Abstract：
:In the United States, demand for total hip arthroplasty (THA) and THA revision procedures are increasing due to an aging population, a longer life expectancy, and an increasing prevalence of osteoarthritis. This retrospective cohort study identified patients 65 years and older in the Medicare 5% Standard Analytic Files who underwent THA for osteoarthritis between January 1, 2009, and September 30, 2010. The authors estimated the 5-year cumulative revision risk (CRR) using the Kaplan-Meier method, revision-related complications, and Medicare expenditures. Using a 6.22% compound annual growth rate from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality, the authors estimated the number of THAs that will be performed from 2018 to 2027 and calculated the 10-year projected savings to Medicare for a 1% reduction in CRR. Among 7820 patients, the mean age was 74.4 years, and 62.4% were female. Cumulative revision risk was 4.2% at 5 years (through September 30, 2015), with 30.8% of revisions occurring within 90 days of the THA. At least 24.4% of revision patients had a complication. Median revision inpatient stay and episode of care (through 90 days) expenditures were $23,847 and $36,157, respectively. With a 1% absolute reduction in CRR, Medicare could save $697 million over a 10-year period, or $985 million when including Medicare Advantage, which represented 29.2% of 2016 Medicare payments. Strategies to reduce the risk of THA revision, such as the use of implant constructs with lower CRR and value-based payment models, are needed to achieve Medicare payment reductions while maintaining or improving quality of care for Medicare beneficiaries. [Orthopedics. 2019; 42(1):e86-e92.].
journal_name
Orthopedicsjournal_title
Orthopedicsauthors
Ackerman SJ,Knight T,Wahl PMdoi
10.3928/01477447-20181120-03subject
Has Abstractpub_date
2019-01-01 00:00:00pages
e86-e92issue
1eissn
0147-7447issn
1938-2367journal_volume
42pub_type
杂志文章相关文献
ORTHOPEDICS文献大全abstract：:The purpose of this study was to examine the acute outcomes and mortality rates of an Advanced Trauma Life Support guideline approach for managing hemodynamically unstable pelvic ring injuries. We retrospectively reviewed the acute outcomes of 48 consecutive patients with hemodynamically unstable pelvic fractures. Pat...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20120222-29
更新日期：2012-03-07 00:00:00
abstract：:The contact stress produced in the tibiofemoral joint from a varus-tilted tibial component was tested in five total knee prostheses. Peak and mean stresses were measured with a digital electronic sensor under compressive load at 15 degrees and 90 degrees flexion. Stresses were measured with the tibial component tilted...
journal_title：Orthopedics
pub_type： 杂志文章
doi：
更新日期：1999-03-01 00:00:00
abstract：:Twenty-one quadricepsplasty procedures were carried out on 21 patients over a 14-year period due to posttraumatic stiffness of the knee joint. Three patients (14.2%) required mobilization under anesthesia in the early postoperative period. The average interval between injury and quadricepsplasty was 18 months (range: ...
journal_title：Orthopedics
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
abstract：:Ankylosing spondylitis is a disease in which inflammation of joints, most often in the axial skeleton, can lead to reactive fibrosis and eventual joint fusion with associated immobility and kyphosis. The disease often involves extra-articular features, such as uveitis and aortic regurgitation, as well as associated in...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20140124-27
更新日期：2014-02-01 00:00:00
abstract：:This article describes the case of a 69-year-old patient with an occult acetabular fracture complicated by an ipsilateral femoral neck fracture occurring within 2 months. The acetabular fracture remained undiagnosed at examination due to insufficient clinical and radiographic data interpretation. The patient was assur...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20090624-28
更新日期：2009-08-01 00:00:00
abstract：:Posterior tibialis tendon rupture is a diagnosis that is often missed in sports-related injuries. This is thought to be secondary to the nonspecific clinical findings in healthy, active individuals, and the lack of any laboratory or radiographic test to reliably confirm the diagnosis. We report five cases of surgicall...
