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A Look into the American Joint Replacement Registry (AJRR)

Moderator:  Jeffrey B. Stambough, MD and Bryan D. Springer, MD
Date: May 28, 2019

Description

This webinar is introduced the American Joint Replacement Registry (AJRR). Faculty reviewed the history of AJRR, focused on current activities, future plans, ways to get involved and ways in which the data collected in the Registry can be used to improve arthroplasty practice.

Objectives
  • Review registry activity and purpose
  • Identify registry uses, including tracking and improving performance
  • Identify steps for getting involved with AJRR

Presentations

Introduction

Bryan D. Springer, MDBryan D. Springer, MD
OrthoCarolina, Attending Orthopaedic Surgeon, Fellowship Director
Carolinas Medical Center, Associate Professor of Orthopaedic Surgery
Dr. Springer completed his residency in orthopaedic surgery at the Mayo Clinic, and completed his Fellowship in Adult Reconstruction of the Hip and Knee at the Harvard School of Medicine/Brigham and Women’s Hospital. He is Chair of the Education Council of AAHKS, Vice Chair of AJRR, and Vice Chair of the International Congress for Joint Replacement (ICJR). Dr. Springer is on the Editorial Board for the Journal of Arthroplasty, Clinical Orthopaedics and Related Research, and is an associate editor for Arthroplasty Today. He is as a member of the Knee Society and the Hip Society, and the past president of the Musculoskeletal Infection Society (MSIS). Dr. Springer is a recipient of many academic, leadership and professional awards. He was named to the next generation of leaders in total joint replacement in 2013, and in 2008, was a John Insall Travelling Fellow.

The American Joint Replacement Registry: Past, Present and Future

Kevin J. Bozic, MD, MBAKevin J. Bozic, MD, MBA
Dell Medical School at the University of Texas at Austin, Chair of Surgery and Perioperative Care

Dr. Bozic is a nationally recognized leader in orthopaedic surgery and value-based health care payment and delivery models. Prior to joining the Dell Medical School, he was the William R. Murray Endowed Professor and Vice Chair of Orthopaedic Surgery at the University of California San Francisco (UCSF) School of Medicine, and Core Faculty of the Philip R. Lee Institute for Health Policy Studies. He holds a Bachelor of Science degree in Biomedical Engineering from Duke University, where he graduated magna cum laude, and an MD with Thesis degree from UCSF. He completed his Orthopaedic Surgery Residency training in the Harvard Combined Orthopaedic Residency Program, and additional Fellowship training in Adult Reconstructive Surgery from Rush University Medical Center in Chicago. Dr. Bozic also holds a Masters of Business Administration from Harvard Business School (HBS), where he continues to serve as a Senior Institute Associate in Professor Michael Porter’s Institute for Strategy and Competitiveness.

What do Registries Tell Us and What Is the Best Way to Use Them?

David G. Lewallen, MDDavid G. Lewallen, MD
Mayo Clinic, Professor of Orthopedic Surgery and Consultant in the Dept. of Orthopedic Surgery
Dr. Lewallen is a graduate of Gustavus Adolphus College. He recieved his MD degree from the University of Minnesota, and completed his residency as well as a master’s degree program in research in the Department of Orthopedic Surgery at the Mayo Clinic. He then completed a fellowship in Biomechanics Research at Beth Israel Hospital in Boston before returning to join the consulting staff at Mayo Clinic. His initial practice was focused on lower extremity problems, including both arthroplasty and trauma-related care, with a special focus on the hip and pelvis. Dr. Lewallen has had a career-long involvement with the Mayo Clinic Total Joint Registry, which has been active since 1969. He has many professional society involvements, being the the past president of AAHKS, the Hip Society, the Association of Bone and Joint Surgeons, and the Mid-America Orthopaedic Association. Dr. Lewallen was also heavily involved with the more than decade-long development of AJRR, and served for three years as the First Chair of the Board of Directors of AJRR after it was incorporated in 2009. In 2013, he transitioned to Medical Director of AJRR and continues to assist in efforts to establish a nationwide registry of arthoplasty procedures. 

