A Regional Resource for Joint Replacement, Trauma, Orthopedics, Sports Medicine and Spine Problems
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ERAS for Hip and Knee (THA and TKA) Arthroplasty – a Need to Look Beyond LOS
ASERalert November 2016 | Volume 1, Issue 1 ERAS for Hip and Knee (THA and TKA) Arthroplasty – A Need to Look Beyond LOS OFFICIAL also in this issue PUBLICATION OF ERAS for Total Enhanced ERAS for Spine Joint Arthroplasty: Recovery for Surgery: A New Past, Present and Orthopedic Frontier ASER ALERT • VOLUME 1, ISSUE 1 • aserhq.org Future Surgery 1 ANNUAL CONGRESS OF ENHANCED RECOVERY AND 2017 PERIOPERATIVE MEDICINE APRIL 27TH-29TH, 2017 HYATT REGENCY WASHINGTON ON CAPITOL HILL 400 NEW JERSEY AVE NW, WASHINGTON, D.C. 20001 For more information please visit www.aserhq.org 2 ASER ALERT • VOLUME 1, ISSUE 1 • aserhq.org Board of Directors President’s Message Officers By Tong J (TJ) Gan, MD, MHS, FRCA, President President Tong J (TJ) Gan, MD, MHS, FRCA President-Elect Julie Thacker, MD t is my great pleasure to announce Vice-President the inaugural issue of the ASER Timothy Miller MB, ChB, FRCA Newsletter. Founded in 2014, Treasurer ASER is a multi-specialty nonprofit Roy Soto, MD Iorganization with an international Secretary membership and is dedicated to the Stefan D. Holubar MD, MS, FACS, FASCRS practice of enhanced recovery in the perioperative patient through education Directors and research. We are experiencing a period of tremendous expansion and Keith A. (Tony) Jones, MD growth, as is evidenced by the great Anthony Senagore, MD interest to implement the enhanced Maxime Cannesson, MD, PhD recovery pathway in hospitals around Terrence Loftus, MD, MBA, FACS the country. Andrew Shaw MB, FRCA, FFICM, FCCM Desiree Chappel, CRNA The ASER Mission is to advance the practice of perioperative enhanced recovery and to contribute to its pathways. -
WARD-DOCUMENT-2020.Pdf (1.324Mb)
3D Printing Impact on the Orthopedic Shoulder Replacement Global Supply Chain The Harvard community has made this article openly available. Please share how this access benefits you. Your story matters Citation Ward, Abner. 2020. 3D Printing Impact on the Orthopedic Shoulder Replacement Global Supply Chain. Master's thesis, Harvard Extension School. Citable link https://nrs.harvard.edu/URN-3:HUL.INSTREPOS:37365004 Terms of Use This article was downloaded from Harvard University’s DASH repository, and is made available under the terms and conditions applicable to Other Posted Material, as set forth at http:// nrs.harvard.edu/urn-3:HUL.InstRepos:dash.current.terms-of- use#LAA 3D Printing Impact on the Orthopedic Shoulder Replacement Global Supply Chain Abner M. Ward, MD, MBA, FACS, FAAOS A Thesis in the Field of Biotechnology Management for the Degree of Master of Liberal Arts in Extension Studies Harvard University May 2020 Copyright 2020 [Abner Ward] Abstract The goal of this work was to investigate a novel new technology being used to improve total shoulder replacements in patients with difficult to treat anatomy. The new technology is the use of three-dimensional (3D) implant creations that can be tailored to a patient’s specific shoulder defects as opposed to shelf, standard size implants. The project will help provide management direction to improve the efficiency in the global supply system so that surgeons in various parts of the world may have access to surgical components in the shortest time without significant delay. The study findings were that hindrances to 3D adoption for just-in-time surgical usage primarily include difficulties with sterilization and lack of a global validation metric when performed at multiple international centers, as opposed to one location in a single country. -
Evicore Musculoskeletal Imaging Guidelines
