South Nassau Communities Hospital

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South Nassau in the Community

10/23/2013

Study Demonstrates Knee Replacement’s Economic Benefit for Patients, Employers


The estimated lifetime savings accrued primarily to patients and their employers from the 600,000 total knee replacements performed in 2009 is approximately $12 billion, according to a study published in a recent edition of the Journal of Bone and Joint Surgery.

The estimated $12 billion in lifetime savings was based on the following data:

  • Total knee replacement increased lifetime direct costs by an average of $20,635 (net present value in 2009 dollars) when compared with nonsurgical treatment; but is offset by a savings of $39,565 from reduced indirect costs (including a savings of 85% due to increased employment and earnings, with the remaining 15% from fewer missed workdays and lower disability payments) resulting in a lifetime net benefit from total knee replacement of $18,930 per patient.

“The results of this study accentuate South Nassau’s steadfast commitment to use the latest advancements in knee replacement surgery so that our patients are relieved of the pain and debilitation caused by osteoarthritis and achieve outcomes that allow them to live and work without any limitations,” said Bradley Gerber, MD, chief of joint replacement surgery at South Nassau Communities Hospital.

The study used the Markov mathematical model to compare direct and indirect costs between surgical and nonsurgical treatment scenarios. The Markov model made it possible to study and compare the treatment scenarios by establishing a present state of the patients and then effecting a transition to a new state of patients after surgery, such a transition being dependent only on the values of the current state, and not dependent on the previous state up to that point.

Direct and indirect costs and quality-of-life measures were incorporated into the model to estimate the impact of total knee arthroplasty on costs over patients’ lifetimes and quality-adjusted life years. The assumptions used in the model were developed with use of claims and survey data as well as clinical expert opinion and the peer-reviewed literature.

Arthritis (whether osteoarthritis, rheumatoid arthritis or traumatic arthritis) is the most common condition that leads to the need for a knee replacement. Degeneration of the knee can also be caused by avascular necrosis or AVN. Mostly diagnosed in young adults and adolescents, AVN occurs in patches on the articular surface, primarily on the femoral condyles (the rounded protrusions at the end of the femur). The bone becomes soft and loses cohesion with the main bone, sometimes producing fragments that can separate and become loose bodies within the joint, resulting in instability, pain, and even joint locking.

Of course, prevention is the best method to avoid the need for a knee replacement and the cost of it. Dr. Gerber and joint replacement surgeons at South Nassau, strongly recommend taking the following steps to improve joint health:

  • Learn good posture:
  • According to the Arthritis Foundation, good posture protects joints from excessive pressure that can lead to osteoarthritis symptoms;
  • Exercise:
  • Low-impact exercise, such as walking and jogging, is an effective deterrent of osteoarthritis;
  • Alternate exercise routines:
  • Vary exercise regimen; doing the same routine every day can stress joints and exacerbate osteoarthritis symptoms;
  • Pay attention to pain:
  • “No pain, no gain” is just a myth. Mild muscle pain after workouts is normal, but sharp pain means you’re overextending;
  • Ice after exercise:
  • An ice pack reduces swelling and facilitates blood in the joint, alleviating irritation caused by exercising;
  • Maintain a healthy body weight: Being overweight stresses joints, especially hips, knees and back – the areas at greatest risk for osteoarthritis;
  • Wear appropriate footwear:
If you’re playing basketball wear sneakers made for basketball, if you’re running, wear running sneakers; if you’re going to work and will be on your feet all day, don’t wear high heels.

If a joint replacement is the only alternative to eliminate the pain and debilitation caused by a degenerative joint, South Nassau provides the continuum of orthopedic care through its Center for Advanced Orthopedics (CAO), which includes the Long Island Joint Replacement Institute™ (LIJRI) and South Nassau Shoulder Center. The CAO was established to meet the rapidly rising long-term need for full-service, specialized orthopedic care. The LIJRI is a recipient of The Joint Commission’s prestigious Gold Seal of Approval™, which it earned for its compliance and continuous dedication to the national standards for health care quality and safety as recommended by the Commission’s Disease-Specific Care Certification Program.

Under the direction of Dr. Gerber, James Germano, MD, and Peter Lementowski, MD, surgeons at the LIJRI specialize in the latest advancements in total and partial knee and hip replacement techniques, including custom-fitted total joint replacement, the Uni-Knee™ partial knee replacement, the mobile-bearing knee system and minimally invasive Birmingham Hip™ resurfacing (a revolutionary alternative to total hip replacement)

LIJRI was one of the first in the United States to combine image-guided medical technology with minimally invasive knee replacement instrumentation to simplify total knee replacement surgery and significantly improve the short- and long-term patient benefits of the operation, including less scarring and faster healing.

To ensure that patients maximize the benefits of knee replacement surgery, South Nassau offers the Sports Medicine and Rehabilitation Therapy Center (SMART). Its physical therapy and rehabilitation programs combine a physiatrist’s keen understanding of the body’s mechanics with a staff of experienced physical, occupational and speech therapists. Patient-specific rehabilitative or therapeutic programs promote short- and long-term health and wellness. The staff works closely with the patient’s primary care physician in developing a personalized rehabilitation program and provides regular updates on progress. The result of this team approach is programs that are based upon individual conditions that help the patients achieve realistic levels of functioning.



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