Decision Analysis: Applications in Orthopaedics
|
|
|
- Percival Strickland
- 6 years ago
- Views:
Transcription
1 Decision Analysis: Applications in Orthopaedics Karim A. Meijer, M.D. Joe Hahn, Ph.D., MBA and Jim Dyer, Ph. D. McCombs School of Business, UT Austin
2 Analysis of Orthopaedic Treatment Decisions Three Applications: Patellar Resurfacing in Total Knee Replacements Treatment of Clavicle Collar Bone Fractures Surgical Treatment of Lisfranc Injuries
3 Analysis of Orthopaedic Treatment Decisions Gameplan Introduction and Anatomy Medical Literature Review and Data Cost Estimates & Probabilities Analysis and Results Decision Tree and Sensitivity Analysis PAYER PERSPECTIVE Discussion/Questions
4 Total Knee Replacement Total Knee Arthroplasty (TKA) is a high volume procedure Estimated to be 3.48 million per year in 2030 Kurtz et JBJS 2007 ~600,000 performed in 2007 with costs exceeding $11 billon Arch Intern Med. 2009
5 Patellar Resurfacing
6 Patella Resurfacing with TKA? Physician (Provider): Government (Payer): Always, Sometimes, Never
7 Decision Tree Model TKA Resurfaced Patella Nonresurfaced Patella
8 Decision Tree Model Instability Aseptic Loosening Resurfaced Patella Reoperations No Reoperations Fracture Ruptured Extensor Mechanism Other
9 Decision Tree Model Anterior Knee Pain Nonresurfaced Patella Reoperations No Further Operations Osteonecrosis Other
10 Decision Tree Analysis
11 Results Resurfaced Nonresurfaced 5 Year Expected Cost $13, $14, Secondary Surgery 0.71% 3.34% Cost Savings of $228 per knee More likely ~$750/knee
12 Chance of Revision for Resurfaced Sensitivity Analysis Two-way Sensitivity Analysis No Resurface Resurface 0 Revision rates shown in Figure Chance of Revision for not-resurfaced
13 Potential Savings Discussion 15% Do not routinely resurface AAHKS 2010 Survey 2007 à $20,500,000/year 2030 à $175,000,000/year (Medicare data) Remember Payer s Perspective!
14 Clavicle Collar Bone Fractures
15 Treatment of Clavicle Fractures Background Data 3-4% of all adult fractures 80% occur in the middle 1/3 Peak incidence in males under 30 McKee et al. JBJS Am 2006 Traditionally treated non-op Retrospective data from 1960s Low rates of nonunion (1%) Included adolescents Neer JAMA 1960 Rowe CORR 1968
16 Clavicle Fractures New Study Results Higher rates of nonunion (up to 15%) Decreased patient satisfaction Biomechanics Advantages & Disadvantages Trends Synthes - domestic clavicle plate sales ,630 Units ,640 U (34% inc) ,430 U (12% inc) ,180 U (4.5% inc) % inc over 2009 Hill et al. JBJS Br 1997 Ledger et al. JSES 2005
17 Decision Tree Model Displaced Midshaft Clavicle Fracture Operative Treatment Nonoperative Treatment
18 Decision Tree Model HWR Operative Treatment Reoperations No Reoperations HWR with I&D Revision ORIF Nonunion
19 Decision Tree Model ORIF Nonoperative Treatment Delayed Operative Procedure No Further Operations ORIF Malunion ORIF Nonunion
20 Decision Tree Model
21 Results Decision tree analysis expected costs Operative treatment- $14, Nonoperative treatment- $3, Projected cost savings of $11,650.56/clavicle fracture
22 Results Sensitivity Analysis 2-way analysis varying rates of reoperation and delayed operative treatment Model remained stable over a wide range of probabilities Two-way Sensitivity Analysis, Medicare Costs x=.1871 y=.2348 Non-OP treatment OP treatment Probability of Delayed Surgery after non-op Treatment
23 Potential Savings $11,650 per fracture How many fractures are there? Incidence fractures / 100,000 population Mueller J Trauma 2008 Robison JBJS 1998 Discussion Let s do the math US ~325,000,000 78, ,750 / per year 80% occur in the midshaft 62, ,600 fractures/year $727 Million $ 2.15 Billion in healthcare savings
24 Lisfranc Injuries
25 What s the Big Deal? Imperative to maintain normal foot biomechanics and function Untreated injuries Persistent pain Lisfranc Injuries Progressive deformity Prolonged disability
26 Surgery Two Options 1. Open Reduction Internal Fixation (ORIF) 2. Primary Arthrodesis Lisfranc Injuries
27 Surgical Treatment of Lisfranc Injuries
28 Cost Estimation Where you have your surgery matters!!! Two decision tree models Outpatient Hospital (APC) Outpatient Ambulatory Surgery Center (ASC)
