Patient compliance with deep vein thrombosis prophylaxis after total hip and total knee arthroplasty.

Even though the Centers for Medicare and Medicaid Services is penalizing hospitals for readmissions, and postoperative prophylaxis has demonstrated reduced complications associated with deep vein thrombosis (DVT), few studies have examined patient compliance with (DVT) prophylaxis at home. A survey querying DVT prophylaxis management and adherence was administered to patients who were within the one to three-month postoperative period after a total knee or total hip replacement. A total of 103 patients completed the survey.

Medicaid Patients Have Greater Difficulty Scheduling Health Care Appointments Compared With Private Insurance Patients: A Meta-Analysis.

Medicaid patients are known to have reduced access to care compared with privately insured patients; however, quantifying this disparity with large controlled studies remains a challenge. This meta-analysis evaluates the disparity in health services accessibility of appointments between Medicaid and privately insured patients through audit studies of health care appointments and schedules. Audit studies evaluating different types of outpatient physician practices were selected.

Does Medicaid Insurance Provide Sufficient Access to Pediatric Orthopedic Care Under the Affordable Care Act?

The Patient Protection and Affordable Care Act had a profound impact on health insurance coverage of children. Given the importance of pediatric specialty care, this study assessed access to pediatric orthopedic urgent care for a child's likely operative distal radius fracture. Researchers called 180 pediatric orthopedic surgeons in 8 states requesting appointments for the caller's fictitious 11-year-old child who suffered a distal radius fracture.

Lyme periprosthetic joint infection in total knee arthroplasty.

Lyme arthritis, caused by the spirochete sensu stricto, is a common tick-borne illness in New England and the upper Midwest. Most often, the disease affects the knee and has typically been reported as a cause of native joint infection. There has been only 1 case of Lyme periprosthetic joint infection (associated with a total knee arthroplasty) reported in the literature, and to our knowledge, no other reported cases of Lyme periprosthetic joint infections exist.

The Role of Intraoperative Intermittent Pneumatic Compression Devices in Venous Thromboembolism Prophylaxis in Total Hip and Total Knee Arthroplasty.

Venous thromboembolism (VTE) is a common complication after total hip arthroplasty (THA) and total knee arthroplasty (TKA), occurring in up to 85% of patients who are not treated with prophylaxis. The initiation of VTE development may occur intraoperatively. This study investigated whether this gap in VTE prophylaxis can be addressed by the use of intraoperative intermittent pneumatic compression devices (IPCDs) and if intraoperative IPCDs have a meaningful benefit in preventing symptomatic VTE.

The Influence of Medical Insurance on Patient Access to Orthopaedic Surgery Sports Medicine Appointments Under the Affordable Care Act.

Background: The goal of the Patient Protection and Affordable Care Act (PPACA) was to expand patient access to health care. Since the rollout of the PPACA, Medicaid patients have demonstrated difficulty obtaining appointments in some specialty care settings.

Purpose: To assess the effect of insurance type (Medicaid and private) on patient access to orthopaedic surgery sports medicine specialists for a semiurgent evaluation of a likely operative bucket-handle meniscus tear.

Access of Patients With Lumbar Disc Herniations to Spine Surgeons: The Effect of Insurance Type Under the Affordable Care Act.

Study Design: Prospective cohort study.

Objective: To determine the effects of insurance type (Medicaid vs. a specific private insurance) on patient access to spine surgeons for lumbar disc herniation as measured by (A) acceptance of insurance, (B) need for a referral, and (C) wait time for appointment.

Primary Care Physician and Patient Perceptions of Reimbursement for Total Knee and Hip Replacement.

Background: The opinions of nonspecialists and patients will be important to determining reimbursements for specialists such as orthopedic surgeons. In addition, primary care physician (PCP) perceptions of reimbursements may affect utilization of orthopedic services.

Methods: We distributed a web-based survey to PCPs, asking how much they believed orthopedic surgeons were reimbursed for total hip arthroplasty (THA) and total knee arthroplasty (TKA).

Survey of Patient Insurance Status on Access to Specialty Foot and Ankle Care Under the Affordable Care Act.

Background: The purpose of this study was to assess the effect of insurance type (Medicaid, Medicare, and private insurance) on access to foot and ankle surgeons for total ankle arthroplasty.

Methods: We called 240 foot and ankle surgeons who performed total ankle arthroplasty in 8 representative states (California, Massachusetts, Ohio, New York, Florida, Georgia, Texas, and North Carolina). The caller requested an appointment for a fictitious patient to be evaluated for a total ankle arthroplasty.

The Effect of Insurance Type on Patient Access to Carpal Tunnel Release Under the Affordable Care Act.

Purpose: To assess the effect of insurance type (Medicaid, Medicare, and private insurance) on access to hand surgeons for carpal tunnel syndrome (CTS).

Methods: The research team called 240 hand surgeons in 8 states (California, Massachusetts, Ohio, New York, Florida, Georgia, Texas, and North Carolina). The caller requested an appointment for her fictitious mother to be evaluated for CTS and possible surgical management through carpal tunnel release (CTR).

The Effect of Insurance Type on Patient Access to Knee Arthroplasty and Revision under the Affordable Care Act.

This study evaluated access to knee arthroplasty and revision in 8 geographically representative states. Patients with Medicaid were significantly less likely to receive an appointment compared to patients with Medicare or BlueCross. However, patients with Medicaid had increased success at making an appointment in states with expanded Medicaid eligibility (37.

NLRP3 inflammasome plays a critical role in the pathogenesis of hydroxyapatite-associated arthropathy.

The proinflammatory and catabolic cytokine IL-1β has been implicated in the pathogenesis of osteoarthritis (OA) by mediating synovial inflammation and cartilage degeneration. Although synovial macrophages are suggested to be the source of IL-1β, the mechanism remains unclear. Ectopic deposition of hydroxyapatite (HA) crystals in joints is closely associated with OA and other arthropathies, but the precise role of HA in arthritis pathogenesis has not been clearly demonstrated.

Actual knee motion during continuous passive motion protocols is less than expected.

Investigations of the usefulness of continuous passive motion (CPM) after TKA have yielded mixed results, with evidence suggesting its efficacy is contingent on the presence of larger motion arcs. Surprisingly, the range of motion (ROM) the knee actually experiences while in a CPM machine has not been elucidated. In this study, the ability of a CPM apparatus to bring about a desired knee ROM was assessed with an electrogoniometer.

Current practices of AAHKS members in the treatment of adult osteonecrosis of the femoral head.

Background: There is currently no standardized protocol for evaluating and treating osteonecrosis of the femoral head in adults in the United States. We sought to understand current treatment practices of a group of surgeons who commonly treat this disease to determine if there was agreement on some aspects of care.

Methods: We designed a two-staged mixed-mode (mailed and faxed) sixteen-question self-administered descriptive survey questionnaire to be sent to all 753 active members of the American Association of Hip and Knee Surgeons (AAHKS).

Sequential dependence of freeze-drying and irradiation on biomechanical properties of rat bone.

Femurs of Sprague-Dawley rats were subjected to in vitro 3-Mrad irradiation and/or freeze-drying to investigate whether these processes have an order-dependent effect on the biomechanical properties of bone. Four experimental groups were designated-irradiated (RAD); freeze-dried (FD); irradiated, then freeze-dried (RAD/FD); and freeze-dried, then irradiated (FD/RAD). After the various treatments, the bones were inspected for microfractures and then torsion-tested.