Oncology Patients Are High Cost Outliers in Total Joint Replacement Bundled Payment Systems

2020 ◽  
Vol 35 (1) ◽  
pp. 12-16.e1
Author(s):  
Erik Woelber ◽  
Kenneth R. Gundle ◽  
Jonah Geddes ◽  
Kathryn L. Schabel ◽  
James B. Hayden ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Total Joint Replacement ◽  
Payment Systems ◽  
Oncology Patients ◽  
Bundled Payment

Patterns of Ninety-Day Readmissions Following Total Joint Replacement in a Bundled Payment Initiative

2017 ◽  
Vol 32 (4) ◽  
pp. 1080-1084 ◽  
Author(s):  
Omar A. Behery ◽  
Benjamin S. Kester ◽  
Jarrett Williams ◽  
Joseph A. Bosco ◽  
James D. Slover ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Total Joint Replacement ◽  
Bundled Payment

The Clinical, Operational, and Financial Components of a Successful Bundled Payment Program for Lower Extremity Total Joint Replacement

NEJM Catalyst ◽  
2021 ◽  
Vol 2 (10) ◽  
Author(s):  
Catherine MacLean ◽  
Matthew Titmuss ◽  
Jennifer Lee ◽  
Linda Russell ◽  
Douglas Padgett
Keyword(s):  
Lower Extremity ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Bundled Payment

Piroxicam spares buprenorphine after total joint replacement

1992 ◽  
Vol 63 (6) ◽  
pp. 658-660
Author(s):  
Michel Boeckstyns ◽  
Marianne Backer ◽  
Else Petersen ◽  
Iben Høj ◽  
Henrik Albrechtsen ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Total Joint Replacement

Postoperative Anesthesia Of Elderly And Senile Patients With Total Joint Replacement Of The Lower Extremities

2020 ◽  
Vol 2 (09) ◽  
pp. 75-81
Author(s):  
Gaziev Z.T. ◽  
Avakov V.E. ◽  
Shorustamov M.T. ◽  
Bektemirova N.T.
Keyword(s):  
Epidural Analgesia ◽  
Postoperative Period ◽  
Joint Replacement ◽  
Total Joint Replacement ◽  
Lower Extremities ◽  
Multimodal Analgesia ◽  
Control Group ◽  
Patient Controlled Analgesia ◽  
Physical Status ◽  
Traumatic Injuries

Objective: To evaluate the efficacy and safety of patient-controlled analgesia through prolonged epidural analgesia after joint replacement of the lower extremities. Material and methods. We analyzed the postoperative period of 213 elderly and senile patients who were operated on for degenerative-dystrophic and traumatic injuries of the joints of the lower extremities. All patients underwent total joint replacement (164 - THA and 49 - TKA). The age of patients is from 65 to 90 years (average age was 78 ± 8 years) with a physical status of ASA 3 and above. All examined patients were divided into 2 groups. 63 patients comprised the main group, which in the postoperative period underwent patient-controlled analgesia (PCA) through prolonged epidural analgesia. The control group consisted of 150 patients, for the anesthesia of which in the postoperative period only standard systemic multimodal analgesia was used Conclusion. Patient-controlled analgesia is an alternative to traditional analgesic regimens. This method should be one of the main methods after surgical anesthesia for joint replacement of the lower limb in elderly and senile patients.

scholarly journals COVID-19 (SARS-CoV-2) lymphocyte responses are associated with inflammatory biomarkers in total joint replacement surgery candidates pre-operatively

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Marco S. Caicedo ◽  
Vianey Flores ◽  
Alicia Padilla ◽  
Samelko Lauryn ◽  
Joshua J. Jacobs ◽  
...  
Keyword(s):  
Joint Replacement ◽  
Total Joint Replacement ◽  
Cross Reactivity ◽  
Inflammatory Biomarkers ◽  
Nucleocapsid Proteins ◽  
Joint Replacement Surgery ◽  
Replacement Surgery ◽  
Operative Planning ◽  
Lymphocyte Responses ◽  
Reactive Lymphocytes

Abstract Background Recent studies indicate that, in addition to antibody production, lymphocyte responses to SARS-CoV-2 may play an important role in protective immunity to COVID-19 and a percentage of the general population may exhibit lymphocyte memory due to unknown/asymptomatic exposure to SARS-CoV-2 or cross-reactivity to other more common coronaviruses pre-vaccination. Total joint replacement (TJR) candidates returning to elective surgeries (median age 68 years) may exhibit similar lymphocyte and/or antibody protection to COVID-19 prior to vaccination Methods In this retrospective study, we analyzed antibody titters, lymphocyte memory, and inflammatory biomarkers specific for the Spike and Nucleocapsid proteins of the SARS-CoV-2 virus in a cohort of n=73 returning TJR candidates (knees and/or hips) pre-operatively. Results Peripheral blood serum of TJR candidate patients exhibited a positivity rate of 18.4% and 4% for IgG antibodies specific for SARS-CoV-2 nucleocapsid and spike proteins, respectively. 13.5% of TJR candidates exhibited positive lymphocyte reactivity (SI > 2) to the SARS-CoV-2 nucleocapsid protein and 38% to the spike protein. SARS-CoV-2 reactive lymphocytes exhibited a higher production of inflammatory biomarkers (i.e., IL-1β, IL-6, TNFα, and IL-1RA) compared to non-reactive lymphocytes. Conclusions A percentage of TJR candidates returning for elective surgeries exhibit pre-vaccination positive SARS-CoV-2 antibodies and T cell memory responses with associated pro-inflammatory biomarkers. This is an important parameter for understanding immunity, risk profiles, and may aid pre-operative planning. Trial registration Retrospectively registered.

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