المؤلفون: Lowenstein, Natalie A., Chang, Yuchiao, Mass, Hanna, Mercurio, Angela M., Ukogu, Chierika, Katz, Jeffrey N., Matzkin, Elizabeth G.

المصدر: The American Journal of Sports Medicine ; volume 52, issue 1, page 116-123 ; ISSN 0363-5465 1552-3365

الوصف: Background: Preoperative risk factors contributing to poor outcomes after arthroscopic partial meniscectomy (APM) have not yet been consolidated and codified into an index scoring system used to predict APM success. Purpose: To create an index score using available preoperative factors to predict the likelihood of favorable postoperative outcomes after APM. Study Design: Case-control study; Level of evidence, 3. Methods: A consecutive cohort of patients undergoing primary APM were enrolled in this study. Patients completed pre- and postoperative patient-reported outcome measure (PROM) questionnaires that included the Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale (VAS) for pain, Veterans RAND 12-Item Health Survey (VR-12 Physical and Mental), and Marx Activity Rating Scale (MARS). Multivariable logistic regression models were performed to evaluate independent predictors of KOOS Pain, Symptoms, and Activities of Daily Living scores and achievement of the minimal clinically important difference (MCID) and substantial clinical benefit (SCB). The authors assigned points to each variable proportional to its odds ratio, rounded to the nearest integer, to generate the index score. Results: In total, 468 patients (mean age, 49 years [SD, 10.4 years; range, 19-81 years]) were included in this study. In the univariate analysis, shorter symptom duration, lower Kellgren-Lawrence (KL) grade, lower preoperative KOOS Pain value, and lower VR-12 Physical score were associated with a higher likelihood of clinical improvement at 1 year. In the multivariable model for clinical improvement with MCID, symptom duration (<3 months: OR, 3.00 [95% CI, 1.45-6.19]; 3-6 months: OR, 2.03 [95% CI, 1.10-3.72], compared with >6 months), KL grade (grade 0: OR, 3.54 [95% CI, 1.66-7.54]; grade 1: OR, 3.04 [95% CI, 1.48-6.26]; grade 2: OR, 2.31 [95% CI, 1.02-5.27], compared with grade 3), and preoperative KOOS Pain value (score <45: OR, 3.00 [95% CI, 1.57-5.76]; score of 45-60: OR, 2.80 [95% CI, 1.47-5.35], ...

الإتاحة: https://doi.org/10.1177/03635465231210303Test

المؤلفون: Katz, Jeffrey N., Betensky, Daniel

المصدر: Journal of Bone and Joint Surgery ; volume 106, issue 3, page 177-179 ; ISSN 0021-9355 1535-1386

الإتاحة: https://doi.org/10.2106/jbjs.23.01388Test

المؤلفون: Williams, Jessica A.R., Collins, Jamie E., Gandhi, Ashvin, Yu, Huizi, Boden, Leslie I., Katz, Jeffrey N., Wagner, Gregory R., Sorensen, Glorian

المساهمون: National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention

المصدر: Journal of the American Medical Directors Association ; volume 25, issue 3, page 403-407.e1 ; ISSN 1525-8610

مصطلحات موضوعية: Health Policy, General Medicine, General Nursing, Geriatrics and Gerontology

الإتاحة: https://doi.org/10.1016/j.jamda.2023.05.021Test
https://api.elsevier.com/content/article/PII:S1525861023004991?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S1525861023004991?httpAccept=text/plainTest

المؤلفون: Acosta, José I., Ermann, Joerg, Isaac, Zacharia, DeFilipp, Miriam, Gottreich, Julia R., Andrew, Michael N., Yuchiao Chang, Zampini, Jay M., Katz, Jeffrey N., Mandell, Jacob C.