CLINICAL GUIDELINES Musculoskeletal Imaging Policy Version 2.1 Effective October 1, 2020 eviCore healthcare Clinical Decision Support Tool Diagnostic Strategies: This tool addresses common symptoms and symptom complexes. Imaging requests for individuals with atypical symptoms or clinical presentations that are not specifically addressed will require physician review. Consultation with the referring physician, specialist and/or individual’s Primary Care Physician (PCP) may provide additional insight. CPT® (Current Procedural Terminology) is a registered trademark of the American Medical Association (AMA). CPT® five digit codes, nomenclature and other data are copyright 2020 American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values or related listings are included in the CPT® book. AMA does not directly or indirectly practice medicine or dispense medical services. AMA assumes no liability for the data contained herein or not contained herein. © 2020 eviCore healthcare. All rights reserved. Musculoskeletal Imaging Guidelines V2.1 Musculoskeletal Imaging Guidelines Procedure Codes associated with Musculoskeletal Imaging 3 MS-1: General Guidelines 5 MS-2: Imaging Techniques 8 MS-3: 3D Rendering 12 MS-4: Avascular Necrosis (AVN)/Osteonecrosis 13 MS-5: Fractures 16 MS-6: Foreign Body 20 MS-7: Ganglion Cysts 22 MS-8: Gout/Calcium Pyrophosphate Deposition Disease (CPPD)/ Pseudogout/Chondrocalcinosis 24 MS-9: Infection/Osteomyelitis 26 MS-10: Soft Tissue Mass or Lesion of Bone 29 MS-11: Muscle/Tendon Unit -
Total Joint Replacement Hip and Knee Pain Pinnacle Orthopedics Pinnacle Medical Network Total Joint Replacement
Total Joint Replacement Hip and Knee Pain Pinnacle Orthopedics Pinnacle Medical Network Total Joint Replacement About Pinnacle Orthopedics and Pinnacle Medical Network South Louisiana’s Premier System for the Delivery of Musculoskeletal Health Care. Our talented team and professional staff offer a fully- equipped facility for the comprehensive care of your bones, joints, ligaments and muscles. Our team is dedicated to your complete care, from assessment to full recovery. Our primary goal is your safe return to work, sports, play and the activities of daily living. Allow our medical professionals to advance your orthopedic care. Total Joint Replacement “It would be embarrassing to get out of a car because everybody had to help me. Somebody would have to pull me up. I felt like this old woman.” “My life got progressively less active, less fun, and less participative.” “Just a day on my feet was exhausting and the pain became greater and greater until Advil and ibuprofen and all of those kinds of drugs couldn't numb it out. It just got worse and worse.” Total Joint Replacement Does this sound familiar? Total Joint Replacement You’re Not Alone More than 43 million people have some form of arthritis. It is estimated that the number of people affected by arthritis will increase to 60 million by 2020. Source: CDC Total Joint Replacement This information will touch upon the following topics: Understanding the Causes of Joint Pain Treatment Options What Joint Replacement Surgery Involves Realistic Expectations After Joint Replacement Total Joint Replacement Total Joint Replacement Total Joint Replacement Did you know? Nearly 21 million Americans suffer from osteoarthritis, a degenerative joint disease that is a leading cause of joint replacement surgery. -
Clinical Guidelines
CLINICAL GUIDELINES Joint Services Guidelines Version 1.0.2019 Clinical guidelines for medical necessity review of comprehensive musculoskeletal management services. © 2019 eviCore healthcare. All rights reserved. Regence: Comprehensive Musculoskeletal Management Guidelines V1.0.2019 Large Joint Services CMM-311: Knee Replacement/Arthroplasty 3 CMM-312: Knee Surgery-Arthroscopic and Open Procedures 14 CMM-313: Hip Replacement/Arthroplasty 35 CMM-314: Hip Surgery-Arthroscopic and Open Procedures 46 CMM-315: Shoulder Surgery-Arthroscopic and Open Procedures 47 CMM-318: Shoulder Arthroplasty/ Replacement/ Resurfacing/ Revision/ Arthrodesis 62 ______________________________________________________________________________________________________ © 2019 eviCore healthcare. All Rights Reserved. Page 2 of 69 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 918-8924 www.eviCore.com Regence: Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-311: Knee Replacement/Arthroplasty CMM-311.1: Definition 4 CMM-311.2: General Guidelines 5 CMM-311.3: Indications and Non-Indications 5 CMM-311.4 Experimental, Investigational, or Unproven 9 CMM-311.5: Procedure (CPT®) Codes 10 CMM-311.6: References 10 ______________________________________________________________________________________________________ © 2019 eviCore healthcare. All Rights Reserved. Page 3 of 69 400 Buckwalter Place Boulevard, Bluffton, SC 29910 (800) 918-8924 www.eviCore.com Regence: Comprehensive Musculoskeletal Management Guidelines V1.0.2019 CMM-311.1: Definition -