How Does it Work and What Does it Take to Get Involved?

Kristina Finney, MPHKristina M. Finney, MPH
American Academy of Orthopaedic Surgeons (AAOS), Director, Registries & Data Science
Kristina oversees operations of the American Joint Replacement Registry (AJRR) as well as leads the strategic direction of the growing AAOS Registry Program. Prior to this role, Kristina was program lead for the Integrated Health Model Initiative (IHMI), the leading healthcare interoperability effort at the American Medical Association (AMA). Kristina’s previous AMA experience includes working as a Senior Policy Analyst for the RBRVS Update Committee (RUC), where she led analysis of resource utilization, code valuation and payment policies. Her experience also includes working on telemedicine platforms at a specialty society, building and maintaining quality registries, and organizing patient safety and quality improvement initiatives. Kristina’s subject-matter expertise spans innovation in healthcare including digital medicine, value-based care, alternative payment models and outcome-based care models for clinical practice. Education: Clinical Research Fellowship – National Institutes of Health (NIH); MPH and Graduate Certificate – Washington University in St. Louis; BS – University of Florida

Questions and Discussion

Jeffrey B. Stambough, MDJeffrey B. Stambough, MD
University of Arkansas for Medical Sciences (UAMS), TJA Surgeon and Assistant Professor of Orthopaedic Surgery
Dr. Stambough went to Cornell University in Ithaca, NY for his undergraduate degree and received his medical degree from the University of Pennsylvania. He then completed his orthopaedic residency training at Washington University in St. Louis and most recently did a fellowship in hip and knee reconstruction at the OrthoCarolina Hip & Knee Center in Charlotte. Dr. Stambough’s clinical focus is on revision and primary joint replacement using time-tested techniques and approaches. His clinical and translational research interests involve investigating discrepancies in access and outcomes involving arthroplasty care as well as studying novel, cost-effective treatment strategies for joint infections and periprosthetic fractures.

Disclosures

Click the following link to view faculty disclosures: Disclosure List

Total Hip Arthroplasty in Dysplastic Hips

Moderator:  Brian M. Curtin, MD
Date: March 26, 2019

Description

This webinar included discussion of important anatomical references in both low and high dislocated hips, how to plan the surgery and which implant options are suitable. Faculty discussed the maximum acceptable lengthening, when and how to place the acetabular cup at the original anatomical site, and different techniques to work the dysplastic femur with or without shortening osteotomy at the subtrochanteric or distal level. Surgical tricks and tips are discussed by experienced surgeons.

Objectives

  • Characterize the anatomical abnormalities often encountered with management of the dysplastic hip.
  • Describe several techniques beneficial in reconstruction of both the acetabulum and femur in patients undergoing total hip replacement with underlying severe hip dysplasia.
  • Review and discuss long term outcome data following reconstruction techniques for hip dysplasia.

Presentations by an International Panel

1. Introduction
Brian Curtin, MDBrian M. Curtin, MD (US)
OrthoCarolina. Member of the fellowship faculty and adjunct faculty with the Carolina’s Medical Center Orthopedic Surgery Department teaching arthroplasty to rotating residents. Active with both the AAOS and AAHKS serving on several committees. Chaired several resident arthroplasty cadaver courses and serves on the ICJR resident education committee. Awarded the Rothman-Ranawat Hip Society Traveling Fellowship in 2015.

2. What matters in dysplastic anatomical alterations and how to solve it: the importance of preoperative planning and implant selection
Luigi Zagra, MDLuigi Zagra, MD (Italy)
Head of the Hip Department at IRCCS Istituto Ortopedico Galeazzi, Milan, Italy and Adjunct Professor at Università degli Studi of Milan. He is Past President of the Italian and of the European Hip Society. Vice Chairman of the Educational Committee and Member of the Executive Committee of EFORT. Chairman of the Scientific Committee of EHS. Member of the International Hip Society and of the International Committee of AAHKS. High volume orthopaedic surgeon, mainly focused on hip surgery including complex primary THA and revision, and knee arthroplasty.