29 Data What Does the Literature Say?
30 APC Expected Costs: ORIF PA Basic Decision Tree Analysis $18,613 $19,803 Expected Savings $1,190
31 ASC Expected Costs: ORIF PA Basic Decision Tree Analysis $11,652 $11,703 Expected Savings $51
32 Results Table 3 One-way Sensitivity Analysis Intersection Points Initial Cost/Percentage Indifference Point Percent Change ORIF Cost APC $13, $14, (+) 8.7% ORIF Cost ASC $8, $8, (+) 0.62% Primary Arthrodesis Cost APC $18, $16, (-) 6.55% Primary Arthrodesis Cost ASC $10, $10, (-) 0.48% Probability of HWR after ORIF APC 60% 74% (+) 23.33% Probability of HWR after ORIF ASC 60% 61% (+) 1.67% HWR Cost ASC $3, $3, (+) 3.02% Probability of Secondary Surgery after PA ASC 17.65% 16.78% (-) 4.92%
33 Sensitivity Analysis: Costs (+) $1, (+8.7%) (-) $1, (-6.55%) APC - ORIF Cost Variation APC - Primary Arthrodesis Cost Variation Expected Value PrecisionTree Course Version University of Texas Austin ORIF Primary Arthrodesis Expected Value ORIF Primary Arthrodesis $10, $11, $12, $13, $14, $15, $16, $17, $18, $13, $14, $15, $16, $17, $18, $19, $20, $21, $22, $23, ORIF Cost Primary Arthrodesis Cost ASC - HWR Cost Variation (+) $ (+3.02%) Expected Value ORIF $2, $2, $2, $3, $3, $3, $3, $3, $4, $4, $4, Primary Arthrodesis HWR Cost
34 Sensitivity Analysis: Probabilities 60% à 74% ( 23.33%) 17.65% à 16.78% ( -4.92%) APC - Rate of HWR after ORIF Rate of Secondary Surgery after Primary Arthrodesis Expected Value ORIF Primary Arthrodesis Expected Value ORIF Primary Arthrodesis % 20% 30% 40% 50% 60% 70% 80% 90% 100% 110% % 10.00% 15.00% 20.00% 25.00% 30.00% Rate of HWR after ORIF Rate of Secondary Surgery after Primary Arthrodesis
35 Two-Way Sensitivities APC: ORIF Cost vs Rate of HWR after ORIF ASC: ORIF Cost vs Rate of HWR after ORIF 100% 100% 90% 90% 80% 80% Rate of HWR after ORIF 70% 60% 50% PrecisionTree Course Version University of Texas Austin ORIF Primary Arthrodesis Rate of HWR after ORIF 70% 60% 50% PrecisionTree Course Version University of Texas Austin ORIF Primary Arthrodesis 40% 40% 30% 30% 20% 20% $10, $11, $12, $13, $14, $15, $16, $17, $18, $6, $6, $7, $7, $8, $8, $9, $9, $10, $10, ORIF Cost ORIF Cost ASC: Primary Arthrodesis Cost vs Rate of HWR after ORIF 100% 90% 80% 70% 60% 50% 40% 30% 20% $7, $8, $9, $10, $11, $12, $13, $14, Rate of HWR after ORIF PrecisionTree Course Version University of Texas Austin ORIF Primary Arthrodesis Primary Arthrodesis Cost
36 Lisfranc Treatment Analysis - Results Sensitivity analyses reveals which inputs influence the decision policy Outcomes can change with small differences in costs or probabilities
37 Analysis of Orthopaedic Treatment Decisions Three Applications: Patellar Resurfacing in Total Knee Replacements Treatment of Clavicle Collar Bone Fractures Surgical Treatment of Lisfranc Injuries
38 Conclusions 1. Patella resurfacing during primary TKA is the optimal financial strategy from a Medicare perspective over a mid term period.
39 Conclusions 2. Initial nonoperative management of mid shaft clavicle fractures is the optimal financial strategy from the payer perspective
40 Conclusions 3. Surgeon discretion is the optimal surgical solution for each unique Lisfranc injury pattern
41 Publications
42 DISCUSSION & QUESTIONS
43 Decision Analysis: Applications in Orthopaedics Karim A. Meijer, M.D. Joe Hahn, Ph.D, MBA and Jim Dyer, Ph.D. McCombs School of Business, UT Austin
What s New in the Treatment of Proximal Humerus Fractures?
NHMI Winter Meeting Stowe, VT January 2015 What s New in the Treatment of Proximal Humerus Fractures? John Bell, M.D., M.S. Associate Professor Shoulder and Elbow Surgery Dartmouth-Hitchcock Medical Center
Clavicle Fractures: How Science Changed Practice
Clavicle Fractures: How Science Changed Practice Michael Professor, St. Toronto, D. McKee, MD, FRCS(C) Division of Orthopaedics, Michael s Hospital, University of Toronto, Canada. Update 05/2016 Disclosure
Christine A. Ho, MD Texas Scottish Rite Hospital for Children Division Director, Dept of Orthopaedics, Children s Health Dallas Associate Professor,
Christine A. Ho, MD Texas Scottish Rite Hospital for Children Division Director, Dept of Orthopaedics, Children s Health Dallas Associate Professor, Dept of Orthopaedics UTSW Participants will learn clinical
Which Fractures Require Internal Fixation?
Which Fractures Require Internal Fixation? THOMAS (QUIN) THROCKMORTON, MD PROFESSOR SHOULDER AND ELBOW SURGERY UNIVERSITY OF TENNESSEE CAMPBELL CLINIC DEPARTMENT OF ORTHOPAEDIC SURGERY I (and/or my co
Difficult Hosts. Treatment Options. Distal Femoral Replacement for Distal Femur Fractures When is it the Best Choice
Distal Femoral Replacement for Distal Femur Fractures When is it the Best Choice Walter W. Virkus, MD IU Health Methodist Hospital Indianapolis, IN Difficult Hosts Distal femur fractures common Distal
Combined Session: Orthopaedic Trauma Association and American Shoulder and Elbow Surgeons
Combined Session: Orthopaedic Trauma Association and American Shoulder and Elbow Surgeons Controversial Upper Extremity Fractures: To Fix or Not? 4:20 pm 5:00 pm Moderators: David C. Ring, MD, PhD (ASES)
Distal Humerus Fractures: How should they be fixed?