المصدر: Spine (03622436); Mar2024, Vol. 49 Issue 5, p332-340, 9p

المؤلفون: Williams, Emma E., Katz, Jeffrey N., Leifer, Valia P., Collins, Jamie E., Neogi, Tuhina, Suter, Lisa G., Levy, Bruce, Farid, Alexander, Safran‐Norton, Clare E., Paltiel, A. David, Losina, Elena

المساهمون: National Institute of Arthritis and Musculoskeletal and Skin Diseases

المصدر: ACR Open Rheumatology ; volume 4, issue 10, page 853-862 ; ISSN 2578-5745 2578-5745

الوصف: Objective We examined the cost‐effectiveness of treatment strategies for concomitant meniscal tear and knee osteoarthritis (OA) involving arthroscopic partial meniscectomy surgery and physical therapy (PT). Methods We used the Osteoarthritis Policy Model, a validated Monte Carlo microsimulation, to compare three strategies, 1) PT‐only, 2) immediate surgery, and 3) PT + optional surgery, for participants whose pain persists following initial PT. We modeled a cohort with baseline meniscal tear, OA, and demographics from the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial of arthroscopic partial meniscectomy versus PT. We estimated risks and costs of arthroscopic partial meniscectomy complications and accounted for heightened OA progression post surgery using published data. We estimated surgery use rates and treatment efficacies using MeTeOR data. We considered a 5‐year time horizon, discounted costs, and quality‐adjusted life‐years (QALYs) 3% per year and conducted sensitivity analyses. We report incremental cost‐effectiveness ratios. Results Relative to PT‐only, PT + optional surgery added 0.0651 QALY and $2,010 over 5 years (incremental cost‐effectiveness ratio = $30,900 per QALY). Relative to PT + optional surgery, immediate surgery added 0.0065 QALY and $3080 (incremental cost‐effectiveness ratio = $473,800 per QALY). Incremental cost‐effectiveness ratios were sensitive to optional surgery efficacy in the PT + optional surgery strategy. In the probabilistic sensitivity analysis, PT + optional surgery was cost‐effective in 51% of simulations at willingness‐to‐pay thresholds of both $50,000 per QALY and $100,000 per QALY. Conclusion First‐line arthroscopic partial meniscectomy has a prohibitively high incremental cost‐effectiveness ratio. Under base case assumptions, second‐line arthroscopic partial meniscectomy offered to participants with persistent pain following initial PT is cost‐effective at willingness‐to‐pay thresholds between $31,000 and $473,000 per QALY. Our analyses suggest that arthroscopic ...

الإتاحة: https://doi.org/10.1002/acr2.11480Test

المؤلفون: Winter, Amelia R., Collins, Jamie E., Katz, Jeffrey N.

المصدر: BMC Musculoskeletal Disorders ; volume 23, issue 1 ; ISSN 1471-2474

مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

الإتاحة: https://doi.org/10.1186/s12891-022-05344-3Test

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.

المساهمون: national institutes of health

المصدر: BMC Musculoskeletal Disorders ; volume 23, issue 1 ; ISSN 1471-2474

مصطلحات موضوعية: Orthopedics and Sports Medicine, Rheumatology

الوصف: 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 ...

الإتاحة: https://doi.org/10.1186/s12891-022-05239-3Test

المؤلفون: Spindler, Kurt P., Imrey, Peter B., Yalcin, Sercan, Beck, Gerald J., Calbrese, Gary, Cox, Charles L., Fadale, Paul D., Farrow, Lutul, Fitch, Robert, Flanigan, David, Fleming, Braden C., Hulstyn, Michael J., Jones, Morgan H., Kaeding, Christopher, Katz, Jeffrey N., Kriz, Peter, Magnussen, Robert, McErlean, Ellen, Melgaard, Carrie, Owens, Brett D., Saluan, Paul, Strnad, Greg, Winalski, Carl S., Wright, Rick

المصدر: Orthopaedic Journal of Sports Medicine ; volume 10, issue 1, page 232596712110654 ; ISSN 2325-9671 2325-9671

