المؤلفون: Losina, Elena, Paltiel, A David, Weinstein, Alexander M, Yelin, Edward, Hunter, David J, Chen, Stephanie P, Klara, Kristina, Suter, Lisa G, Solomon, Daniel H, Burbine, Sara A, Walensky, Rochelle P, Katz, Jeffrey N

المصدر: Arthritis Care & Research. 67(2)

مصطلحات موضوعية: Osteoarthritis, Chronic Pain, Health Services, Pain Research, Arthritis, Aging, Clinical Research, 6.1 Pharmaceuticals, Evaluation of treatments and therapeutic interventions, Musculoskeletal, Good Health and Well Being, Adult, Aged, Arthroplasty, Replacement, Knee, Female, Health Care Costs, Health Services Needs and Demand, Humans, Male, Middle Aged, Models, Economic, Osteoarthritis, Knee, United States, Clinical Sciences, Public Health and Health Services, Psychology

الوصف: ObjectiveThe impact of increasing utilization of total knee arthroplasty (TKA) on lifetime costs in persons with knee osteoarthritis (OA) is understudied.MethodsWe used the Osteoarthritis Policy Model to estimate total lifetime costs and TKA utilization under a range of TKA eligibility criteria among US persons with symptomatic knee OA. Current TKA utilization was estimated from the Multicenter Osteoarthritis Study and calibrated to Health Care Cost and Utilization Project data. OA treatment efficacy and toxicity were drawn from published literature. Costs in 2013 dollars were derived from Medicare reimbursement schedules and Red Book Online. Time costs were derived from published literature and the US Bureau of Labor Statistics.ResultsEstimated average discounted (3% per year) lifetime costs for persons diagnosed with knee OA were $140,300. Direct medical costs were $129,600, with $12,400 (10%) attributable to knee OA over 28 years. OA patients spent a mean ± SD of 13 ± 10 years waiting for TKA after failing nonsurgical regimens. Under current TKA eligibility criteria, 54% of knee OA patients underwent TKA over their lifetimes. Estimated OA-related discounted lifetime direct medical costs ranged from $12,400 (54% TKA uptake) when TKA eligibility was limited to Kellgren/Lawrence grades 3 or 4 to $16,000 (70% TKA uptake) when eligibility was expanded to include symptomatic OA with a lesser degree of structural damage.ConclusionBecause of low efficacy of nonsurgical regimens, knee OA treatment-attributable costs are low, representing a small portion of all costs for OA patients. Expanding TKA eligibility increases OA-related costs substantially for the population, underscoring the need for more effective nonoperative therapies.

وصف الملف: application/pdf

الوصول الحر: https://escholarship.org/uc/item/49w7j4fmTest

المؤلفون: Katz, Jeffrey N.

المصدر: Medical Care, 2001 Mar 01. 39(3), 203-205.

الوصول الحر: https://www.jstor.org/stable/3767734Test

المؤلفون: Katz, Jeffrey N., Phillips, Charlotte B., Fossel, Anne H., Liang, Matthew H.

المصدر: Medical Care, 1994 Feb 01. 32(2), 183-188.

الوصول الحر: https://www.jstor.org/stable/3766314Test

المؤلفون: Katz, Jeffrey N., Larson, Martin G., Phillips, Charlotte B., Fossel, Anne H., Liang, Matthew H.

المصدر: Medical Care, 1992 Oct 01. 30(10), 917-925.

الوصول الحر: https://www.jstor.org/stable/3765971Test

المؤلفون: Dempsey, Kyle E, Ghazinouri, Roya, Diez, Desiree, Alcantara, Luis, Beagan, Carolyn, Aggouras, Barbara, Hoagland, Monica, Thornhill, Thomas S, Katz, Jeffrey N

مصطلحات موضوعية: Total joint replacement, International medical mission, Dominican, Arthroplasty, Program evaluation