Distal Humerus Fractures: How should they be fixed? Dr. Emil Schemitsch, MD, FRCS(C) Richard Ivey Professor and Chairman, Department of Surgery, Western University Chief of Surgery London Health Sciences
COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF OPERATIVE AND NON-OPERATIVE TREATMENT IN MIDSHAFT CLAVICLE FRACTURES
COMPARATIVE STUDY OF FUNCTIONAL OUTCOME OF OPERATIVE AND NON-OPERATIVE TREATMENT IN MIDSHAFT CLAVICLE FRACTURES R. Sahaya Jose 1 1Assistant Professor, Department of Orthopaedics, Sree Mookambika Institute
Comparison of Complication Rates of Intramedullary Pin Fixation Versus Plating of Midshaft Clavicle Fractures in an Active Duty Military Population
Comparison of Complication Rates of Intramedullary Pin Fixation Versus Plating of Midshaft Clavicle Fractures in an Active Duty Military Population Jerome J. Wenninger Jr., PA-C; Joseph H. Dannenbaum,
Operative Cost Comparison: Plating Versus Intramedullary Fixation for Clavicle Fractures
Operative Cost Comparison: Plating Versus Intramedullary Fixation for Clavicle Fractures Andrew E. Hanselman, MD; Timothy R. Murphy, MD; George K. Bal, MD, FACS; E. Barry McDonough, MD abstract Although
recovery. Many methods of treatment for fractures of the clavicle had been IJMDS January 2016; 5(1) 991
Original article A clinical study on role of different types of plates in surgical management of middle one third clavicle fracture in adults Garg V 1, Agarwal A 2 ABSTRACT Background: Fractures of the
HUMERAL SHAFT FRACTURES: ORIF, IMN, NONOP What to do?
HUMERAL SHAFT FRACTURES: ORIF, IMN, NONOP What to do? TRAUMA 101 2018 FRACTURE CARE FOR THE COMMUNITY ORTHOPEDIST William W. Cross III, MD Assistant Professor Division of Orthopaedic Trauma Chair, Division
Distal Femur Fractures: Tips and Tricks for Plating and Nailing? Conflict of Interest 9/24/2015
Distal Femur Fractures: Tips and Tricks for Plating and Nailing? Cory Collinge, MD Professor of Orthopedic Surgery Vanderbilt University Medical Center Nashville, TN Conflict of Interest Consultant: Smith
Tibial Shaft Fractures
Tibial Shaft Fractures Mr Krishna Vemulapalli Consultant Orthopaedics Surgeon Queens & King George Hospitals Queens Hospital 14/03/2018 Google Maps Map data 2018 Google 10 km Orthopaedics Department Covers
Orthopedic Injury Coding. Bryant Oliphant 10:20
Orthopedic Injury Coding Bryant Oliphant 10:20 Orthopaedic Trauma in MTQIP Bryant Oliphant, MD, MBA, MSc Research Investigator bryantol@med.umich.edu @BonezNQuality DEPARTMENT OF ORTHOPAEDIC SURGERY None
Early Versus Delayed Operative Intervention in Displaced Clavicle Fractures
ORIGINAL ARTICLE OTA HIGHLIGHT PAPER Early Versus Delayed Operative Intervention in Displaced Clavicle Fractures Avishek Das, MRCS, Katie E. Rollins, MRCS, Kathleen Elliott, MRCS, Philip Johnston, MD,
Should We Really be Performing HHR for Proximal Humeral Fractures Anymore?
Should We Really be Performing HHR for Proximal Humeral Fractures Anymore? Anthony A. Romeo, MD Professor, Dept. of Orthopaedic Surgery Head, Section of Shoulder and Elbow Rush University Medical Center
Index. Note: Page numbers of article titles are in boldface type.
Note: Page numbers of article titles are in boldface type. A AAOS. See American Academy of Orthopaedic Surgeons (AAOS) ACA. See Affordable Care Act (ACA) ACL injuries. See Anterior cruciate ligament (ACL)
Stefan Rahm MD University Hospital Balgrist
Knee Prosthesis Models & Materials, Surgical Techniques and Approaches Stefan Rahm MD University Hospital Balgrist INTRODUCTION VARUS VALGUS 46 Y OLD MALE Pain in the medial compartment left more than
Proximal Humeral Fractures RSA v HHR. Proximal Humeral Fractures RSA v HHR. Introduction
Proximal Humeral Fractures RSA v HHR Xavier A. Duralde, MD Peachtree Orthopaedic Clinic Atlanta, GA Proximal Humeral Fractures RSA v HHR Consultant: Smith+Nephew Board of Directors: CORR Introduction Incidence
Total Elbow Arthroplasty: an Update
Total Elbow Arthroplasty: an Update Emilie Cheung, M.D. Associate Professor Chief, Shoulder and Elbow Service Stanford University Department of Orthopedic Surgery Procedure volumes and rates increased
Index. orthopedic.theclinics.com. Note: Page numbers of article titles are in boldface type.
