Documenting Medical Necessity for TJR

Mary Ann Porucznik

Although a total hip or total knee arthroplasty is frequently seen as an “elective” procedure, for most patients, it’s also the last step in a long effort to maintain quality of life. Most orthopaedic surgeons won’t recommend a total joint replacement (TJR) until after multiple other options to reduce pain and maintain function have been tried.

Stemming the Effects of Bone Loss

Jay D. Lenn

A noncemented femoral stem in total hip arthroplasty (THA) needs to achieve fixation immediately after implant to enable bone ingrowth. But proximal bone loss due to traumatic injury, disease, or previous surgery may prevent bone-implant integration and lead to implant failure. Limited data exist on how much bone loss precludes noncemented arthroplasty or how well different stem designs function with varying degrees of bone loss. Benjamin C.

Making Clinical Practice Guidelines ROCK

Kevin G. Shea, MD; James L. Carey, MD, MPH; Nathan L. Grimm, BS; John C. Jacobs, BS

The Institute of Medicine (IOM) and other healthcare agencies have called for the increased use of evidence-based clinical practice guidelines (CPG) to reduce practice variation, improve quality of care, and decrease inefficiencies. The IOM has even outlined the qualities of a trust-worthy guideline.

The AJRR: Becoming a National U.S. Joint Registry

A roundtable discussion with participating physicians The American Joint Replacement Registry (AJRR) is a national total joint replacement registry, governed by an independent, not-for-profit entity, under the direction of orthopaedic surgeons in partnership with stakeholders. The goal of the AJRR is to improve the quality, outcomes, and cost-effectiveness of total joint replacement (TJR) surgeries. Recently, E.

Physician Burnout and Patient Safety

M. Catherine Sargent, MD

During the past few years, the medical community has become increasingly aware of the problem of physician burnout. Burnout—a pathologic response to stress manifested by the triad of emotional exhaustion, depersonalization, and diminished sense of personal accomplishment—is common among healthcare workers, including orthopaedic surgeons. I have been involved in several projects looking at burnout in orthopaedics.

ORS to Host Clinical Research Forum

Clinical research trials have always played an important role in improving patient care. Clinical trials provide both doctors and patients with vital information that can advance medical treatment. Getting the most out a trial requires proper study design, planning, and study management throughout the course of the trial.