Surgeons' Perspectives on Premium Implants in Total Joint Arthroplasty.

Abstract:

:Declining total joint arthroplasty reimbursement and rising implant prices have led many hospitals to restrict access to newer, more expensive total joint arthroplasty implants. The authors sought to understand arthroplasty surgeons' perspectives on implants regarding innovation, product launch, costs, and cost-containment strategies including surgeon gain-sharing and patient cost-sharing. Members of the International Congress for Joint Reconstruction were surveyed regarding attitudes about implant technology and costs. Descriptive and univariate analyses were performed. A total of 126 surgeons responded from all 5 regions of the United States. Although 76.9% believed new products advance technology in orthopedics, most (66.7%) supported informing patients that new implants lack long-term clinical data and restricting new implants to a small number of investigators prior to widespread market launch. The survey revealed that 66.7% would forgo gain-sharing incentives in exchange for more freedom to choose implants. Further, 76.9% believed that patients should be allowed to pay incremental costs for "premium" implants. Surgeons who believed that premium products advance orthopedic technology were more willing to forgo gain-sharing (P=.040). Surgeons with higher surgical volume (P=.007), those who believed implant companies should be allowed to charge more for new technology (P<.001), and those who supported discussing costs with patients (P=.004) were more supportive of patient cost-sharing. Most arthroplasty surgeons believe technological innovation advances the field but support discussing the "unproven" nature of new implants with patients. Many surgeons support alternative payment models permitting surgeons and patients to retain implant selection autonomy. Most respondents prioritized patient beneficence and surgeon autonomy above personal financial gain. [Orthopedics. 2017; 40(5):e825-e830.].

journal_name

Orthopedics

journal_title

Orthopedics

authors

Wasterlain AS,Bello RJ,Vigdorchik J,Schwarzkopf R,Long WJ

doi

10.3928/01477447-20170619-02

subject

Has Abstract

pub_date

2017-09-01 00:00:00

pages

e825-e830

issue

5

eissn

0147-7447

issn

1938-2367

journal_volume

40

pub_type

杂志文章
  • Accuracy of navigation: a comparative study of infrared optical and electromagnetic navigation.

    abstract::We evaluated the accuracy of navigation systems for measuring the mechanical axis in patients undergoing total knee arthroplasty and in the synthetic bone model. Infrared optical and electromagnetic navigation systems were compared. Both systems were found to be accurate and reproducible in an experimental environment...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Song EK,Seon JK,Park SJ,Yoon TR

    更新日期:2008-10-01 00:00:00

  • Flexion distraction injuries of the thoracolumbar spine: a review.

    abstract::Flexion-distraction injuries of the thoracolumbar spine and the "seat belt syndrome" are reviewed. The incidence, pathogenesis, classification, diagnosis, and treatment of these injuries are discussed. ...

    journal_title:Orthopedics

    pub_type: 杂志文章,评审

    doi:

    authors: Triantafyllou SJ,Gertzbein SD

    更新日期:1992-03-01 00:00:00

  • Quality of information on the Internet about carpal tunnel syndrome: an update.

    abstract::The use of the Internet for health-related information has increased significantly. In 2000, the current authors examined the source and content of orthopedic information on the Internet. At that time, Internet information regarding carpal tunnel syndrome was found to be of limited quality and poor informational value...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20130724-20

    authors: Lutsky K,Bernstein J,Beredjiklian P

    更新日期:2013-08-01 00:00:00

  • Low back pain.

    abstract::This study attempts to define the validity of radiographic imaging for the diagnosis of low back pain. ...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20060301-08

    authors: Stein H,Braun Y,Volpin G

    更新日期:2006-03-01 00:00:00

  • Fluoroscopic imaging of acetabular cup position during THA through a direct anterior approach.

    abstract::Mobile image intensifiers are more readily used to assess acetabular cup placement when performing a total hip arthroplasty through a direct anterior approach. However, patient positioning affects pelvic tilt and rotation, which in turn requires proper C-arm fluoroscopy adjustments for image interpretation. The author...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20130920-06

    authors: Alvarez AM,Suarez JC,Patel P,Benton EG

    更新日期:2013-10-01 00:00:00

  • Salvage of failed total hip arthroplasty with proximal femoral replacement.