journal_title：Orthopedics
pub_type： 杂志文章
doi：
更新日期：1995-08-01 00:00:00
abstract：:Conservative management is typically recommended for postpartum diastasis of the pubic symphysis, despite significant functional disability and chronic pain associated with this condition. With a reported incidence of 1:500, the authors describe diagnosis and management controversies with an additional review of relev...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20160307-02
更新日期：2016-03-01 00:00:00
abstract：:We report a case of a skeletally immature achondroplastic adolescent with significant thoracolumbar lordosis who presented with neurogenic claudication and urinary incontinence progressing over a 1-year period. She underwent decompressive lumbar laminectomy from T12 to L5 with preservation of the facet joints. Over th...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20080201-01
更新日期：2008-02-01 00:00:00
abstract：:The purpose of this study was to evaluate the outcomes of patients undergoing subpectoral biceps tenodesis for bicipital tendonitis with a superior labral anterior-posterior (SLAP) tear. Patients undergoing primary subpectoral biceps tenodesis for arthroscopically confirmed SLAP tears with signs or findings of bicipit...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20150105-60
更新日期：2015-01-01 00:00:00
abstract：:Implant-associated infection is one of the most devastating complications following orthopedic surgery. Early identification is crucial for treatment. Currently, however, a reliable diagnostic tool is lacking, partly due to disparate bacteria colonies (virulent vs non-virulent), difficulty in distinguishing infection ...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20210104-07
更新日期：2021-01-07 00:00:00
abstract：:There is no mystery regarding the allure of metal-metal bearings: high stability and low wear potential. The special risks associated with these bearings are coming into focus and include a macrophage response to excessive metal particles (metal reactivity) and a lymphocyte-dominated reaction (metal sensitivity). The ...
journal_title：Orthopedics
pub_type： 杂志文章,评审
doi：10.3928/01477447-20090728-06
更新日期：2009-09-01 00:00:00
abstract：:Halo-vest orthoses have been associated with complications. Previous reports have suggested increased complications in elderly patients; however, data are limited. This study reviewed 75 patients =/>65 years with cervical spine fractures treated with halo-vest orthoses. Forty-one patients (55%) experienced at least 1 ...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20080501-35
更新日期：2008-05-01 00:00:00
abstract：:This article describes a new alternative technique for stabilization of unstable sacroiliac injuries using the Texas Scottish Rite Hospital (TSRH) instrumentation. The TSRH instrumentation was applied in 14 consecutive patients with unstable posterior pelvic ring disruptions. All patients underwent follow-up for an av...
journal_title：Orthopedics
pub_type： 临床试验,杂志文章
doi：
更新日期：2000-04-01 00:00:00
abstract：:Although distal humeral fractures are well described in the literature, concomitant distal triceps avulsion has not previously been reported. One population that warrants a high index of suspicion for tendon injury after trauma is patients with renal disease. Clinical tests on such patients may yield equivocal results...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20100129-26
更新日期：2010-03-01 00:00:00
abstract：:Rupture of the distal biceps tendon most commonly is secondary to mechanical overload during eccentric muscle contraction. Due to deficits of strength and endurance, surgical repair usually is recommended. Although both single- and double-incision approaches have been described, double-incision techniques have been sh...
journal_title：Orthopedics
pub_type： 杂志文章,评审
doi：10.3928/01477447-20190723-05
更新日期：2019-11-01 00:00:00
abstract：:Aseptic loosening is a common cause of long-term failure of cemented femoral components in hip arthroplasty. Initiation of aseptic loosening has been associated with suboptimal cement mantle thickness and uniformity with the resultant progressive development of detrimental cement mantle defects. Long-term success is h...
journal_title：Orthopedics
pub_type： 杂志文章
doi：
更新日期：2005-08-01 00:00:00
abstract：:Outcomes after lumbar disk herniation in baseball athletes are currently unknown. It has been postulated that the repetitive torque-producing motions of a baseball player may have negative implications after a disk injury. Sixty-nine lumbar disk herniations (40 treated operatively, 29 nonoperatively) in 64 professiona...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20111122-40
更新日期：2012-01-01 00:00:00
abstract：:Clavicle fractures are rarely associated with more severe neurologic or vascular injuries. When these associated injuries are encountered, prompt recognition and treatment are paramount to optimize outcome. The majority of fractures that result in neurovascular compromise are from high-energy trauma; however, a high i...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20110826-31
更新日期：2011-10-05 00:00:00
abstract：:One hundred seventy-five threaded titanium alloy prostheses (TTAP) acetabular cups and 125 cemented cups were evaluated clinically and radiographically at 1 to 3 years postoperatively. The series was statistically different in that there were more women in the cemented group than in the non-cemented group (P less than...
