ORTHO NEWS

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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Medical Minute: Joint Replacement Innovation

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by: Keni Mac, Sponsored by Colorado Springs Orthopaedic Group

Posted: Jul 22, 2022 / 02:20 PM MDT

Updated: Jul 22, 2022 / 02:20 PM MDT

In today’s Medical Minute, Orthopedic Joint Replacement Surgeon, Dr. Ted Stringer, with Colorado Springs Orthopaedic Group, dives into the the innovation of joint replacement over time. He explains that today’s advanced technology has improved the medical world greatly. Stringer says “digital” is the future of medical procedures.

Visit CSOG’s website to learn how you can schedule your next appointment.
Click here: CSOG.net.

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Originally Appeared Here

ROM Technologies: How Far Knee Recovery Technology Has Come

HARTFORD, CT, July 23, 2022 /24-7PressRelease/ — It is often said that a knee is simply not a knee post-surgery. As is the case with so many aspects of our lives and bodies that we take for granted. We scarcely realize how much pressure a joint like the knee must endure to keep us moving smoothly and pain-free. Of course, this is until something goes wrong and we need surgery to correct it.

While knee surgeries are sometimes the best option, they have come a long way. Improvements have been primarily due to the changes in medical knowledge and available technologies.

How ROM Technologies is Changing the Game

As stated prior, technology has done wonders to improve the results we experience from undergoing knee surgery. Much of this is due to changes in post-surgery knee recovery technology. ROMTech is a leading organization in pre-op and post-op knee surgery recovery.

Knee replacement is the most popular surgical option. In the past, this would leave recipients with stiff knees that would not help them move or function as efficiently as they desired. Today, the opposite is true.

Today, athletes can undergo knee replacement surgery and, with strategic rehabilitative work, find that they can work their way back to peak capacity. Thanks to leading medical technology organizations, having a knee rehabilitation resource helps ensure that patients can recover as quickly and efficiently as possible with smooth, pain free movement.

Knee replacement surgery no longer means that a sporting career has to end or that daily life has to be significantly hampered. Thanks to ROMTech’s work in producing high-quality joint replacement material, their work is not only limited to knees.

ROM Technologies PortableConnect actually used in both knee and hip patients rehabilitation as well. This makes sense, as a debilitatingly injured or arthritic hip can impact the knees negatively and vice versa. It makes sense that these key features of the lower extremities are considered in tandem.

How to Get Started Working with ROMTech

Since their PortableConnect device enables knee and hip recovery it is easy to see what their focus is on, improving quality of life. Sometimes people with knee and hip issues may be concerned with having to do a procedure.

However, the advancements in ROM Technologies help ensure that higher-quality replacements help reduce the likelihood of the same. As such, they encourage anyone who may need replacement surgery (irrespective of age or even profession) to have it done sooner rather than later.

—
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“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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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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A Less Invasive Hip Replacement

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“How long will it take for me to recover from a total hip replacement surgery?” That’s the No. 1 question patients ask Dr. Logan Cooper, a fellowship-trained total joint and reconstructive specialist and orthopedic surgeon at East Falls Orthopaedics. Thanks to an advanced, minimally invasive approach to total hip replacement surgeries, Dr. Cooper assures patients that recovery is quicker than ever.

“It’s a difficult question to answer because every person is different and there’s not a clear moment when a person can declare they’ve recovered. So, I tell patients that 80 to 90 percent of recovery occurs during the first 6 weeks; then it takes several months to get that last 10 to 20 percent,” Dr. Cooper said. “But the good news is that research and literature consistently show a quicker and easier recovery for patients who undergo an anterior approach to total hip replacement.”

An anterior approach means the surgeon accesses the damaged ball-and-socket joint by entering from the front of the hip. With the frontal entry point, the surgery is minimally invasive, only requiring one small incision and muscle-sparing, as surgeons don’t need to cut through muscle at all.

“Because I don’t cut muscle to access the hip joint, patients have a less painful recovery and they can tolerate activities earlier and have fewer restrictions post-operatively,” Dr. Cooper explained.