    abstract:EDUCATIONAL OBJECTIVES:As a result of reading this article, physicians should be able to: 1. Identify the available types of reconstruction for failed total hip arthroplasty. 2. Summarize the preoperative workup of patients with failed total hip arthroplasty and massive proximal femoral bone loss. 3. Assess the surgica...

    journal_title:Orthopedics

    pub_type: 杂志文章,评审

    doi:10.3928/01477447-20140924-07

    authors: Savvidou OD,Mavrogenis AF,Sakellariou V,Christogiannis I,Vottis C,Christodoulou M,Vlasis K,Papagelopoulos PJ

    更新日期:2014-10-01 00:00:00

  • Does electric stimulation of the vastus medialis muscle influence rehabilitation after total knee replacement?

    abstract::Patients with knee osteoarthritis present with reduced quadriceps muscle strength, which is partially responsible for impaired function and disability. Although total knee replacement (TKR) is an effective surgical procedure, residual muscle weakness is not usually addressed and may persist for years postoperatively. ...

    journal_title:Orthopedics

    pub_type: 杂志文章,随机对照试验

    doi:10.3928/01477447-20110124-06

    authors: Avramidis K,Karachalios T,Popotonasios K,Sacorafas D,Papathanasiades AA,Malizos KN

    更新日期:2011-03-11 00:00:00

  • Medical Crowdfunding for Patients Undergoing Orthopedic Surgery.

    abstract::Crowdfunding for medical expenses is growing in popularity. Through several websites, patients create public campaign profiles to which donors can contribute. Research on medical crowdfunding is limited, and there have been no studies of crowdfunding in orthopedics. Active medical crowdfunding campaigns for orthopedic...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20171114-04

    authors: Durand WM,Johnson JR,Eltorai AEM,Daniels AH

    更新日期:2018-01-01 00:00:00

  • Long-term results of valgus tibial osteotomy.

    abstract::Valgus tibial osteotomy is a well-recognized procedure for medial compartment arthritis of the knee. The femorotibial angle must be adequately realigned; most unsatisfactory outcomes result from undercorrection. This study of 27 patients (38 knees) with a valgus tibial osteotomy for unicompartmental arthritis of the k...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Pachelli AF,Kaufman EE

    更新日期:1987-10-01 00:00:00

  • Philosophy of osteosynthesis in shoulder fractures.

    abstract::A wide range of workable instrumentation is available for the treatment of proximal humeral fractures, whereas osteosynthesis of scapular fractures is commonly achieved by plate/screw fixation. Older persons are confronted with a steadily rising incidence of osteoporotic fractures. Especially for this group of patient...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Fleischmann W,Kinzl L

    更新日期:1993-01-01 00:00:00

  • Collagen nerve wrap for median nerve scarring.

    abstract::Nerve wrapping materials have been manufactured to inhibit nerve tissue adhesions and diminish inflammatory and immunologic reactions in nerve surgery. Collagen nerve wrap is a biodegradable type I collagen material that acts as an interface between the nerve and the surrounding tissues. Its main advantage is that it ...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20150204-04

    authors: Kokkalis ZT,Mavrogenis AF,Ballas EG,Papagelopoulos PJ,Soucacos PN

    更新日期:2015-02-01 00:00:00

  • Lumbar disk replacement failures: review of 29 patients and rationale for revision.

    abstract::The Charité III (DePuy Spine, Inc, Raynham, Massachusetts) and ProDisc II (Synthes Spine, West Chester, Pennsylvania) artificial disk replacements were approved for use by the United States Food and Drug Administration in October 2004 and January 2006, respectively. The purpose of this study was to retrospectively rev...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20090624-08

    authors: Rosen C,Kiester PD,Lee TQ

    更新日期:2009-08-01 00:00:00

  • Clinical benefits of intra-articular anakinra for arthrofibrosis.

    abstract::Postoperative inflammation and stiffness, as well as the struggle to achieve full range of motion (ROM), following knee surgery is a significant clinical challenge. Interleukin-1 is a crucial mediator of the inflammatory response and development of pathological conditions leading to chronic inflammation. We hypothesiz...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20101021-09

    authors: Brown CA,Toth AP,Magnussen B

    更新日期:2010-12-01 00:00:00

  • Fracture of polyethylene tibial component in a total knee replacement. A case report.

