Joint Replacement: A Case Study

Total joint replacements are very common in the United States, and are becoming even more common with increasing obesity rates and an increase in life expectancy. Long-lasting and high-performance implants are needed for the younger, active population that receives them. The Agency for Healthcare Research and Quality states more than 285,000 total hip arthroplasties (THA) and 600,000 total knee arthroplasties (TKA) are performed in the United States alone each year (2). Longevity of these joint replacements is dependent on several factors: the durability of the fixation of the implant surface to the bone, the bearing surface’s wear rate, and the accuracy of the surgeon in implantation of the total joint (2). Of these total joint replacements, periprosthetic osteolysis and aseptic loosening occurs in about twenty percent of cases, and aseptic loosening is responsible for about seventy-five percent of total joint replacement failures (2). This is

The aim of this paper is to provide a brief description of the bundle payment initiative will be addressed in relationship to the Affordable Care Act (ACA). Additional focuses will be placed on comparisons of the bundle strategy with traditional Medicare fee-for-service (FFS) payments. The purpose of the analysis is to implement and design a bundle payment program for community acquired pneumonia (CAP) patients utilizing the bundle program. The analysis will address health care providers and service vendors needed to successfully implement the program. Additionally, AONE nurse executive competencies will be discussed in relation to skills needed by nurse leaders in collaboration with the programs implementation.

Any proposed policy to improve healthcare must address the current payment method, and the rising cost of healthcare. The common reimbursement method for healthcare services is the fee-for-service payment model. It requires providers to figure-out all incurred costs to render services for patients. Additionally, providers need to determine what is the insurer proposing to pay, which thought to reward quantity over quality. An alternative to this model is using a bundle

Mr. ___ [NAME] is a 49-year-old white male, a patient of Dr. ___ [NAME], with a history of right knee replacement x 4, secondary to a gunshot wound in ___ [DATE]. Left knee, he has had multiple surgeries, primarily on the ligaments and I understand the meniscus. Also has right hip pain. The hip is probably related to his difficulty with the right knee. He has chronic pain in the knees. He has a need for testosterone as his labs are very low. PTSD, (___) anxiety. Really here today to follow up on the testosterone. Lab was drawn; other results are not yet available. His non-fasting glucose today was 106 and the hemoglobin A1c that was done was 5.9. He does have some history of hyperglycemia, but I think there were primarily non-fasting, he may just have some glucose intolerance. Complains primarily of knee pain and right hip pain. He is having erectile dysfunction, was given Viagra, and when he saw the urologist he was told that he needed testosterone, as it was quite low at 1.8.

I agree, physicians run the risk of non-payment and persuading them to adopt this payment system is challenging. Additionally, physicians are concern of complications that may occur outside the episode-based payments—how would they get paid and should they be paid separately. Finally, physicians are subject to losing patient’s if they opt out the bundled payment system to others that adopted the plan.

Becker’s Hospital Review offered three value-based alternative approaches to the controversial challenges to the current health system. Becker’s review discussed holding everyone who would naturally form the ACO to be financially accountable for keeping costs down but continue to be held to a standard to improve patient health (Becker’s Hospital Review, 2011). If the time is not right to implement the ACO, the pay-for-performance and its quality performance model can still be utilized; the bundled payments option and its episode of care option of paying for single use; and the medical home reimbursement tool that has already been proven to lower costs and improve satisfaction, are all models that can be used if the time is not right for the

Joint replacement is entering an era of greater minimally invasive alternatives, which provide patients with options to minimize recovery time and financial expense. The three major costs of joint replacement surgery include the price of the implant, extraneous hospital fees, and postoperative rehabilitation expenses [1]. Although minimizing length of stay would reduce these costs, several factors traditionally necessitate overnight hospitalization for arthroplasty patients, including pain control, blood loss, and monitoring of comorbidities. However, with recent advancements in analgesia technology, implant design, surgical technique, and postoperative management [2], many practices now offer outpatient surgery as an alternative to decrease

Hip replacement is a surgical procedure in which the hip joint is replaced by a prosthetic implant. Hip replacement surgery can be performed as a total replacement (or) a hemi (half) replacement. In a total hip replacement the damaged bone and cartilage is removed and replaced with prosthetic components. The damaged femoral head is removed and replaced with a metal stem that is placed into the hollow center of the femur .A hemiarthroplasty involves half of the hip ,which replaces only the ball portion of hip joint, not the socket portion. In total hip replacement, the socket is also replaced.

Jane Brody [2017] argues that there are million of Americans outliving their joints which are why millions of people have surgery to replace worn out joints but the numbers are going to grow in coming decades as people get older. Joint replacements are good when a person has lost mobility because humans need to move in order to do exercise and be healthy. Surgery can get rid of the joint pain but most patients in a study did not get a joint replacement. However, the numbers of patients of getting joint replacements are increasing rapidly. In a study, it showed people who had surgery recover equally well and typically experience less complication only if they go home directly from the hospital. Also, people who get outpatient rehabilitation

The value of total joint arthroplasty is well established. Doctors, nurses, and patients know that the procedures are common and effective, and that successful surgeries have great benefits. Successful operations are known to relieve pain and to improve the quality of life for patients and families. Should one of the surgeries result in infection, however, the consequences can be harsh, including serious illness, additional surgeries, or even deadly complications.

75-year-old male was admitted for and elective revision of a Left total hip replacement by Q225

Medical diagnosis: V43.64- Total hip replacement (Rt.) with secondary diagnoses of essential HTN (401.9), hypercholesterolemia (272), and depression.

The primary apprehension pertaining to the total knee replacement (TKR) is that the tibia tray suffers from aseptic loosening and it occurs due to physical stress shielding pertaining to the bone which further may need a revision surgery. The finest material is expected to be put to use for the process pertaining to the TKR surgery (Nasab & Hassan, 2010). According to Okazaki et al. (2004) the material used for prosthesis which had rigidity had lead to stress pertaining to the components along with the bones that are adjacent to the artificial knee. It leads to affecting the bone stress shielding as well. During the recent times, there has been development of such graded materials which have been invented for being considered as the probable tibia try biomaterial pertaining to the implant for ensuring enhancement in the ability pertaining to the distribution of the stress experienced.

A 19 year old Bahrain male has been referred to out physical therapy clinic by the family physician for right hip avascular necrosis (AVN). The patient subjectively reported that he suffers this problem long time back and was refusing the operation of hip replacement. Therefore, he is under a very long course of Opioids (morphine). He said" 3 time a day I came to the physician to have the dose of morphine injunction. This dialogue was between me and the patient in one of the following sessions:

Currently, I am working in Biology department at Dartmouth College, NH, USA on one year postdoctoral leave from QAU from September, 2015. Besides I wanted to get knee pain treatments and after detailed checkups and physiotherapies, doctors here suggested me for the knee replacement surgery in early 2016. Meantime, they figured it out that they have to first do another surgery (some gynecological issue) in emergency to keep my Hemoglobin levels normal (as I had to go for the blood transfusions almost every second month), So they did this surgery on 13th of July (Attached doctor’s letter-1) and rescheduled Knee replacement surgery in November, 2016 (Attached doctor’s letter-2) provided everything goes ok. I am still on bed rest after