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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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28
Mar |
Medicare/Medicaid Rule Increases Costs Without Improving Patient Outcomes For Defibrillator ImplantsCategory: Medicare / Medicaid / SCHIP | Leave a Comment |
The cost to place an implantable cardioverter-defibrillator (ICD) increased by $844 per case after a new requirement from the Centers for Medicare and Medicaid Services (CMS) went into effect in February 2010, according to research presented at the American College of Cardiology’s 61st Annual Scientific Session…
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15
Feb |
Evaluating The Factors Underlying Medicare Decisions On Coverage Of Medical TechnologyCategory: Medicare / Medicaid / SCHIP | Leave a Comment |
A new study by researchers at Tufts Medical Center provides unique insight into factors that affect Medicare decisions on whether to pay for medical technologies…
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16
May |
Maine Medical Equipment Providers Back Congressional Bill To Repeal Flawed Medicare Bidding ProgramCategory: Medicare / Medicaid / SCHIP | Leave a Comment |
Maine home medical equipment and services (HME) providers support H.R. 1041, a bipartisan bill in Congress to repeal the controversial Medicare “competitive” bidding program for home medical equipment and services. “If competitive bidding is not repealed, both Maine businesses and Medicare patients will suffer…
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1
Apr |
New Bundle Reimbursement For End-Stage Renal Disease (ESRD) To Have Predominantly Negative Effect On $535 Million Treatment Device MarketCategory: Medicare / Medicaid / SCHIP | Leave a Comment |
According to Millennium Research Group (MRG), the global authority on medical technology market intelligence, the new reimbursement system from the Centers for Medicare & Medicaid Services (CMS) for end stage renal disease will have a mixed but mostly negative effect on the market for ESRD treatment devices…
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27
Feb |
Medicare Continues To Impose Conditions When Covering New TechnologiesCategory: Medicare / Medicaid / SCHIP | Leave a Comment |
The Centers for Medicare and Medicaid Services (CMS), the government agency that administers the Medicare program, made 11 National Coverage Determinations (NCDs) for medical technologies and procedures in 2010. NCDs permit or prohibit Medicare coverage for new technologies on a nationwide basis…
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17
Feb |
New Medical Equipment Program Offers Value For Medicare BeneficiariesCategory: Medicare / Medicaid / SCHIP | Leave a Comment |
The Centers for Medicare & Medicaid Services (CMS ) launched the first phase of the Durable Medical Equipment, Prosthetics, Orthotics, and Supplies (DMEPOS) Competitive Bidding Program on January 1, 2011, in nine different areas of the country…
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22
Jan |
Home Medical Equipment Group Asks President Obama To Review ‘Patchwork’ Of Ineffective Medicare Regulations For Home-Based CareCategory: Medicare / Medicaid / SCHIP | Leave a Comment |
This week, the American Association for Homecare asked President Obama to review the “onerous and outdated regulations that hamper job creation and threaten access to quality home medical equipment (HME) and services under the Medicare program…
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21
Jan |
Viewpoints: Endorsing - And Repudiating - Health Law Repeal; Gov. Brewer On Ariz. Medicaid; Medical Devices ‘Red Tape’Category: Medicare / Medicaid / SCHIP | Leave a Comment |
USA Today: Our View On Health Law: House GOP Vote Is Easy. Now What? The reason the GOP never got around to proposing a serious plan to expand coverage and control costs is because doing that is excruciatingly hard and politically dangerous. Look how long Democrats struggled to craft a measure and what happened to them after they passed it…
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17
Dec |
President Signs One-Year ‘Pay-Fix’; Medicare Tests Competitive Bidding For Common Medical EquipmentCategory: Medicare / Medicaid / SCHIP | Leave a Comment |
The Kansas City Star reports on a new Medicare program that will apply competitive bidding to common medical equipment and supplies. Meanwhile, President Obama signed into law yesterday a one-year delay in Medicare payment cuts for physicians…
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9
Dec |
Personalized Medicine Advocates Push For Better Reimbursement SystemCategory: Medicare / Medicaid / SCHIP | Leave a Comment |
CQ Healthbeat: “The U.S. reimbursement for diagnostic tests is outdated and inhibits the development of more personalized tests for patients, according to a report released Tuesday by the Personalized Medicine Coalition. The report detailed problems with coding, coverage and payment issues that advocates say stifle scientific innovation…