الوصف: Background Several organizations seek to address the growing burden of arthritis in developing countries by providing total joint replacements (TJR) to patients with advanced arthritis who otherwise would not have access to these procedures. Because these mission trips operate in resource poor environments, some of the features typically associated with high quality care may be difficult to implement. In the U.S., many hospitals that perform TJRs use the Blue Cross/Shield’s Blue Distinction criteria as benchmarks of high quality care. Although these criteria were designed for use in the U.S., we applied them to Operation Walk (Op-Walk) Boston’s medical mission trip to the Dominican Republic. Evaluating the program using these criteria illustrated that the program provides high quality care and, more importantly, helped the program to find areas of improvement. Methods We used the Blue Distinction criteria to determine if Op-Walk Boston achieves Blue Distinction. Each criterion was grouped according to the four categories included in the Blue Distinction criteria— “general and administrative”, “structure”, “process”, or “outcomes and volume”. Full points were given for criteria that the program replicates entirely and zero points were given for criteria that are not replicated entirely. Of the non-replicated criteria, Op-Walk Boston’s clinical and administrative teams were asked if they compensate for failure to meet the criterion, and they were also asked to identify barriers that prevent them from meeting the criterion. Results Out of 100 possible points, the program received 71, exceeding the 60-point threshold needed to qualify as a Blue Distinction center. The program met five out of eight “required” criteria and 11 out of 19 “informational” criteria. It scored 14/27 in the “general” category, 30/36 in the “structure” category, 17/20 in the “process” category, and 10/17 in the “outcomes and volume” category. Conclusion Op-Walk Boston qualified for Blue Distinction. Our analysis highlights areas of ...

العلاقة: http://www.biomedcentral.com/1471-2474/14/275Test

الإتاحة: http://www.biomedcentral.com/1471-2474/14/275Test

المؤلفون: Edwards, Robert R., Campbell, Claudia, Schreiber, Kristin L., Meints, Samantha, Lazaridou, Asimina, Martel, Marc O., Cornelius, Marise, Xu, Xinling, Jamison, Robert N., Katz, Jeffrey N., Carriere, Junie, Khanuja, Harpal P., Sterling, Robert S., Smith, Michael T., Haythornthwaite, Jennifer A.

المصدر: BMC Musculoskeletal Disorders; 3/29/2022, Vol. 23 Issue 1, p1-17, 17p

مستخلص: Background: Knee osteoarthritis (OA) is among the most common and disabling persistent pain conditions, with increasing prevalence and impact around the globe. In the U.S., the rising prevalence of knee OA has been paralleled by an increase in annual rates of total knee arthroplasty (TKA), a surgical treatment option for late-stage knee OA. While TKA outcomes are generally good, post-operative trajectories of pain and functional status vary substantially; a significant minority of patients report ongoing pain and impaired function following TKA. A number of studies have identified sets of biopsychosocial risk factors for poor post-TKA outcomes (e.g., comorbidities, negative affect, sensory sensitivity), but few prospective studies have systematically evaluated the unique and combined influence of a broad array of factors.Methods: This multi-site longitudinal cohort study investigated predictors of 6-month pain and functional outcomes following TKA. A wide spectrum of relevant biopsychosocial predictors was assessed preoperatively by medical history, patient-reported questionnaire, functional testing, and quantitative sensory testing in 248 patients undergoing TKA, and subsequently examined for their predictive capacity.Results: The majority of patients had mild or no pain at 6 months, and minimal pain-related impairment, but approximately 30% reported pain intensity ratings of 3/10 or higher. Reporting greater pain severity and dysfunction at 6 months post-TKA was predicted by higher preoperative levels of negative affect, prior pain history, opioid use, and disrupted sleep. Interestingly, lower levels of resilience-related "positive" psychosocial characteristics (i.e., lower agreeableness, lower social support) were among the strongest, most consistent predictors of poor outcomes in multivariable linear regression models. Maladaptive profiles of pain modulation (e.g., elevated temporal summation of pain), while not robust unique predictors, interacted with psychosocial risk factors such that the TKA patients with the most pain and dysfunction exhibited lower resilience and enhanced temporal summation of pain.Conclusions: This study underscores the importance of considering psychosocial (particularly positively-oriented resilience variables) and sensory profiles, as well as their interaction, in understanding post-surgical pain trajectories. [ABSTRACT FROM AUTHOR]