Benefits of an anterior approach to hip replacement surgery include:

Earlier hospital discharge, with some patients returning home the same day
Less postoperative pain
Faster recovery times
More functionality during recovery at home
Lower risk of a persistent limp after surgery
Lower risk of hip dislocating after surgery

During the procedure, an orthopedic surgeon replaces the patient’s worn-out or damaged bone and cartilage with a prosthetic implant made of metal, ceramic and hard plastic. The surgery takes a few hours, and patients begin walking with assistance on their new hip soon after they’re awake and alert.

One caveat with the anterior approach to total hip replacement surgery: Patients need a surgeon trained, experienced and confident with the more complex method.

“It’s a difficult procedure to learn. Make sure your orthopedic surgeon is trained and comfortable with an anterior approach, and that he or she performs the surgery frequently enough to stay comfortable with it,” Dr. Cooper said.

For example, Dr. Cooper dedicated years to specialized training and additional education focused on the anterior hip replacement approach so that he can offer superior surgical care to patients. As the specialized joint replacement orthopedic surgeon at his clinic, he performs multiple anterior approach hip replacements every week.

“I received training in the approach from the first year of residency through my fellowship, so I’ve become very comfortable with it and am extremely pleased with my patients’ results,” Dr. Cooper said.

Results confirm that patients who undergo total hip replacement surgery with an anterior approach walk away with renewed quality of life and less pain.

“It’s so gratifying to me and the patient to see such immediate results. I treat people who have suffered chronic pain in the hip for so long that it becomes debilitating. They come to me unable to participate in activities that bring them joy in life. Then the same day we do surgery, those patients tell me how much better they feel and that their troublesome arthritic pain is gone,” Dr. Cooper said.

Arthritic damage is the most common reason people need a total hip replacement. Although arthritic pain typically worsens over time, physicians can provide patients with a variety of helpful treatment options to alleviate pain before considering surgery.

“That’s why I prefer it when a patient comes to see me as soon as they begin having hip pain,” Dr. Cooper said. “We can start with non-surgical conservative care like physical therapy, anti-inflammatory medication and weight loss. There’s not a one-size-fits-all treatment plan. It’s best to tailor our approach to an individual’s situation and needs.”

If you’re ready for relief from hip pain, schedule a consultation with Dr. Cooper at East Falls Orthopaedics, by calling 208-535-4580.

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MedWatch Today: Why Physical Therapy is So Important After an Orthopedic Surgery

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After a surgery, having a personalized physical therapy plan can help ensure your body heals properly.

At Community Health System, patients who undergo orthopedic surgery are encouraged to move within the first day after their procedure. Our physical therapists help patients strengthen their muscles around their new joint and help regain motion.

Fresno resident Michael Yamane spends lots of time at the outpatient physical therapy facility at Clovis Community Medical Center. He’s a FedEx employee and had shoulder surgery last November, and hip surgery this past Spring.

“We do a lot of heavy lifting, so I was loading trucks before all this happen, so I was loading the trucks… TV’s and furniture and swimming pools and all those big heavy things,” described Michael.

Michael explains, after his total hip replacement surgery on his left hip, “The next morning they tried to get you propped up and standing and see if you can step you know I did that slowly,”

Michael works with physical therapist Erika McFarland.

“At Community we have a total joint replacement program, and that’s where the patient is informed prior to going into the surgery they’re informed about what to expect for the surgery and then as far as what to expect afterward as far as rehabilitation goes,” stated Erika.

Erika said when post-surgery patients are in the hospital, a team of physical therapists will help them start to slowly move. Patients walk at first with the help of a walker or crutches.

She continued, “After you’re done at the hospital, then we are able to determine if you need to go home for a little bit more therapy at home, or if you’re high enough functioning, then you can transition into an outpatient physical therapy program.”

In the outpatient physical therapy facility, Erika works with Michael on strengthening and endurance.

“I did a lot of stretching and balancing and just getting my normal rhythm back,” said Michael.

