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Background: A treatment algorithm and screening examination have been developed to guide patient management and prospectively determine potential for highly active individuals to succeed with nonoperative care after anterior cruciate ligament rupture.

Objective: To prospectively characterize and classify the entire population of highly active individuals over a 10-year period and provide final outcomes for individuals who elected nonoperative care.

Methods: Inclusion criteria included presentation within 7 months of the index injury and an International Knee Documentation Committee level I or II activity level before injury. Concomitant injury, unresolved impairments, and a screening examination were used as criteria to guide management and classify individuals as noncopers (poor potential) or potential copers (good potential) for nonoperative care.

Results: A total of 832 highly active patients with subacute anterior cruciate ligament tears were seen over the 10-year period; 315 had concomitant injuries, 87 had unresolved impairments, and 85 did not participate in the classification algorithm. The remaining 345 patients (216 men, 129 women) participated in the screening examination a mean of 6 weeks after the index injury. There were 199 subjects classified as noncopers and 146 as potential copers. Sixty-three of 88 potential copers successfully returned to preinjury activities without surgery, with 25 of these patients not undergoing anterior cruciate ligament reconstruction at the time of follow-up.

Conclusion: The classification algorithm is an effective tool for prospectively identifying individuals early after anterior cruciate ligament injury who want to pursue nonoperative care or must delay surgical intervention and have good potential to do so.



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Bloomberg: The Politics, Investments Of Judges Bloomberg: Judges In Lawsuits Over U.S. Health Care Overhaul Hold Industry Stock Three federal judges overseeing challenges to the Obama administration’s health-care overhaul own shares of companies in the industry, including insurers and medical-device makers, the government watchdog group Center for Public Integrity reported…

 

As humans are living longer, new treatments appear, and more people develop chronic (long-term) diseases, health costs are soaring to the point of pushing 100 million people each year into poverty globally, especially among those who have to pay directly for health services, according to this year’s World Health Report by the World Health Organization (WHO)…

 

The Hill’s Healthwatch blog: “The Air Force’s top uniformed officer on Tuesday warned that growing healthcare costs could hurt other critical military needs. … [Gen. Norton] Schwartz said that the Pentagon pays $40 billion in healthcare costs for military members and retirees, and is expected to pay as much as $60 billion by 2015 - about 13 percent of the entire Pentagon budget” (Tiron, 10/12)…

 

President Obama met with 34 NAIC (National Association of Insurance Commissioners) and discussed the implementation of PPACA (Patient Protection and Affordable Care Act). The National Association of Insurance Commissioners is a voluntary organization of the chief insurance regulatory officials of the 50 states, the District of Columbia and five U.S. territories. Jane L…

 

Bloomberg BusinessWeek: Within the health bill is an element that “has generated far less attention and political heat than other parts of the White House’s plan to expand medical coverage to 32 million uninsured Americans. The measure requires the U.S…

 

On Tuesday, “[p]rovider groups hailed the president’s historic signing of the Senate’s healthcare reform bill, which seeks to overhaul the healthcare system through the establishment of a new insurance marketplace, expansions to Medicaid and various insurance reforms,” Modern Healthcare reports…

 

Health care companies stand to gain from legislation that would expand their market to millions of new consumers, but many are also complaining about specific provisions of the House health care overhaul bill, the New York Times reports. “Insurers do not like the provision to create a new government-run insurance program.

 

A couple stories Friday examine just how Americans ended up with a system where employers pick up the tab for health insurance and which groups will end up paying more for health reform. NPR on the history of the employer-based system: “The evolution of the American health care system began in the 1920s, when choices boiled down to which crazy cure you preferred.

 

Health care industry CEOs are analyzing their wins and losses in the bills being considered in Congress. “The drug industry stands to gain in a health-care overhaul by getting tens of millions of newly insured customers, while insurance companies — especially those that cater to the individual market — look like they are in for a tougher time,”

 

Interest groups are fighting some of the new taxes proposed in the Senate Finance bill. “Insurance companies, unions, medical device makers and others in the health care industry are furiously lobbying lawmakers to shift burdens onto someone else - anyone else - before they find themselves saddled with billions of dollars in taxes under new health care legislation,”




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