Index Note: Page numbers of article titles are in boldface type. A Acetabular fractures thromboembolic disease after, 341 Achilles tendon rupture ACL. See Anterior cruciate ligament (ACL) Adolescent idiopathic
Jeannie Huh, MD Christopher Gross, MD Alex Lampley, MD Samuel B. Adams, MD James K. DeOrio, MD James A. Nunley II, MD Mark E.
Jeannie Huh, MD Christopher Gross, MD Alex Lampley, MD Samuel B. Adams, MD James K. DeOrio, MD James A. Nunley II, MD Mark E. Easley, MD Duke University Medical Center Durham, NC Disclosures Predictors
2018 OAOS Annual Orthopaedic Conference Objectives
2018 OAOS Annual Orthopaedic Conference Objectives PANEL: The Opioid Crisis in America: Orthopaedic Responsibility & Response 300 Seconds to Save a Life: The Opioid Epidemic at Your Doorstep The pervasive
21/01/10. Disclosures. Results of High Tibial Osteotomy Osteotomy: Review of the Literature. Introduction. OW osteotomy and bone graft
3rd Annual Advanced Course on Knee Surgery January 17-22, 2010, Val D Isere, Results of High Tibial Osteotomy Osteotomy: Review of the Literature Disclosures Conflict of interest related to this presentation:
The Society for Patient Centered Orthopedics. Choosing Wisely List. James Rickert, MD 1
The Society for Patient Centered Orthopedics Choosing Wisely List James Rickert, MD 1 Extremities and Trauma Vertebroplasty Rotator Cuff Repair: For atraumatic (degenerative) tears in patients greater
DISTAL HUMERUS FRACTURES WHAT I HAVE LEARNED DISTAL HUMERUS FRACTURES WHAT I HAVE LEARNED 63 YO WOMAN CT FIXABLE OSTEOTOMY NOT NEEDED
AMERICAN SHOULDER AND ELBOW SURGEONS ORTHOPAEDIC TRAUMA ASSOCIATION SPECIALTY DAY SAN DIEGO, MARCH 2017 Graham JW King MD, MSc, FRCSC 63 YO WOMAN CT FIXABLE OSTEOTOMY NOT NEEDED 64 YO WOMAN FALL OF LADDER
MIDFOOT INJURIES-ARE WE UNDERTREATING IT? Mr Rajiv Limaye Mr Prasad Karpe University Hospital of North Tees 3 rd Foot and Ankle Symposium
MIDFOOT INJURIES-ARE WE UNDERTREATING IT? Mr Rajiv Limaye Mr Prasad Karpe University Hospital of North Tees 3 rd Foot and Ankle Symposium Introduction Increasing sports injuries RTA and traumatic injuries
1:00 pm Welcome and Introduction Paul Tornetta III, MD and J. Tracy Watson, MD
AAOS/OTA Daily Dilemmas in Trauma: Your Topics, Expert Solutions #3248 May 2-4, 2019 Orlando, FL Paul Tornetta III, MD and J. Tracy Watson, MD; Course Directors SCHEDULE THURSDAY, MAY 2 12:00 1:00 pm Registration/Exhibits
Elbow Fractures ORIF VS Arthroplasty
Elbow Fractures ORIF VS Arthroplasty Oke Anakwenze, M.D. Olympus Orthopedics No disclosures Disclosures Distal humerus fractures 0.5-0.7% of all fractures 30% of all elbow fractures Bimodal etiology Young
Functional outcome of open reduction and internal fixation of clavicle fracture
International Journal of Research in Medical Sciences Pillai MG. Int J Res Med Sci. 2016 Aug;4(8):3205-3210 www.msjonline.org pissn 2320-6071 eissn 2320-6012 Research Article DOI: http://dx.doi.org/10.18203/2320-6012.ijrms20162255
Complex fractures of the humeral shaft. Janos Solyom Sahlgrenska University Hospital Gothenburg, Sweden
Complex fractures of the humeral shaft Janos Solyom Sahlgrenska University Hospital Gothenburg, Sweden Kopenhagen 2018 Complex fracture Changes in the AO/OTA classification system Complex Multifragmentary
Hassan R. Mir, MD, MBA, FACS
DISCLOSURES Hassan R. Mir, MD, MBA, FACS Paid Consultant for a Company or Supplier Smith & Nephew Zimmer Biomet Trice Medical Stock or Stock Options Core Orthopaedics OrthoGrid Systems Research Support
2018 Professional Education Course Calendar
2018 Professional Education Course Calendar Reconstruction, Sports Medicine, and Trauma/Extremities Our Mission We believe in attracting and building a community of health care professionals who are committed
2018 Professional Education Course Calendar
2018 Professional Education Course Calendar Reconstruction, Sports Medicine, and Trauma/Extremities Our Mission We believe in attracting and building a community of health care professionals who are committed
Clavicle Fracture Solutions Value Analysis Committee - Resource Guide
Clavicle Fracture Solutions Value Analysis Committee - Resource Guide Clavicle Fractures Incidence and Patient Demographics Current clinical literature estimates that approximately 2% to 5% of all fractures
Managements of Acute Midshaft Clavicular Fracture - Evidence-Based Medicine. 骨科部外傷骨科游宜勳 December 29th 2009
Managements of Acute Midshaft Clavicular Fracture - Evidence-Based Medicine 骨科部外傷骨科游宜勳 December 29th 2009 Acute midshaft clavicular fracture Early opinion (before and around 1990) Favor conservative treatment