Predictors of Outcome Following Standardized Rehabilitation for Patients with Shoulder Pain
University of Kentucky UKnowledge Theses and Dissertations--Rehabilitation Sciences Rehabilitation Sciences 2013 Predictors of Outcome Following Standardized Rehabilitation for Patients with Shoulder Pain Stephanie D. Moore University of Kentucky, [email protected] Right click to open a feedback form in a new tab to let us know how this document benefits ou.y Recommended Citation Moore, Stephanie D., "Predictors of Outcome Following Standardized Rehabilitation for Patients with Shoulder Pain" (2013). Theses and Dissertations--Rehabilitation Sciences. 15. https://uknowledge.uky.edu/rehabsci_etds/15 This Doctoral Dissertation is brought to you for free and open access by the Rehabilitation Sciences at UKnowledge. It has been accepted for inclusion in Theses and Dissertations--Rehabilitation Sciences by an authorized administrator of UKnowledge. For more information, please contact [email protected]. STUDENT AGREEMENT: I represent that my thesis or dissertation and abstract are my original work. Proper attribution has been given to all outside sources. I understand that I am solely responsible for obtaining any needed copyright permissions. I have obtained and attached hereto needed written permission statements(s) from the owner(s) of each third-party copyrighted matter to be included in my work, allowing electronic distribution (if such use is not permitted by the fair use doctrine). I hereby grant to The University of Kentucky and its agents the non-exclusive license to archive and make accessible my work in whole or in part in all forms of media, now or hereafter known. I agree that the document mentioned above may be made available immediately for worldwide access unless a preapproved embargo applies. -
Breakthrough in Shoulder Surgery Brings New Hope to Patients
Breakthrough in Shoulder Surgery Brings New Hope to Patients ll her life, Millie has been active – raising six children, bowling in a league, even skating in After a shoulder replacement, Millie Athe roller derby 60 years ago. But when is back to the job she loves at the 81-year-old from Chantilly began Louise Archer Elementary School. experiencing difficulty raising her arms to complete simple tasks such as brushing her hair or reaching up to a shelf, she knew something was wrong. Her limited range of motion also made it hard to do her office job at Louise Archer Elementary School in Vienna. Millie consulted Commonwealth surgeon David Novak, MD, who diagnosed advanced osteoarthritis in both her shoulders. When several months of cortisone shots failed to alleviate her symptoms, she opted for a total shoulder replacement on her left side. This procedure involves replacing the arthritic joint surfaces with a metal and plastic implant. The components come Dr. Novak is among just a handful of surgeons in the area who in various sizes and are either cemented or press fit into the bone. perform this advanced procedure. “Patients like Millie, with end-stage arthritis and intact rotator cuff tendons, who no longer respond to conservative treatment – such Following both of her surgeries, Millie wore a sling for four weeks. as NSAIDs, cortisone or physical therapy – are generally good She spent two months working with a physical therapist on exercises candidates for total shoulder replacement,” Dr. Novak explains. to regain range of motion and strengthen her shoulder joint. It was all part of a rigorous rehabilitation program that every patient goes The surgery restored function to Millie’s left shoulder and she was through. -
EPO Surgeryplus Plan Amendment
