Perceptions of government-assisted payors: a survey and analysis of American Shoulder and Elbow Surgeons current Medicare, Medicare Advantage, and Medicaid practice allocation.

Introduction: Significant discrepancy and variance exist in the United States health care system with regard to patient access to medical care based on a patient's insurance type, whether that be government-assisted or a private insurer. There are currently 3 major government-assisted insurance programs, Medicare, Medicare Advantage, and Medicaid, each of which has its own patient mix and regulatory processes that govern care delivery. The purpose of this study was to evaluate the current perceptions of shoulder and elbow surgeons surrounding practice patterns and barriers to access for patients whose primary insurance is a government-assisted payor.

Orthopedic advocacy: a starter's guide for optimizing physician engagement and public awareness.

Orthopedic advocacy is an indispensable tool for surgeons to help shape health care policies and address the mounting challenges they face in providing quality care to patients and maintaining a sustainable practice. Health care advocacy embodies a commitment to fair health care access and provider autonomy, employs diverse strategies to amplify patient and doctor voices, and advances public health imperatives. Orthopedic advocacy confronts a myriad of legislative challenges specific to the orthopedic specialty, from reimbursement complexities to regulatory burdens.

Small-Bore Needle Arthroscopic Extensor Carpi Radialis Brevis Release Results in Improved Outcomes at One Year Postoperatively.

Purpose: To evaluate outcomes of patients who underwent small-bore needle arthroscopic extensor carpi radialis brevis (ECRB) release for the management of recalcitrant lateral epicondylitis.

Methods: Patients who underwent elbow evaluation and ECRB release using a small-bore needle arthroscopy system were included in this study Thirteen patients were included. Quick Disabilities of the Arm Shoulder and Hand and Single Assessment Numerical Evaluation scores, as well as overall satisfaction scores, were collected.

Diagnostic and Therapeutic Elbow Arthroscopy Using Small-Bore Needle Arthroscopy.

Needle arthroscopy may provide several potential advantages over standard arthroscopy. The smaller camera size and weight allows for a minimally invasive and percutaneous approach with decreased fluid use. As resolution and image quality improve, the potential to expand clinical use for therapeutic applications becomes possible.

Validation of PROMIS Global-10 compared with legacy instruments in patients with shoulder instability.

Background: Outcomes instruments are used to measure patients' subjective assessment of health status. The Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 was developed to be a concise yet comprehensive instrument that provides physical and mental health scores and an estimated EuroQol-5 Dimension (EQ-5D) score.

Methods: A total of 175 prospectively enrolled patients with shoulder instability completed the PROMIS Global-10, EQ-5D, American Shoulder and Elbow Surgeons (ASES), Single Assessment Numeric Evaluation (SANE), and Western Ontario Shoulder Instability Index.

Management of irreparable massive rotator cuff tears: a systematic review and meta-analysis of patient-reported outcomes, reoperation rates, and treatment response.

Background: There is no consensus on the treatment of irreparable massive rotator cuff tears. The goal of this systematic review and meta-analysis was to (1) compare patient-reported outcome scores, (2) define failure and reoperation rates, and (3) quantify the magnitude of patient response across treatment strategies.

Methods: The MEDLINE, Embase, CENTRAL (Cochrane Central Register of Controlled Trials), and Scopus databases were searched for studies including physical therapy and operative treatment of massive rotator cuff tears.

Development of a clinical risk calculator for prolonged opioid use after shoulder surgery.

Background: Understanding risk factors associated with prolonged opioid use to help mitigate abuse and develop presurgical screening programs to identify at-risk patients is paramount. The purpose of this study was to develop and validate a clinical risk assessment tool to preoperatively predict prolonged opioid use after shoulder surgery.

Methods: A total of 561 patients who underwent shoulder surgery within a tertiary health care system were identified, and opioid prescription data were retrospectively collected from the Connecticut Prescription Monitoring and Reporting System.

Performance of PROMIS Global-10 to Legacy Instruments in Patients With Lateral Epicondylitis.

Purpose: To validate the Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 for patients who have lateral epicondylitis requiring surgical treatment in comparison with other gold standard patient-reported outcomes.

Methods: Sixty-two patients with lateral epicondylitis of the elbow were prospectively enrolled before arthroscopic treatment. Inclusion criteria were patients 18 years of age or older with a diagnosis of lateral epicondylitis.

Outcomes of Total Shoulder Arthroplasty With Posterior Capsular Plication.

Background: Glenoid loosening and instability are among the most common complications after anatomic total shoulder arthroplasty (TSA), resulting in poor function. Posterior instability is one contributing factor. The purpose of this study is to report the clinical and radiographic outcomes of a series of patients treated with posterior capsule plication for intraoperative posterior instability during TSA.

Predictors of Length of Stay and Discharge Disposition After Shoulder Arthroplasty: A Systematic Review.

Introduction: Identifying patient factors that affect length of stay (LOS) and discharge disposition after shoulder arthroplasty is key in managing patient expectations. In this systematic review, we identify patient-specific covariates that correlate with increased LOS and need for discharge to a facility.

Methods: We searched biomedical databases to identify associations between patient-specific factors and LOS and discharge disposition after shoulder arthroplasty.

Performance of PROMIS Global-10 compared with legacy instruments in patients with shoulder arthritis.

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) Global-10 measures physical and mental health and provides an estimated EuroQol-5 Dimension (EQ-5D) score. The purpose of this study was to determine the correlation between the PROMIS Global-10 and several gold-standard legacy measures to validate its overall performance and usefulness in patients with shoulder arthritis.

Methods: The study prospectively enrolled 161 patients with shoulder arthritis before treatment.