9/24/2015. When Can I Use a SHS? When CAN T I Use a SHS? Sliding Hip Screw. Time proven. Technically simple. Cheap. Quick
When Can I Use a SHS? Frank A. Liporace, MD Associate Professor Director of Orthopaedic Trauma Research Director of Orthopaedic Trauma Jersey City Medical Center New York University / Hospital for Joint
Adult Reconstruction Hip Education Tracks
Adult Reconstruction Hip Education Tracks Adult Reconstruction Hip Track for the Specialist - HIP1 ICL 281 A Case-based Approach to High Risk Total Hip - When Do I Do Something Differently? ICL 241 The
Reverse Total Shoulder Arthroplasty: A New Frontier (of Complications)
Reverse Total Shoulder Arthroplasty: A New Frontier (of Complications) Emilie Cheung, MD Associate Professor Chief Shoulder Elbow Svc Stanford University Department of Orthopedic Surgery Procedure volumes
Anterior Plating of Displaced Middle Third Fractures of Clavicle An Effective Alternate Method
IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) e-issn: 2279-0853, p-issn: 2279-0861.Volume 17, Issue 3 Ver.8 March. (2018), PP 24-28 www.iosrjournals.org Anterior Plating of Displaced Middle Third
Operative Treatment of Acetabular Fractures in the Medicare Population
Operative Treatment of Acetabular s in the Medicare Population Peter J. Hayes, BA; Colin M. Carroll, MD; Craig S. Roberts, MD, MBA; David Seligson, MD; Edmund Lau, MS; Steven Kurtz, PhD; Kevin Ong, PhD;
The Influence of Patient Activation, Pain Self-Efficacy, and Resilience on Patient-Reported Pain and Function in Patients with Hip and Knee Arthritis
The Influence of Patient Activation, Pain Self-Efficacy, and Resilience on Patient-Reported Pain and Function in Patients with Hip and Knee Arthritis Tiffany C. Liu BA, Tom Crijns BSc, Kevin J. Bozic MD
AcUMEDr. LoCKING CLAVICLE PLATE SYSTEM
AcUMEDr LoCKING CLAVICLE PLATE SYSTEM LoCKING CLAVICLE PLATE SYSTEM Since 1988 Acumed has been designing solutions to the demanding situations facing orthopedic surgeons, hospitals and their patients.
)372( COPYRIGHT 2018 BY THE ARCHIVES OF BONE AND JOINT SURGERY
)372( COPYRIGHT 2018 BY THE ARCHIVES OF BONE AND JOINT SURGERY RESEARCH ARTICLE Economic Analysis of the Cost of Implants Used for Treatment of Distal Radius Fractures Suneel B. Bhat MD, MPhil; Frederic
Fundamentals of Hip and Knee Arthroplasty for Orthopaedic Residents. Presented by AAOS, AAHKS, The Knee Society and The Hip Society PROGRAM SCHEDULE
Fundamentals of Hip and Knee Arthroplasty for Orthopaedic Residents Presented by AAOS, AAHKS, The Knee Society and The Hip Society PROGRAM SCHEDULE SURGICAL SKILLS! May 18 20, 2018 Long Beach, CA Erik
AAOS/OTA Daily Dilemmas in Trauma: Your Topics, Expert Solutions
AAOS/OTA Daily Dilemmas in Trauma: Your Topics, Expert Solutions You pick the topics. We bring the expertise. May 2 4, 2019 Orlando, FL Paul Tornetta III, MD & J. Tracy Watson, MD Course Directors AAOS/OTA
Locked plating constructs are creating a challenge for surgeons.
Locked plating constructs are creating a challenge for surgeons. Three recent studies examining supracondylar femur fractures show concern for the high degree of stiffness of locked plating constructs
Talus Fractures: When and Why on Screws and Plates
Talus Fractures: When and Why on Screws and Plates Frank A. Liporace, MD Associate Professor Director of Orthopaedic Research New York University / Hospital for Joint Diseases, NY, NY Director Orthopaedic
Technology and Health Care 21 (2013) DOI /THC IOS Press
Technology and Health Care 21 (2013) 143 147 143 DOI 10.3233/THC-130714 IOS Press Comparison between conservative and surgical treatment of midshaft clavicle fractures: Outcome of 151 cases Kiriakos Daniilidis
SAN ANTONIO, TEXAS DECEMBER 9-11, 2010 Hyatt Regency Hill Country Resort & Spa Resort, San Antonio, TX USA. Program Agenda
6 th ANNUAL INTERNATIONAL EXTERNAL FIXATION SYMPOSIUM The Diabetic Charcot Foot SAN ANTONIO, TEXAS DECEMBER 9-11, 2010 Hyatt Regency Hill Country Resort & Spa Resort, San Antonio, TX USA Program Agenda
Origins of PF Pain. Genesis of Iatrogenic Patellofemoral Pain
Origins of PF Pain Genesis of Iatrogenic Patellofemoral Pain ISAKOS: DonJoy Consensus Meeting: Understanding Patellofemoral Pain Saturday, May 26, 2007 8:00-12:30 Talk: 7 minutes Improper Techniques Iatrogenic:
Codes for internal or external fixation are to be used only when internal or external fixation is not already listed as part of the basic procedure.