AMENDMENT TO THE COLORADO EMPLOYER BENEFIT TRUST EPO MEDICAL BENEFIT PLAN AND SUMMARY PLAN DESCRIPTION, EFFECTIVE JANUARY 1, 2019 The CEBT EPO Medical Benefit Plan and Summary Plan Description, effective January 1, 2019 (the “Plan”), shall be amended effective July 1, 2019 to include SurgeryPlus Benefits as follows: 1. Medical Covered Expenses: SURGERYPLUS BENEFIT Charges for certain surgeries, procedures, and related travel expenses are payable as shown on the Schedule of Benefits. This plan will pay charges for surgeries, procedures, and related travel as approved by SurgeryPlus for one Episode of Care. The SurgeryPlus benefit terminates upon your discharge from the hospital, ambulatory surgical center, or other facility following the Episode of Care. Any services rendered after the termination of the Episode of Care are subject to the applicable rules of this plan. Travel benefits may be payable if you do not have access to SurgeryPlus surgeons. The travel benefits will be determined by SurgeryPlus based upon the procedure, provider, and geographic distance of the provider in relation to your residence. Travel benefits may also be provided for a companion if your procedure requires inpatient or overnight care. Travel arrangements must be made through your SurgeryPlus Care Advocate for benefits to be payable. Some examples of the surgeries and procedures available through SurgeryPlus, include, but are not limited to the following: Knee: Foot & Ankle: General Surgery: Knee Replacement Ankle Replacement Gallbladder Removal Knee Replacement -
Understanding Shoulder Pain and Shoulder Replacement Surgery
Understanding shoulder pain and shoulder replacement surgery. 2 Understanding shoulder pain and shoulder replacement surgery | 1 Table of Contents Understanding how your shoulder works ………………………………… 2 Why does my shoulder hurt? ……………… 3 Proximal Humeral Fracture …………………… 3 Rotator Cuff Arthropathy ……………………… 4 Osteoarthritis …………………………………… 5 Diagnosis ………………………………………… 6 What Is shoulder replacement? ………… 7 What Risks Are Involved? ……………………… 5 What is it Like to have shoulder replacement surgery? ……………………… 9 Understanding shoulder pain and shoulder replacement surgery | 1 Renew your passion for living. If shoulder pain is keeping you from the things you love, you and your doctor may decide it is time for shoulder replacement surgery. While there are many important factors to consider, keep in mind that surgical treatments are designed to reduce pain and restore function. This brochure is intended to provide an overview of shoulder pain and treatment options, and should be reviewed with your orthopedic specialist. It does not include all of the information needed to determine eligibility for shoulder replacement or for the proper use and care of shoulder implant. Please consult your orthopedic specialist for more information. For more information, visit zimmerbiomet.com to find a doctor near you. The information herein is of a general nature and does not represent or constitute medical advice or recommendations and is for general education purposes only. This information is not meant to replace the specific verbal and written recommendations and instructions provided by your surgeon for your specific situation. Patient treatment plans and outcomes will vary. 2 Understanding shoulder pain and shoulder replacement surgery | 3 Understanding how your shoulder works Your shoulder is a ball-and-socket joint made up mainly of two bones. -
Shoulder Replacement Commonly Asked Questions
Shoulder Replacement Commonly Asked Questions Patrick J Denard, MD Shoulder Specialist 2780 E. Barnett Rd Medford, OR 97530 541-779-6250 Background Information What is the anatomy of the shoulder? The shoulder joint is very complex and involves three bones and more than one joint. These bones are the clavicle (collar bone), the scapula (shoulder blade), and the humerus (upper arm bone). Numerous muscles, ligaments, and tendons surround the joint (Figure). The upper end of the arm bone (humerus) and the outside edge of the scapula bone (glenoid) form a “ball-and-socket joint”. This joint is remarkable because it typically allows greater range of motion than any other joint in your body. WFighuerneis1a shoulder replacement needed? Shoulder replacement surgery is most commonly used for severe degenerative joint disease (osteoarthritis) of the ball-and-socket joint. When the smooth surfaces (cartilage) of the ball and socket become rough, they rub against each other rather than glide. This Updated May 2019 1 