Immediate surgery versus waiting list policy in revision total hip arthroplasty

Saleh, Khaled J.; Wood, Kenneth C.; Gafni, Amiram; Gross, A E

doi:10.1016/s0883-5403(97)90040-1

Cited by 27 publications

(5 citation statements)

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“… 4 , 11 , 15 Compared with primary THA or TKA, revision surgery has been shown to be costlier, technically more difficult, and associated with higher rates of complications and inferior outcomes. 8 , 15–19 Considering this evidence, the vast impact TJA will have on US healthcare and economy in the near future quickly becomes evident. Although understanding of the mechanisms underlying osteolysis-induced AL has substantially improved in recent decades, barriers in the implementation of effective intervention obviating the need for revision surgery or minimizing its technical and financial demands still exist.…”

Section: Introductionmentioning

confidence: 99%

A review of UHMWPE wear-induced osteolysis: the role for early detection of the immune response

et al. 2016

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In a world where increasing joint arthroplasties are being performed on increasingly younger patients, osteolysis as the leading cause of failure after total joint arthroplasty (TJA) has gained considerable attention. Ultra-high molecular weight polyethylene wear-induced osteolysis is the process by which prosthetic debris mechanically released from the surface of prosthetic joints induces an immune response that favors bone catabolism, resulting in loosening of prostheses with eventual failure or fracture. The immune response initiated is innate in that it is nonspecific and self-propagating, with monocytic cells and osteoclasts being the main effectors. To date, detecting disease early enough to implement effective intervention without unwanted systemic side effects has been a major barrier. These barriers can be overcome using newer in vivo imaging techniques and modules linked with fluorescence and/or chemotherapies. We discuss the pathogenesis of osteolysis, and provide discussion of the challenges with imaging and therapeutics. We describe a positron emission tomography imaging cinnamoyl-Phe-(D)-Leu-Phe-(D)-Leu-Phe-Lys module, specific to macrophages, which holds promise in early detection of disease and localization of treatment. Further research and increased collaboration among therapeutic and three-dimensional imaging researchers are essential in realizing a solution to clinical osteolysis in TJA.

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Section: Introductionmentioning

confidence: 99%

A review of UHMWPE wear-induced osteolysis: the role for early detection of the immune response

et al. 2016

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“…Elderly patients living alone or in care settings can spend years with an asymptomatic but loose component, or may deny a revision intervention for other health reasons. In addition, patients in need of a revision may have long waiting times, especially in state-administered health care systems such as Canada (Saleh et al 1997), England (Chakravarty et al 2005), or Scandinavia (Lofvendahl et al 2005).…”

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confidence: 99%

Patient-related risk factors leading to aseptic stem loosening in total hip arthroplasty: A case-control study of 5,035 patients

et al. 2006

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“…In our study, healthcare costs were not associated with time between scheduling an appointment and seeing a hand surgeon. One study found that immediate surgery for patients undergoing total hip arthroplasty revision reduced healthcare expenditure [4]. Another study found that waiting more than 6 months for total hip arthroplasty resulted in higher overall costs (including medical, personal, and societal) [5].…”

Section: Discussionmentioning

confidence: 99%

Time from Booking Until Appointment and Healthcare Utilization in Hand Surgery Patients with Discretionary Conditions

et al. 2016

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Delaying treatment for benign musculoskeletal conditions may allow patients to learn self-efficacy and develop coping strategies, leading to less medical intervention and reduced cost. We tested the hypothesis that time from booking until appointment is not associated with healthcare costs. We further tested the secondary hypothesis that time from booking to appointment is not associated with specific healthcare utilizations. We identified 16,750 patients (55 % women; mean age 50 years) making first clinic visits to hand surgeons at our hospital between January 1, 2003 and December 31, 2012. Booking time was defined as the time between the scheduling of an appointment and the actual visit. Imaging procedures, injections, nerve conduction studies, occupational therapy visits, surgery, and referrals were determined up until the patient's second visit with the surgeon, or 90 days. Costs were determined in Relative Value Units. Duration between booking and office visit was not associated with higher cost (regression coefficient [β] 0.0023, P = 0.77). Duration between booking and office visit was associated with a higher rate of nerve conduction studies (odds ratio [OR] 1.02, P < 0.001) and a lower rate of occupational therapy (OR 0.98, P < 0.001). There was substantial variation between surgeons. Greater wait time was not therapeutic, but is associated with different diagnostic and treatment measures that suggest people that are willing to wait have different types of problems. The variation by surgeon may make variation based on other factors, including time between booking and appointment, difficult to discern.

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Immediate surgery versus waiting list policy in revision total hip arthroplasty

Cited by 27 publications

References 50 publications

A review of UHMWPE wear-induced osteolysis: the role for early detection of the immune response

A review of UHMWPE wear-induced osteolysis: the role for early detection of the immune response

Patient-related risk factors leading to aseptic stem loosening in total hip arthroplasty: A case-control study of 5,035 patients

Time from Booking Until Appointment and Healthcare Utilization in Hand Surgery Patients with Discretionary Conditions

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