code it ALLOPURE Cancellous Allograft Wedge 2015 Reimbursement Codes The following codes contained within this document are representative of possible services or diagnoses that may be associated with
Original Date: December 2015 Page 1 of 8 FOR CMS (MEDICARE) MEMBERS ONLY
National Imaging Associates, Inc. Clinical guidelines TOTAL JOINT ARTHROPLASTY -Total Hip Arthroplasty -Total Knee Arthroplasty -Replacement/Revision Hip or Knee Arthroplasty CPT4 Codes: Please refer to
Lower Extremity Fracture Management. Fractures of the Hip. Lower Extremity Fractures. Vascular Anatomy. Lower Extremity Fractures in Children
Lower Extremity Fracture Management Brian Brighton, MD, MPH Levine Children s s Hospital Carolinas Medical Center Charlotte, NC Oscar Miller Day October 16, 2009 Lower Extremity Fractures in Children Anatomic
MANAGEMENT OF DISPLACED MIDDLE THIRD CLAVICULAR FRACTURES WITH SUPERIOR RECONSTRUCTION PLATING
Original Article Orthopaedics MANAGEMENT OF DISPLACED MIDDLE THIRD CLAVICULAR FRACTURES WITH SUPERIOR RECONSTRUCTION PLATING Kalyan Kaushik Bharam 1, Ram Kalyan T 1, R Siva Prasad 2, Rithika Singh 3 1
PERIPROSTHETIC FRACTURE FOLLOWING TOTAL KNEE ARTHROPLASTY: REVIEW ARTICLE
PERIPROSTHETIC FRACTURE FOLLOWING TOTAL KNEE ARTHROPLASTY: REVIEW ARTICLE Dr. Mohan Krishna Dhunju*, Prof. Dr. Lu Hou Gen and Prof. Dr. Liu Jun Department of Orthopaedics Surgery Unit-1, Clinical Medical
Geriatric Odontoid Fractures
Geriatric Odontoid Fractures M A R K E S K E N A Z I, M. D. S P I N E I N S T I T U T E O F S O U T H F L O R I D A A F F I L I A T E A S S I S T A N T P R O F E S S O R O F C L I N I C A L B I O M E D
Austin Hill MD MPH. Assistant Professor Dell Medical School Dept of Surgery and Perioperative Care Orthopaedic Trauma
Austin Hill MD MPH Assistant Professor Dell Medical School Dept of Surgery and Perioperative Care Orthopaedic Trauma Disclosures Orthopedic Implant Company ownership, stock, or options Increasing volume
Convertibilité. Ph. Valenti. Paris Shoulder Unit Clinique Bizet (Paris, France)
Convertibilité Ph. Valenti Paris Shoulder Unit Clinique Bizet (Paris, France) Disclosures Arthroplasty Consultant : FH orthopaedics receive royalties Arthroscopy Consultant : Zimmer Biomet Arthrex In Last
Are too many reverse TSAs being done? Problems it is causing
Are too many reverse TSAs being done? Problems it is causing Hithem Rahmi, DO John Itamura, MD The Kerlan Jobe Orthopaedic Clinic Professor of Orthopaedic Surgery Keck School of Medicine University of
Orthopaedics Business. Dave Illingworth, President February
Orthopaedics Business Dave Illingworth, President February 23 2005 1 Smith & Nephew Orthopaedics Attractive market Strong performance Momentum 2 Attractive market Demographics - 2x Growth by 2020 Active
NE Nebraska Trauma Conference Tristan Hartzell, MD November 8, 2017
NE Nebraska Trauma Conference 2017 Tristan Hartzell, MD November 8, 2017 Traumatic arm injuries in the elderly Fractures Hand Wrist Elbow Shoulder Soft tissue injuries Definitions Elderly? old or aging
Ideal Candidate for Cartilage Restoration. Large or Complex Lesions
Complex Biological Knee Reconstruction: Bipolar, Multifocal Lesions and Osteoarthritis William Bugbee, MD Attending Physician, Scripps Clinic 18 th International Sports Medicine Fellow s Conference Ideal
Ambulatory Knee Arthroplasty
Ambulatory Knee Arthroplasty Harlan B. Levine, MD Hartzband Center for Hip & Knee Replacement Hackensack University Medical Center Hackensack, New Jersey Disclosure Zimmer Consultant Biomet Consultant
Fractures and dislocations around elbow in adult
Lec: 3 Fractures and dislocations around elbow in adult These include fractures of distal humerus, fracture of the capitulum, fracture of the radial head, fracture of the olecranon & dislocation of the
Trauma symposium 2017
Trauma symposium 2017 Organised by Orthopaedics section Tuesday 21 february 2017 8.20 am Registration, tea and coffee 8.50 am Welcome and introduction Mr Jon Monk and Mr Rajarshi Bhattacharya, President,
Minimally Invasive Plating of Fractures:
Minimally Invasive Plating of Fractures: Advantages, Techniques and Trade-offs Matthew Garner, MD Created January 2016 OUTLINE Principles of fracture management The importance of vascular supply Equipment
Syndesmotic Ankle Injuries: Diagnosis and Treatment
Syndesmotic Ankle Injuries: Diagnosis and Treatment John A. Scolaro, M.D., M.A. Assistant Professor of Orthopaedic Surgery University of California, Irvine California Orthopaedic Association - 2016 Disclosures
A Patient s Guide to Adult Forearm Fractures
A Patient s Guide to Adult Forearm Fractures Orthopedic and Sports Medicine 825 South 8th Street, #550 Minneapolis, MN 55404 Phone: 612-333-5000 Fax: 612-333-6922 1 DISCLAIMER: The information in this
Acu-Sinch Repair System. Technical Monograph
Acu-Sinch Repair System Technical Monograph Acumed is a global leader of innovative orthopaedic and medical solutions. We are dedicated to developing products, service methods, and approaches that improve
DIRECT SUPERIOR HIP APPROACH IN TOTAL HIP ARTHROPLASTY. Anil Thomas, MD Adult Reconstruction Peachtree Orthopedics Atlanta, GA
DIRECT SUPERIOR HIP APPROACH IN TOTAL HIP ARTHROPLASTY Anil Thomas, MD Adult Reconstruction Peachtree Orthopedics Atlanta, GA Disclosures None Direct Superior Approach History and development of the approach
type of fixation associated with the prevalence of brachial plexus palsy after surgical repair of a
1 2 Unplanned Operations and Adverse Events After Surgery for Diaphyseal Fracture of the Clavicle 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 Abstract Purpose: We used a database of patients treated at three
I have no relevant disclosures pertaining to this talk.