rubbing causes pain, stiffness and swelling. Most patients who decide to have shoulder replacement surgery have experienced shoulder pain for a long time. Many patients have developed pain that limits their daily activities, as well as interferes with their sleep. Shoulder stiffness also interferes with the use of their arm for everyday activities. A shoulder replacement is performed to alleviate shoulder pain. It also helps to improve the range of motion of your shoulder joint, which also improves your function and the quality Wofhyaotuarrleifteh. e types of replacement? The two most common types of shoulder replacement are an anatomic shoulder replacement and a reverse total shoulder replacement. -
Arthroscopic Biologic Total Shoulder Replacement the Arthroscopic
Arthroscopic Biologic Total Shoulder Replacement The arthroscopic biologic total shoulder replacement is a new procedure that I have been working on for more than two years in partnership with my colleagues at Arthrex, Inc. The procedure is designed to resurface, a term used in orthopaedics to commonly refer to ‘replace’, the warn cartilage of the shoulder joint with transplanted donor cartilage and bone. In order to understand the rationale for developing this new procedure, it’s important to consider what is currently done to treat end-stage or late osteoarthritis of the shoulder. The hallmarks of symptomatic osteoarthritis in the shoulder, as with other joints, are pain and stiffness. Patients who have a painful stiff shoulder usually try conservative treatments in the form of oral anti-inflammatories, activity modification, or physical therapy among other modalities. Once conservative measures to relieve pain and/or increase function have failed, which will typically occur over time as part of the natural history of this disorder, operative intervention may be indicated. Typical operative treatments employed for arthritis in the shoulder include arthroscopic debridement with or without chondroplasty and capsular release, partial shoulder replacement, or total shoulder replacement. The outcomes for arthroscopic debridement and chondroplasty as well as other experimental procedures are unpredictable according to several studies reported in the literature. The most reliable operative interventions for the treatment of symptomatic late osteoarthritis have been reported with total shoulder replacement or partial shoulder replacements (hemiarthroplasty). These partial or total shoulder replacements involve removing a substantial part of the ball (proximal humerus) and/or socket (glenoid) bone and replacing the bone with metal and/or plastic. -
Surgical Considerations of the TMJ
Surgical Considerations of the TMJ Peter B. Franco DMD, FACS Diplomate, American Board of Oral and Maxillofacial Surgery Fellow, American College of Surgeons Carolinas Center for Oral and Facial Surgery Surgical Options of the TMJ • Arthroscopy • Open Arthroplasty – Disk preservation – Diskectomy Surgical Options of TMJ • General Indications – Significant TMJ pain or dysfunction – Non-surgical therapy has failed – Radiographic evidence of disease Failure to manage associated myofascial pain and dysfunction lowers the rate of surgical success. Arthroscopic Arthroplasty • Biopsy of suspected lesions or disease • Confirmation of other diagnostic findings that may warrant surgical treatment • Unexplained persistent joint pain that is non-responsive to medical treatment Arthroscopic Arthroplasty Indications • Closed, locked articular disc • Painful popping joint • Adhesions • Perforated disc • Hypermobile joints • Inflammatory joint disease • Hypermobility • Degenerative Joint Disease • Traumatic Injuries • Suspected Infection Arthroscopic Arthroplasty Equipment • Video/monitoring equipment • Arthroscopic cannula, scissors, forceps, probes, shavers • Laser Arthroscopic Arthroplasty Equipment • Scope • Arthroscopic cannula, scissors, forceps, probes, shavers • Laser Arthroscopic Arthroplasty Equipment • Scope • Video/monitoring equipment • Laser Arthroscopic Arthroplasty Equipment • Scope • Video/monitoring equipment • Arthroscopic cannula, scissors, forceps, probes, shavers Arthroscopic Arthroplasty Equipment Arthroscopic Arthroplasty Arthroscopic