: Copyright of BMC Musculoskeletal Disorders is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

المؤلفون: Price, Andrew J, Alvand, Abtin, Troelsen, Anders, Katz, Jeffrey N, Hooper, Gary, Gray, Alastair, Carr, Andrew, Beard, David

المصدر: Price , A J , Alvand , A , Troelsen , A , Katz , J N , Hooper , G , Gray , A , Carr , A & Beard , D 2018 , ' Knee replacement ' , Lancet Oncology , vol. 392 , no. 10158 , pp. 1672-1682 . https://doi.org/10.1016/S0140-6736Test(18)32344-4

مصطلحات موضوعية: Arthroplasty, Replacement, Knee/adverse effects, Biomedical Technology/legislation & jurisprudence, Cost-Benefit Analysis, Humans, Knee Prosthesis, Osteoarthritis, Knee/epidemiology, Patient Reported Outcome Measures, Postoperative Complications/prevention & control, Prosthesis Design, Quality of Life, Reoperation, United Kingdom/epidemiology, United States/epidemiology

الوصف: Knee replacement surgery is one of the most commonly done and cost-effective musculoskeletal surgical procedures. The numbers of cases done continue to grow worldwide, with substantial variation in utilisation rates across regions and countries. The main indication for surgery remains painful knee osteoarthritis with reduced function and quality of life. The threshold for intervention is not well defined, and is influenced by many factors including patient and surgeon preference. Most patients have a very good clinical outcome after knee replacement, but multiple studies have reported that 20% or more of patients do not. So despite excellent long-term survivorship, more work is required to enhance this procedure and development is rightly focused on increasing the proportion of patients who have successful pain relief after surgery. Changing implant design has historically been a target for improving outcome, but there is greater recognition that improvements can be achieved by better implantation methods, avoiding complications, and improving perioperative care for patients, such as enhanced recovery programmes. New technologies are likely to advance future knee replacement care further, but their introduction must be regulated and monitored with greater rigour to ensure patient safety.

الإتاحة: https://doi.org/10.1016/S0140-6736Test(18)32344-4
https://curis.ku.dk/portal/da/publications/knee-replacementTest(1ecbc955-04f4-4804-b44f-4669be06510c).html

المؤلفون: Suter, Lisa G, Smith, Savannah R, Katz, Jeffrey N, Englund, Martin, Hunter, David J, Frobell, Richard, Losina, Elena

المصدر: School of Medicine and Health Sciences Student Works

مصطلحات موضوعية: Anterior Cruciate Ligament Injuries, Anterior Cruciate Ligament Reconstruction, Arthroplasty, Replacement, Knee, Cohort Studies, Computer Simulation, Female, Humans, Male, Osteoarthritis, Risk, Young Adult

العلاقة: https://hsrc.himmelfarb.gwu.edu/smhs_student_works/154Test; http://dx.doi.org/10.1002/acr.22940Test

الإتاحة: https://doi.org/10.1002/acr.22940Test
https://hsrc.himmelfarb.gwu.edu/smhs_student_works/154Test

المؤلفون: Prokopetz, Julian Jz, Losina, Elena, Bliss, Robin L., Wright, John, Baron, John A., Katz, Jeffrey N.

المصدر: BMC Musculoskeletal Disorders, 13(1)

مصطلحات موضوعية: Female, Arthroplasty, Replacement, Hip, Reoperation, Odds Ratio, Age Factors, Joint Diseases, Prosthesis Failure, Aged, 80 and over, Adult, Risk Assessment, Hip Prosthesis, Hip Joint, Male, Postoperative Complications, Humans, Comorbidity, Middle Aged