Bryan Houseman, D.O., ATC Orthopaedic Trauma and Fracture Surgeon New Hampshire Orthopaedic Center September 10, 2016 I have no relevant disclosures pertaining to this talk. From Rockwood & Green, 8 th
Gerald R. Williams, MD
Reverse Arthroplasty: Is Overutilization a Problem? Gerald R. Williams, MD John M. Fenlin, Jr, MD Professor of Shoulder and Elbow Surgery The Rothman Institute Jefferson Medical College Royalties Conflict
Study of open reduction and internal fixation by tension band wiring fracture patella
Original article: Study of open reduction and internal fixation by tension band wiring fracture patella Dr Sachin Umrekar, Dr Soniya Umrekar Umrekar Multispecialty Hospital, Nanded, Maharashtra Corresponding
2018 OAOS Annual Orthopaedic Conference Objectives
2018 OAOS Annual Orthopaedic Conference Objectives #1 PANEL: Fracture Complications Supracondylar Femur Fractures: Nail or Plate Paul Tornetta, MD Discuss supracondylar femur fractures using nail vs. plate.
Pilon Fractures Pearls of Treatment Steven Steinlauf, MD The Orthopaedic Foot and Ankle Institute of South Florida CSOT November 2017, Tampa
Pilon Fractures Pearls of Treatment Steven Steinlauf, MD The Orthopaedic Foot and Ankle Institute of South Florida CSOT November 2017, Tampa Disclosures No relevant disclosures There is more literature
UPDATE ON COMMUNITY TRAUMA. Ericka R. Glass Orthopaedic Traumatologist Spectrum Orthopaedics
UPDATE ON COMMUNITY TRAUMA Ericka R. Glass Orthopaedic Traumatologist Spectrum Orthopaedics OBJECTIVES Understand common fractures that present to community trauma centers Outline basic treatment principles
Complications Cast Treatment Psychosocial effect on children Economoic effects on their families [Hughes 1995] ORIF with Plate Ex Fix Antegrade Nail L
![Complications Cast Treatment Psychosocial effect on children Economoic effects on their families [Hughes 1995] ORIF with Plate Ex Fix Antegrade Nail L](/thumbs/78/78093115.jpg "Complications Cast Treatment Psychosocial effect on children Economoic effects on their families [Hughes 1995] ORIF with Plate Ex Fix Antegrade Nail L")
Introduction Cast or Traction + cast Nicol [2000] ORIF Kregor [ 93], Ward [92] Ex Fix Aronson [ 92], Tolo [93] Antegrade Nail Beaty [94], Buford [98], Galpin [ 94], Herndon [ 89] Flexible IM Pinning [00],
For Commercial products, please refer to the following policy: Preauthorization via Web-Based Tool for Procedures
Medical Coverage Policy Total Joint Arthroplasty Hip and Knee EFFECTIVE DATE: 08/01/2017 POLICY LAST UPDATED: 06/06/2017 OVERVIEW Joint replacement surgery, also known as arthroplasty, has proved to be
Clavicle Fractures in Children and Adolescents
Clavicle Fractures in Children and Adolescents John A. Schlechter, DO Children s Hospital Orange County Orange, CA Objectives The Bone The Fracture The Treatment The Controversies The Bone The Clavicle
Patello-Femoral Replacement (PFR) Do you have severe pain under or around your kneecap?