    abstract::Aseptic loosening is the most common mode of failure for total knee replacements. Component breakage is rare, usually attributable to errors of design or manufacture. A case is presented in which rotational malplacement of the femoral component resulted in accelerated wear and eventual fracture of the polyethylene tib...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Mowery C,Botte M,Bradley G

    更新日期:1987-02-01 00:00:00

  • Once Annealed Highly Cross-Linked Polyethylene Exhibits Low Wear at 9 to 15 Years.

    abstract::A once annealed highly cross-linked polyethylene (HXLPE) was introduced in 1998. Concerns regarding its long-term performance and oxidative resistance exist because of the presence of retained free radicals. The authors studied 48 patients with 50 hip implants having an average age of 62 years. They were followed for ...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20160414-03

    authors: D'Antonio J,Capello WN,Ramakrishnan R

    更新日期:2016-05-01 00:00:00

  • Radiologic case study. Rupture of the long head of the biceps tendon.

    abstract::Rupture of the long head of the biceps tendon frequently is encountered in the setting of coexisting rotator cuff pathology and chronic impingement, but traumatic rupture is occasionally seen, as in this case. Signs and symptoms are not always diagnostic, and MRI or MR arthrography can be a useful tool for evaluation ...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Khanna G,Glockner JF,Sundaram M

    更新日期:2000-08-01 00:00:00

  • Bankart operation for recurrent anterior dislocation of the shoulder using suture anchor.

    abstract::Between June 1989 and December 1994, a total of 19 patients (20 shoulders) underwent open repair of Bankart lesions using suture anchors. Subscapularis muscle and anterior capsule were cut as one layer and sutured end to end without overlap. Coracoid osteotomy was not necessary. Average follow-up was 53.6 months (rang...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Bhagia SM,Ali MS

    更新日期:2000-06-01 00:00:00

  • Safe Positioning for Sexual Intercourse After Proximal Femoral Replacement.

    abstract::Hip arthroplasty is a common procedure used for the treatment of fractures and degenerative processes affecting the hip. Proximal femoral replacement is an uncommon type of hip arthroplasty used for reconstruction after extensive bone loss. Proximal femoral replacement is used most commonly after the resection of the ...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20170918-09

    authors: Couch CG,Nicholas RW,Montgomery CO

    更新日期:2018-03-01 00:00:00

  • A quantitative assessment of degenerative changes acceptable in the unoperated compartments of knees undergoing unicompartmental replacement.

    abstract::Thirty-five unicondylar knee arthroplasties were performed on 32 patients. In the unresurfaced compartments, degenerative cartilaginous changes were observed intraoperatively and recorded. The Outerbridge grading scale was used to assess the degree of arthritic change. In addition, the surface area involved was estima...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Corpe RS,Engh GA

    更新日期:1990-03-01 00:00:00

  • Use of an Irrigation Pump System in Arthroscopic Procedures.

    abstract::Since its inception, arthroscopic surgery has become widely adopted among orthopedic surgeons. It is therefore important to have an understanding of the basic principles of arthroscopy. Compared with open techniques, arthroscopic procedures are associated with smaller incisions, less structural damage, improved intra-...

    journal_title:Orthopedics

    pub_type: 杂志文章,评审

    doi:10.3928/01477447-20160427-01

    authors: Hsiao MS,Kusnezov N,Sieg RN,Owens BD,Herzog JP

    更新日期:2016-05-01 00:00:00

  • Closed needle biopsy of the lumbar spine: a safe and easy method.

    abstract::Numerous articles have been written about methods of closed biopsy of the spine. One of the most recent is by Moore et al,1 who describes his method as used at the Los Angeles General Hospital. The method described in this report is a simple and safe method for closed biopsy of the lumbar vertebra. ...

    journal_title:Orthopedics

    pub_type: 社论

    doi:10.3928/0147-7447-19800401-06

    authors: Cozen L

    更新日期:1980-04-01 00:00:00

  • Gunshot fractures: a medical, social, and economic analysis.

    abstract::One hundred ten fractures due to gunshots were reviewed to examine the medical, social, and financial implants of such injuries. The population was predominantly male (91%), unemployed (56%), and uninsured (79%). Sixty-eight percent were documented substance abusers, and 65% of the injuries appeared to be related to i...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Hakanson R,Nussman D,Gorman RA,Kellam JF,Hanley EN Jr

    更新日期:1994-06-01 00:00:00

  • Intramedullary reaming and nailing: its early effects on cortical bone vascularization.