مصطلحات موضوعية: Orthopedics and Sports Medicine

الوصف: Background: BEAR (bridge-enhanced anterior cruciate ligament [ACL] restoration), a paradigm-shifting technology to heal midsubstance ACL tears, has been demonstrated to be effective in a single-center 2:1 randomized controlled trial (RCT) versus hamstring ACL reconstruction. Widespread dissemination of BEAR into clinical practice should also be informed by a multicenter RCT to demonstrate exportability and compare efficacy with bone--patellar tendon–bone (BPTB) ACL reconstruction, another clinically standard treatment. Purpose: To present the design and initial preparation of a multicenter RCT of BEAR versus BPTB ACL reconstruction (the BEAR: Multicenter Orthopaedic Outcomes Network [BEAR-MOON] trial). Design and analytic issues in planning the complex BEAR-MOON trial, involving the US National Institute of Arthritis and Musculoskeletal and Skin Diseases, the US Food and Drug Administration, the BEAR implant manufacturer, a data and safety monitoring board, and institutional review boards, can usefully inform both clinicians on the trial’s strengths and limitations and future investigators on planning of complex orthopaedic studies. Study Design: Clinical trial. Methods: We describe the distinctive clinical, methodological, and operational challenges of comparing the innovative BEAR procedure with the well-established BPTB operation, and we outline the clinical motivation, experimental setting, study design, surgical challenges, rehabilitation, outcome measures, and planned analysis of the BEAR-MOON trial. Results: BEAR-MOON is a 6-center, 12-surgeon, 200-patient randomized, partially blinded, noninferiority RCT comparing BEAR with BPTB ACL reconstruction for treating first-time midsubstance ACL tears. Noninferiority of BEAR relative to BPTB will be claimed if the total score on the International Knee Documentation Committee (IKDC) subjective knee evaluation form and the knee arthrometer 30-lb (13.61-kg) side-to-side laxity difference are both within respective margins of 16 points for the IKDC and 2.5 mm for ...

الإتاحة: https://doi.org/10.1177/23259671211065447Test

المؤلفون: Ellrodt, Jack, Pincus, Theodore, Shadick, Nancy A., Stratton, Jacklyn, Santacroce, Leah, Katz, Jeffrey N., Smolen, Josef, Solomon, Daniel H.

المصدر: JCR: Journal of Clinical Rheumatology ; volume 28, issue 5, page 265-269 ; ISSN 1536-7355 1076-1608

الوصف: Objective Limited information is available concerning experiences of participants in a virtual learning collaborative (LC), and little qualitative data or participant feedback on how this format can be improved. One prior in-person LC in rheumatology successfully improved adherence with treat-to-target (TTT) for RA. We conducted a virtual LC on TTT and herein report on participant satisfaction. Methods We conducted a virtual LC with 18 rheumatology practices from across the United States during 2020 to 2021. The LC included a virtual kickoff meeting and monthly videoconferences, accompanied by data submission and feedback. At the conclusion of the LC, we surveyed the 45 LC participants concerning individual experience and satisfaction. Results All sites and 78% of participants responded to the surveys. The LC included small and large practices, 14 academic and 4 nonacademic, and respondents ranged in their roles: 24 physicians, 5 nurses or nurse practitioners, 3 administrators, and 3 other roles. Overall, 94% of respondents indicated they were either somewhat or very satisfied with the LC, and 94% said they would recommend a similar LC to a colleague. Aspects of the LC described as “very useful” included a kickoff meeting, intersite discussion, and monthly speakers; however, digital tools such as the Web site and meeting recordings were not found useful. Conclusions Virtual LCs are feasible, and participants reported strong satisfaction. Virtual LCs were highly valued by rheumatologists, trainees, and their practice staffs. Potential topics were identified for future LCs that could improve the quality of care delivered to rheumatology patients.

الإتاحة: https://doi.org/10.1097/rhu.0000000000001851Test

المؤلفون: Selzer, Faith, Zarra, Michael B., MacFarlane, Lindsey A., Song, Shuang, McHugh, Claire G., Bronsther, Corin, Huizinga, Jamie, Losina, Elena, Katz, Jeffrey N.

المصدر: Osteoarthritis and Cartilage Open ; volume 4, issue 4, page 100311 ; ISSN 2665-9131

مصطلحات موضوعية: General Medicine

الإتاحة: https://doi.org/10.1016/j.ocarto.2022.100311Test
https://api.elsevier.com/content/article/PII:S2665913122000796?httpAccept=text/xmlTest
https://api.elsevier.com/content/article/PII:S2665913122000796?httpAccept=text/plainTest