KineMatch Patient-Specific PFR Patello-Femoral Replacement (PFR) Do you have severe pain under or around your kneecap? Have you been told by your doctor that you may need knee replacement surgery? Are
Other Upper Extremity Trauma. Inje University Sanggye Paik Hospital Yong-Woon Shin
Other Upper Extremity Trauma Inje University Sanggye Paik Hospital Yong-Woon Shin Forearm Fractures Forearm fractures - the most common orthopaedic injuries in children - 30-50% of all pediatric fractures
Terrible triad of the elbow
Terrible triad of the elbow Vasu Pai ? Terrible triad of the elbow" Posterior dislocation of the elbow + Fractures of the radial head + Fracture of coronoid process Uncommon injury 5% of dislocation Problems
Foot Injuries. Dr R B Kalia
Foot Injuries Dr R B Kalia Overview Dramatic impact on the overall health, activity, and emotional status More attention and aggressive management Difficult appendage to study and diagnose. Aim- a stable
GENERAL ORTHOPAEDIC PROGRAM SCHEDULE 18. January 25 26, 2019 Rosemont, IL. Albert J. Aboulafia, MD & Isador H. Lieberman, MD, MBA, FRCSC
AAOS Board Maintenance of Certification Preparation and Review GENERAL ORTHOPAEDIC PROGRAM SCHEDULE 18 CME Credits January 25 26, 2019 Rosemont, IL Albert J. Aboulafia, MD & Isador H. Lieberman, MD, MBA,
Anterior knee pain following total knee replacement caused by isolated Paget's disease of patella
ISPUB.COM The Internet Journal of Orthopedic Surgery Volume 9 Number 2 Anterior knee pain following total knee replacement caused by isolated Paget's disease of patella R Gupta, S Canty, W Ryan Citation
Anthony F. Infante, Jr., DO, MS 2013 CURRICULUM VITAE
Anthony F. Infante, Jr., DO, MS 2013 CURRICULUM VITAE 1. EDUCATION College Graduate School Medical School Internship (Rotating) Residency Fellowship Swarthmore College Swarthmore, PA BA-Biology 1987 Neuroanatomy
Injuries to the lower extremity II Aree Tanavalee MD Associate Professor Department of Orthopaedics Faculty of Medicine Chulalongkorn University
Injuries to the lower extremity II Aree Tanavalee MD Associate Professor Department of Orthopaedics Faculty of Medicine Chulalongkorn University Topics Fracture of the shaft of the femur Fractures around
Orthopedic Surgery in Pennsylvania
Orthopedic Surgery in Pennsylvania Total Joint Replacement and Common Spine Procedures 2010 Pennsylvania Health Care Cost Containment Council Orthopedic Surgery April in 2012 Pennsylvania - 2010 a About
Biomechanical concepts of total shoulder replacement. «Shoulder Course» Day 1. Richard W. Nyffeler Orthopädie Sonnenhof Bern. 11. Sept.
Biomechanical concepts of total shoulder replacement Richard W. Nyffeler Orthopädie Sonnenhof Bern First total shoulder prosthesis Jules Emile Péan, 1830-1898 Monobloc prostheses Charles Neer, 1917-2011
Current Controversies in Shoulder Surgery:
Current Controversies in Shoulder Surgery: Shoulder Instability Rotator Cuff Injury and Repair Reverse Shoulder Arthroplasty Brian Feeley, MD UC San Francisco Sports Medicine and Shoulder Surgery Disclosures
Acute management of clavicle fractures A long term functional outcome study
Acta Orthop. Belg., 2008, 74, 303-307 ORIGINAL STUDY Acute management of clavicle fractures A long term functional outcome study Byron CHALIDIS, Nick SACHINIS, Efthimios SAMOLADAS, Christos DIMITRIOU,
FIRST DESCRIBED RETROGRADE TECHNIQUE USING MEDIAL EPICONDYLE 6/5/2018. RETROGRADE vs. ANTEGRADE FEMORAL NAILING
What do I do? ISSUES ANTEGRADE vs. RETROGRADE PIRIFORMIS vs. TROCHANTER FLAT vs. FRACTURE TABLE SWIONTKOWSKI, 1984 FIRST DESCRIBED RETROGRADE TECHNIQUE USING MEDIAL EPICONDYLE 1 RETROGRADE NAILING SANDERS
Cost and Time Considerations: Are Minifragment Plates Worth It? Disclosure. More Disclosures. Are minifragment plates worth it? it depends!
Cost and Time Considerations: Are Minifragment Plates Worth It? Andrew Choo, MD Vumedi Webinar November 15, 2016 Disclosure Paid speaker: Depuy Synthes More Disclosures Price quotes are estimates only!
Fri., 10/17/14 Polytrauma, PAPER #74, 4:00 pm OTA 2014
Fri., 10/17/14 Polytrauma, PAPER #74, 4:00 pm OTA 2014 Clinical Indications for CT Angiography in Lower Extremity Trauma Joseph T. Patterson, MD 1 ; Thomas Fishler, MD 2 ; Daniel D. Bohl, MPH 3 ; Michael
Condylar constrained system in primary total knee replacement: our experience and literature review
Original Article Page 1 of 5 Condylar constrained system in primary total knee replacement: our experience and literature review Luigi Sabatini 1, Salvatore Risitano 1, Lorenzo Rissolio 1, Andrea Bonani
Treatment Alternatives for Pediatric Femoral Fractures
Treatment Alternatives for Pediatric Femoral Fractures Gregory A. Schmale, MD Seattle Children's Hospital, USA, gregory.schmale@seattlechildrens.org version 2 I have no conflicts of interest to report
Foot and Ankle Systems Coding Reference Guide
Foot and Ankle Systems Coding Reference Guide Physician Arthrodesis 27870 Arthrodesis, ankle, open 27871 Arthrodesis, tibiofibular joint, proximal or distal 28705 Arthrodesis; pantalar 28715 Arthrodesis;