journal_title：Orthopedics
pub_type： 杂志文章
doi：
更新日期：1989-09-01 00:00:00
abstract：:Soft-tissue chondromas are rare and benign soft-tissue tumors. Over 95% occur in the hands and feet. They are seen in both sexes equally and mainly occur in patients aged 30-60 years. If excised fully, they do not reoccur, and no cases in the literature have reported malignant transformations. ...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20070301-13
更新日期：2007-03-01 00:00:00
abstract：:The performance of TKA through less than traditional visualization presents a new set of problem areas. ...
journal_title：Orthopedics
pub_type： 杂志文章
doi：
更新日期：2005-11-01 00:00:00
abstract：:Heterotopic ossification is a known complication of traumatic injuries. To minimize iatrogenic complications during excision, an understanding of anatomic relationships is essential. Current imaging modalities, such as computed tomography and plain radiographs, are limited to providing a 2-dimensional representation o...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20130327-06
更新日期：2013-04-01 00:00:00
abstract：:This study assessed the outcome of pediatric both-bone forearm fractures treated with operative intervention. A retrospective review was conducted of 31 patients treated over a 40-month period. Fifteen patients were treated with flexible intramedullary nailing and 16 treated with open reduction and internal fixation. ...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20070501-08
更新日期：2007-05-01 00:00:00
abstract：:We examined a consecutive group of patients who had undergone either open (34 patients) or single portal endoscopic (12 patients) carpal tunnel release performed by one surgeon over a period of 3 years. Fifty-seven total procedures were performed. There were no operative complications. Retrospective evaluation was don...
journal_title：Orthopedics
pub_type： 杂志文章
doi：
更新日期：1996-12-01 00:00:00
abstract：:The EMG-force relationships of skeletal muscles are of significant interest to the orthopedic-biomechanics researcher and have been a topic of interest and controversy for the last three decades. We present the developments reported in the literature, from the early 1950s, relevant to this topic, outlining the details...
journal_title：Orthopedics
pub_type： 杂志文章
doi：
更新日期：1986-11-01 00:00:00
abstract：:Free vascularized fibular grafting (FVFG) is an effective method to treat corticosteroid-induced osteonecrosis of the femoral head (ONFH). Some patients continued to receive maintenance doses of corticosteroids to treat the primary disease postoperatively. This study was performed to evaluate outcomes of FVFG for cort...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20140401-56
更新日期：2014-04-01 00:00:00
abstract：:Dislocation of the peroneal tendons associated with calcaneus fractures should be repaired during fracture fixation to prevent complications. The only documented approach for repair is by proximal extension of the vertical limb of the lateral extensile approach to the calcaneus. However, enlarging the inherently fragi...
journal_title：Orthopedics
pub_type： 临床试验,杂志文章
doi：10.3928/01477447-20140124-05
更新日期：2014-02-01 00:00:00
abstract：:The best screening method for developmental dysplasia of the hip is controversial. Ultrasonography is sensitive, but cost-effectiveness may limit its use. This study assessed whether ultrasound screening would increase in effectiveness if targeted toward infants with established risk factors for developmental dysplasi...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20150804-61
更新日期：2015-08-01 00:00:00
abstract：:In 6 patients with stage II knee osteonecrosis, all 6 with thrombophilia and 4 with concurrent hypofibrinolysis, the authors prospectively determined whether anticoagulation with enoxaparin could prevent collapse and progression to osteoarthritis, ameliorate pain, and restore function. The 6 patients were treated with...
journal_title：Orthopedics
pub_type： 杂志文章
doi：10.3928/01477447-20140924-59
更新日期：2014-10-01 00:00:00
abstract：:The Bateman Universal Proximal Femoral Assembly has been used primarily in the treatment of subcapital fractures of the femoral head when the acetabulum was judged to be adequate. The indications for this procedure are the same as for a standard hemiarthroplasty. A contraindication against its use is a severe neurolog...
journal_title：Orthopedics
pub_type： 社论
doi：10.3928/0147-7447-19801001-05
更新日期：1980-10-01 00:00:00
