel more engaged in their recovery.”

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Originally Appeared Here

INOV8 Surgical Performs First Surgery using THINK Surgical’s Next-Generation Robot Technology for Knee Replacement

FREMONT, Calif., Aug. 26, 2021 /PRNewswire/ — THINK Surgical, Inc., an innovator in the field of orthopedic active robot surgery, is pleased to announce that INOV8 Surgical is the first healthcare facility to utilize the second-generation TSolution One® Total Knee Application for total knee arthroplasty (TKA). Stefan Kreuzer, M.D., orthopedic surgeon, and the founder of INOV8 Orthopedics, performed the first procedure with the new system on August 24^th at INOV8 Surgical Ambulatory Surgery Center (ASC) in Houston, Texas. THINK’s TSolution One system is the only robot system for TKA that supports an open implant library, giving surgeons the largest choice of implant options from different manufactures facilitating broad patient customization.

“My team and I are pleased to offer our patients the accuracy and reproducibility made possible in joint replacement procedures by THINK Surgical’s next-generation active robot,” said Dr. Kreuzer*. “Adoption of this advanced technology demonstrates our commitment to deliver exceptional outcomes for our patients.”

Dr. Kreuzer incorporated the first-generation TSolution One system into the INOV8 Surgical orthopedics program in early 2020, shortly after initial FDA clearance. INOV8 Surgical is a leading healthcare facility specializing in outpatient total joint procedures.

“We are very excited to have our latest robotic technology available to patients through the INOV8 Surgical ASC,” said Jay Yang, acting CEO and COO of THINK Surgical, Inc. “Our innovative engineers continue to advance robotic orthopedic surgery as demonstrated by our next-generation system and by future product launches.”

The TSolution One system consists of TPLAN^®, a 3D pre-surgical planning workstation, and TCAT^®, an active robot. Pre-surgical planning allows the surgeon to design and prepare the patient’s personalized joint replacement surgical plan in a virtual environment. The active robot aids the surgeon in executing the preoperative surgical plan with precise, automated cutting and removal of the diseased bone and cartilage. The TSolution One system assists surgeons with optimizing joint implant placement based on each patient’s unique anatomy.

About THINK Surgical^®, Inc.
THINK Surgical, Inc., a privately held U.S.-based medical device and technology company, develops, manufactures, and markets active robotics for orthopedic surgery. The core technology of the TSolution One system has been used in tens of thousands of successful total joint replacements worldwide.

The TSolution One system is the only robot available for total joint replacement procedures that features an open implant library.

THINK Surgical actively collaborates with healthcare professionals around the globe to refine of our orthopedic products, improving the lives of those suffering from advanced joint disease with precise, accurate, and intelligent technology. Please refer to the instructions for use for the TSolution One system for a complete list of indications, contraindications, warnings, and precautions. For additional product information, please visit www.thinksurgical.com.

*Dr. Kreuzer is a paid consultant of THINK Surgical.

Media Contact
Sheri Hensley
SHensley@thinksurgical.com
510-602-0951

(PRNewsfoto/THINK Surgical, Inc.)

View original content to download multimedia:https://www.prnewswire.com/news-releases/inov8-surgical-performs-first-surgery-using-think-surgicals-next-generation-robot-technology-for-knee-replacement-301363227.html

SOURCE THINK Surgical, Inc.

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Originally Appeared Here

Same-day knee, hip replacement surgeries becoming the new norm

It’s difficult to manage when the knee or hip joint you demand so much of fails you. Good joint health is important so you can remain mobile, but we tend to do nothing for our knees or hips until the pain becomes too much to bear.

David J. Peterson, DO, orthopedic knee and hip replacement specialist at Bingham Healthcare Orthopedics & Sports Medicine, offers an effective and minimally invasive solution to help patients find relief from pain: same-day knee and hip replacements.

“Having a total or partial knee or hip replacement once meant patients had to stay in the hospital for several days,” says Dr. Peterson. “With recent improvements in technology and surgical techniques, I have the ability to perform knee and hip replacements much more effectively and efficiently. After the surgery, many patients can go directly home to recover.”

Bingham Healthcare Orthopedic & Sports Medicine is proud to offer same-day knee and hip replacements. Dr. Peterson was the first surgeon in Idaho to perform a robotic-assisted total knee replacement. Since that time, he has performed over 1,000 knee and hip replacements using robotic technology, more than any other surgeon in the Intermountain West. In addition to Idaho, his patients have come from Utah, Wyoming, Montana, Oregon, Washington, and Nevada, and from even as far away as the East Coast.

Research has shown the Mako system to be the most accurate, most reproducible, and safest way to perform hip and knee replacement surgeries. “Mako robotic-arm assisted hip and knee surgery has dramatically changed the way joint replacement procedures are performed, by providing each patient with a personalized surgical experience based on their specific diagnosis and anatomy,” says Dr. Peterson. “With the use of a virtual 3D model, the Mako system allows me to create each patient’s surgical plan pre-operatively, before the patient even enters the operating room.”

During surgery, the surgeon can validate that plan and make any necessary adjustments while guiding the robotic-arm to execute the procedure exactly as planned. Because every surgery is customized to the meet the needs of each patient, this makes them less invasive.

In addition, pain management has changed. We used to rely on strong pain medications, which can have undesirable side effects. We now offer non-narcotic pain blocks around the hip or knee joint, significantly reducing the need for narcotics and allowing patients to walk and perform stairs within a few hours after surgery.

“I also feel more comfortable sending many patients home the same day of their surgery because home health services have evolved greatly,” says Dr. Peterson. In the past, many patients were sent to rehab centers for several weeks to recover. “Research has shown that patients recover a lot faster in their own homes. There’s less chance of infection, they sleep better, and they feel safer, more secure, and comfortable in their own environment, surrounded by family.”

While a same-day, or outpatient, knee or hip replacement certainly has its advantages, don’t expect to fully resume your normal daily activities within a week or two after surgery. Healing takes time and patience. The damage to your joint happened over time; recovery and healing will take time as well.

“It’s exciting to be able to offer same-day knee and hip replacements surgery options throughout the region,” says Dr. Peterson. “Especially because it’s less daunting for patients and I know how much this surgery can change someone’s life for the better.”

Meet Dr. David J. Peterson

As a leading orthopedic surgeon in Eastern Idaho, Dr. Peterson specializes in arthritis and minimally invasive joint replacement for the knee and hip, including partial knee resurfacing. He is board certified in orthopedics and fellowship trained in knee and hip replacement.

He sees patients in Pocatello, Blackfoot, and Idaho Falls. If you have questions about your knee or hip health, or are ready to find relief from constant knee or hip arthritis pain, call (208) 782-2999 to schedule an appointment.

Originally Appeared Here