الوصف: BackgroundNumerous papers have been published examining risk factors for revision of primary total hip arthroplasty (THA), but there have been no comprehensive systematic literature reviews that summarize the most recent findings across a broad range of potential predictors.MethodsWe performed a PubMed search for papers published between January, 2000 and November, 2010 that provided data on risk factors for revision of primary THA. We collected data on revision for any reason, as well as on revision for aseptic loosening, infection, or dislocation. For each risk factor that was examined in at least three papers, we summarize the number and direction of statistically significant associations reported.ResultsEighty-six papers were included in our review. Factors found to be associated with revision included younger age, greater comorbidity, a diagnosis of avascular necrosis (AVN) as compared to osteoarthritis (OA), low surgeon volume, and larger femoral head size. Male sex was associated with revision due to aseptic loosening and infection. Longer operating time was associated with revision due to infection. Smaller femoral head size was associated with revision due to dislocation.ConclusionsThis systematic review of literature published between 2000 and 2010 identified a range of demographic, clinical, surgical, implant, and provider variables associated with the risk of revision following primary THA. These findings can inform discussions between surgeons and patients relating to the risks and benefits of undergoing total hip arthroplasty.

العلاقة: https://doi.org/10.17615/dkdw-7z85Test; https://cdr.lib.unc.edu/downloads/6682xb462?file=thumbnailTest; https://cdr.lib.unc.edu/downloads/6682xb462Test

الإتاحة: https://doi.org/10.17615/dkdw-7z85Test
https://cdr.lib.unc.edu/downloads/6682xb462?file=thumbnailTest
https://cdr.lib.unc.edu/downloads/6682xb462Test

المؤلفون: Collins, Jamie E., Donnell-Fink, Laurel A., Yang, Heidi Y., Usiskin, Ilana M., Lape, Emma C., Wright, John, Katz, Jeffrey N., Losina, Elena

المصدر: Journal of Bone & Joint Surgery, American Volume; 11/1/2017, Vol. 99 Issue 21, p1812-1818, 7p

مصطلحات موضوعية: BODY mass index, OSTEOARTHRITIS, ARTHROPLASTY, OVERWEIGHT persons, TOTAL knee replacement, OBESITY complications, CONVALESCENCE, KNEE diseases, OBESITY, PATIENT satisfaction, POSTOPERATIVE pain

مستخلص: Background: While obesity may be a risk factor for complications following total knee arthroplasty, data remain sparse on the impact of the degree of obesity on patient-reported outcomes following this procedure. Our objective was to determine the extent to which obesity level affects the trajectory of recovery as well as patient-reported pain, function, and satisfaction with surgery following total knee arthroplasty.Methods: We followed a cohort of patients who underwent total knee arthroplasty at 1 of 4 medical centers. Patients were ≥40 years of age with a primary diagnosis of osteoarthritis. We stratified patients into 5 groups according to the World Health Organization classification of body mass index (BMI). We assessed the association between BMI group and pain and function over the time intervals of 0 to 3, 3 to 6, and 6 to 24 months using a piecewise linear model. We also assessed the association between BMI group and patient-reported outcomes at 24 months. Multivariable models adjusted for age, sex, race, diabetes, musculoskeletal functional limitations index, pain medication use, and study site.Results: Of the 633 participants included in our analysis, 19% were normal weight (BMI of <25 kg/m), 32% were overweight (BMI of 25 to 29.9 kg/m), 27% were class-I obese (BMI of 30 to 34.9 kg/m), 12% were class-II obese (BMI of 35 to 39.9 kg/m), and 9% were class-III obese (BMI of ≥40 kg/m). Study participants with a higher BMI had worse preoperative WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index) pain and function scores and had greater improvement from baseline to 3 months. The mean change in pain and function from 3 to 6 and from 6 to 24 months was similar across all BMI groups. At 24 months, participants in all BMI groups had similar levels of pain, function, and satisfaction.Conclusions: Because of the differential trajectory of recovery in the first 3 months following total knee arthroplasty, the participants in the higher BMI groups were able to attain absolute pain and function scores similar to those in the nonobese and class-I obese groups. These data can help surgeons discuss expectations of pain relief and functional improvement with total knee arthroplasty candidates with higher BMI.Level Of Evidence: Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

: Copyright of Journal of Bone & Joint Surgery, American Volume is the property of Lippincott Williams & Wilkins and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)