Erika explained, “For balance in particular, we worked on single leg balance, so I have him stand at a counter so he can hold on if he needs to… And that not only helps the hip joint but also his ankle his knee even his core… For his strengthening, we did some squatting, we did some work on the machines, we did like the leg press for him, we had him do hamstring curls.”

Erika said it’s crucial that post-surgery patients stick to their rehabilitation plan because it will help them heal safer and faster. It’s also important to practice what they learn here at home.

“We can help give you the tools to specifically help the muscles that are weak, or the muscles that are tight, or the different joints that need that better movement,” said Erika.

“It helped me gain confidence and I can feel more strength in my legs and before I couldn’t even push myself,” ended Michael.

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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

Improved outcomes for joint replacement patients as short-stay program rolled out

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Orthopaedic surgeon Dr Damian Smith is now offering an Enhanced Recovery Joint Replacement program in Canberra. Photo: InMotion Orthopaedics.

Healthy patients can expect to go home just one or two days after knee or hip replacement surgery following the introduction of an Enhanced Recovery Joint Replacement (ERJR) program in Canberra.

Orthopaedic surgeon Dr Damian Smith and his team from InMotion Orthopaedics and Physiotherapy are working with hospitals to offer patients the short-stay option.

Dr Smith says patients are keen to get home to their families and their own beds following surgery, and the new program provides them with that opportunity.

Two Canberra patients have already been through the pilot program, coming out the other side with a new lease of life.

Dr Smith says with good preoperative preparation and postoperative support, healthy patients can be discharged from hospital the day after surgery and begin their road to recovery.

“Patient preparation, communication and a great medical and family support network is crucial to the success and optimisation of care,” he says.

“We hold sessions with patients before surgery, which includes preoperative conditioning and strengthening exercises, education and familiarisation with mobility aids.

“The day after the operation, the patient is assessed and, if they are ready and want to go home, they will be fully prepared mentally and physically, and will know what they need to do, such as exercises and using crutches.”

Dr Smith says communication with all parties is essential, and his team has been working closely with hospitals to develop the program, which is being rolled out in Canberra this month.

“Underpinning the success of these programs is the involvement and communication of a multidisciplinary team, including the surgeon, the anaesthetist, allied health, hospital admissions and nurses,” he says.

With waiting lists growing and more people seeking joint replacements, the short-stay program will benefit patients, as well as reducing health costs to the broader community.

READ ALSO: Sport set the wheels in motion for Canberra orthopaedic surgeon

According to the Australian Orthopaedic Association National Joint Replacement Registry, there were more than 51,000 total hip replacements and more than 66,000 total knee replacements carried out in 2019, and Dr Smith says, with an ageing population, demand for these procedures is expected to increase.

He says advances in surgical techniques, anaesthetics and optimisation of pain management has enabled the development of ERJR programs which “aim to improve patient recovery and minimise complications from prolonged hospital stay”.

“Several studies have shown no significant difference in complication or readmission rates with short-stay replacement surgery,” says Dr Smith.

“One study showed a 50 per cent reduction in minor complications and no difference in major complications to traditional longer hospital stay joint replacement programs.”

However, not all hip and joint replacement patients will be eligible for the short-stay option.

They must not have any significant co-morbidities or physical or mental health conditions that would prevent early mobilisation; they must have a body mass index (BMI) below 40; and must have a suitable home environment, which includes being close to a hospital, and having a relative or friend available to assist with care.

Dr Smith says patients opting for ERJR will not be “shunted out the door” after surgery. They can leave hospital when they feel confident.

The program doesn’t change the cost for private hospital patients, and Dr Smith believes it could reduce public health costs as well as waiting lists if it is rolled out to public hospitals in the future.

To find out more about the Enhanced Recovery Joint Replacement program, contact the team at InMotion Orthopaedics.

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AAOS releases new trends and outcomes reports from the American Joint Replacement Registry and the Shoulder & Elbow Registry

ROSEMONT, Ill., Aug. 31, 2021 /PRNewswire/ — The American Academy of Orthopaedic Surgeons (AAOS) Registry Program is pleased to announce the availability of two new clinical data reports – the American Joint Replacement Registry Program (AJRR) 2020 Annual Report Supplement and the Shoulder & Elbow Registry (SER) 2020 Annual Report. The reports, which were released during the AAOS 2021 Annual Meeting in San Diego, offer actionable information to guide physicians and patient decision making to improve care.