    abstract::The early effect of reaming the medullary cavity prior to intramedullary nailing using Küntscher's method, on human cortical bone vascularization in the femur is discussed. In sections of the femur where the medullary tissue had been totally reamed, the inner two-thirds of the cortical bone tube was completely avascul...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Olerud S,Strömberg L

    更新日期:1986-09-01 00:00:00

  • Treatment of considerations in patients with compartment syndrome and an inherited bleeding disorder.

    abstract::In addition to consultation with an experienced hematologist, the following are recommendations regarding compartment syndrome in a patient with an inherited bleeding disorder. Von Willebrand's Disease. Humate-P (rich in von Willebrand factor) is the replacement therapy of choice for surgical procedures in patients wi...

    journal_title:Orthopedics

    pub_type: 杂志文章,评审

    doi:

    authors: Naranja RJ Jr,Chan PS,High K,Esterhai JL Jr,Heppenstall RB

    更新日期:1997-08-01 00:00:00

  • Herpes zoster virus: an unusual but potentially treatable cause of sciatica and foot drop.

    abstract::The herpes zoster virus is a rare but potential cause of acute motor weakness. This article describes 2 patients with drop foot secondary to an infection of varicella zoster who were incorrectly referred to an orthopedic clinic from their general practitioners. The first patient was a 74-year-old man who presented wit...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20111021-26

    authors: Sprenger De Rover WB,Alazzawi S,Hallam PJ,Hutchinson R,Di Mascio L

    更新日期:2011-12-06 00:00:00

  • Computer-assisted surgery of cartilage defects in the knee: comparison of rigid-body fixation techniques in a human cadaver study.

    abstract::This experimental cadaver study assessed computer navigation for the arthroscopic measurement of full-thickness cartilage defects in the knee joint. Cartilage defects were measured during arthroscopy using three cartilage defect-managing modules to compare fixed (invasive) and noninvasive rigid-body fixations. The com...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:

    authors: Marlovits S,Zimmermann V,Vekszler G,Resinger C

    更新日期:2007-10-01 00:00:00

  • The post-hospital discharge venous thrombosis risk of the orthopedic patient.

    abstract::ABSTRACTA prospective, randomized, double-blind trial was performed in total hip replacement patients to document the risk of deep vein thrombosis (DVT) after hospital discharge, and to assess the efficacy of sustained antithrombotic prophylaxis. In a total of 179 patients receiving enoxaparin 40 mg/day during hospita...

    journal_title:Orthopedics

    pub_type: 社论

    doi:10.3928/0147-7447-19970202-08

    authors: Planes A,Vochelle N

    更新日期:1997-02-01 00:00:00

  • Intraoperative Distal Femoral Fine Wire Traction to Facilitate Intramedullary Nailing of the Femur.

    abstract::Many techniques have been employed to facilitate intramedullary nailing of femur fractures. Maintaining limb length during the operation can be difficult. The authors describe the use of distal femoral fine wire skeletal traction as a technique to maintain reduction while allowing intramedullary nailing of femur fract...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20160201-07

    authors: Githens M,Alton TB,Firoozabadi R,Bishop JA

    更新日期:2016-03-01 00:00:00

  • Unicompartmental and total knee arthroplasty in the over 70 population.

    abstract::This retrospective study compares the short-term outcomes of small-incision unicompartmental knee arthroplasty (41 patients) with standard total knee arthroplasty (TKA) (50 patients) in 91 consecutive patients older than 70 years. Knee Society Scores and range of motion (ROM) were assessed preoperatively, at 6 weeks a...

    journal_title:Orthopedics

    pub_type: 杂志文章

    doi:10.3928/01477447-20100722-05

    authors: Fisher DA,Dalury DF,Adams MJ,Shipps MR,Davis K

    更新日期:2010-09-07 00:00:00

  • Rotational alignment of the tibial component in total knee arthroplasty.

    abstract::This study compares two different methods of aligning the tibial component in a total knee arthroplasty, one by aligning the component with the border between the medial one third and lateral two thirds of the tibial tubercle and the other by allowing the component to seek its own position as the knee is taken through...

    journal_title:Orthopedics

    pub_type: 杂志文章,评审

    doi:

    authors: Bindelglass DF

    更新日期:2001-11-01 00:00:00