“There’s great momentum across the AAOS family of registries,” said William J. Maloney, MD, FAAOS, chair of the AAOS Registry Oversight Committee. “The number of anatomical areas and procedures covered continues to grow and the data being submitted by participating sites is paving the way for improved orthopaedic outcomes in the United States. We are pleased to publish these clinical insights from the AJRR and the SER and look forward to seeing continued growth and increasingly impactful analyses in the years ahead.”

AJRR 2020 Annual Report Supplement
Data presented in the 2020 AJRR Annual Report Supplement were submitted to the AJRR by 1,110 institutions through June 2020, covering procedures from 2012 to 2019. For the second consecutive year, the supplement includes reporting of device-specific cumulative percent revision estimates, drawn from the registry’s unique linkage with Centers for Medicare and Medicaid Services (CMS) claims data. In addition, analyses in the 2020 supplement were expanded to include many more devices than the 2019. This year’s analysis also examines cumulative, all-cause revision at target timepoints with further stratification of devices based on fixation and bearing descriptions.

This report found all hip device constructs included in analysis had a cumulative percent revision of less than 2.7% at one year and less than 4.6% at final follow-up for each respective device. Knee device constructs included in analysis were found to have less than 2.5% cumulative percent revision at three years and less than 3.7% at final follow-up for each respective device

To read and download the 2020 AJRR Annual Report Supplement, visit the AAOS’ website.

Shoulder & Elbow Registry Second Annual Report
The SER includes representatives from the American Shoulder and Elbow Surgeons (ASES), the American Orthopaedic Society for Sports Medicine (AOSSM), the Arthroscopy Association of North America (AANA), and the American Society for Surgery of the Hand (ASSH). The SER collects shoulder and elbow procedural data in the United States to establish survivor curves, track revisions, and support orthopaedic care and best practices. The program’s latest annual report represents submitted shoulder and elbow procedures dating from 2015 through 2020.

“The AAOS Shoulder and Elbow Registry is one of the most important endeavors being undertaken in shoulder and elbow surgery,” said SER Steering Committee member Stephen F. Brockmeier, MD, FAAOS. “This data will drive future clinical care, answer critical questions and contribute to research in the field, and dramatically enhance our ability to provide optimal outcomes for our patients. As can be seen in the 2020 SER Annual Report, the Registry data continues to accumulate at a rapid pace, and new procedures are added for study each year.”

To date, there are more than 112 SER participating facilities including hospitals, private practices, and ambulatory surgical centers spanning 35 states across the United States. To read and download the complete 2020 SER Annual Report, visit the AAOS’ website.

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AAOS Registry Program
The AAOS Registry Program’s mission is to improve orthopaedic care through the collection, analysis, and reporting of actionable data. The American Joint Replacement Registry (AJRR), the Academy’s hip and knee replacement registry, is the cornerstone of the AAOS’s Registry Program, and the world’s largest national registry of hip and knee joint replacement data by annual procedural count, with more than 2.4 million procedures contained within its database. Additional registries include the Fracture & Trauma Registry, the Musculoskeletal Tumor Registry (MsTR), the Shoulder & Elbow Registry (SER), and the American Spine Registry (ASR), a collaborative effort between the American Association of Neurological Surgeons (AANS) and the AAOS.

About the AAOS
With more than 39,000 members, the American Academy of Orthopaedic Surgeons is the world’s largest medical association of musculoskeletal specialists. The AAOS is the trusted leader in advancing musculoskeletal health. It provides the highest quality, most comprehensive education to help orthopaedic surgeons and allied health professionals at every career level best treat patients in their daily practices. The AAOS is the source for information on bone and joint conditions, treatments, and related musculoskeletal health care issues, and it leads the health care discussion on advancing quality.

https://www.aaos.org/

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