3. How to perform the acetabular part in Crowe II, III and IV
Klaus-Peter Gunther, MDKlaus-Peter Günther, MD (Germany)
Co-Director of the University Centre of Orthopaedics and Traumatology, University Hospital Carl Gustav Carus Dresden. Professor and Chairman, Department of Orthopaedics, Technical University of Dresden. Vice-President of European Federation of Orthopaedics and Traumatology (EFORT). Steering committee member of the OMERACT/OARSI initiative “Outcome measures in osteoarthritis.” Executive Board member of European Federation of Orthopaedics and Traumatology (EFORT). Editor Orthopädie und Unfallchirurgie. Main areas of clinical research: epidemiology of hip osteoarthritis, joint preserving hip surgery and joint replacement.

4. How to deal with the dysplastic femur: osteotomy or not; which and where?
TokozogluMazhar Tokgozoglu, MD (Turkey)
Professor of Orthopedics and Traumatology at the Hacettepe University Faculty of Medicine in Ankara, Turkey. Chairman of the Department of Orthopedics and Traumatology, Hacettepe University Faculty of Medicine. Member of the European Hip Society, International Hip Society, Turkish Arthroplasty Society, Turkish Society of Orthopedics & Traumatology. Editorial boards of the Hip International, Orthopedics Today Europe, Bone and Joint Journal. Areas of interest: primary and complex revision total joint arthroplasty surgery, management of prosthetic joint infections, hip preservation surgery and reconstruction after musculoskeletal tumor resections.

5. Long term results of acetabuloplasty and shortening osteotomies
Th. KarachaliosTheofilos Karachalios, MD (Greece)
Professor in Orthopaedic Surgery, University of Thessalia, University General Hospital of Larissa, Hellenic Republic. Treasurer of the European Hip Society and member of the International Hip Society. Co-Editor-in -Chief of Hip International. 2015 Chairman of HAOST (Greek Orthopaedic Association). Elected EFORT treasurer in 2017.

6. Discussion
Brian M. Curtin, MD (US) and panel

Disclosures

To view faculty disclosures, click the following link: Disclosure List.

Total Knee Arthroplasty in End Stages of Degenerative Disease: The Articulation in Primary Total Knee Arthroplasty - Recording

Moderator:  Adolph V. Lombardi, Jr., MD, FACS
Co-Moderator: Jeremy M. Gililland, MD
Date: December 18, 2018

Description

The clinical presentation of end-stage degenerative disease of the knee requiring arthroplasty has various degrees of disease and deformity.  Therefore, a continuum of constraint has been designed and developed to address the needs of patients undergoing primary total knee arthroplasty for treatment of endstage degenerative joint disease.  This symposium will review the indications, surgical technique, and clinical results of the various articulations available in total knee arthroplasty.  Illustrative cases will be discussed and audience participation will be elicited via audience response questions. 

Objectives

  • Describe the continuum of constraint in total knee arthroplasty 
  • Identify the indications for specific articulations in total knee arthroplasty  
  • Present the rationale and surgical techniques for the various degrees of constraint in primary total knee arthroplasty  
  • Review the clinical results of various articulations in primary total knee arthroplasty  
  • Review the pros and cons of various degrees of constraints in total knee arthroplasty 6. Understand the limitations of the various articulations available for total knee arthroplasty. 

Presentations and Faculty

  1. God Gave You an ACL and a PCL, Keep Them: The ACL/PCL Preserving Knee
    Alfred J. Tria, MD
  2. Respect the PCL: The Cruciate-Retaining Total Knee
    Christopher L. Peters, MD
  3. Medial Stability is All You Need: The Medial Pivot Knee
    C. Lowry Barnes, MD
  4. There is No Need for an ACL or PCL or Even a Spine-Cam: The Ultra-Congruent Knee
    Michael P. Bolognesi, MD
  5. The Collateral Ligaments in Conjunction with a Spine-Cam Work the Best: The Posterior-Stabilized Knee
    Giles R. Scuderi, MD
  6. At the End of the Day Stability Is a Requisite You Can’t Live Without: Indications for Varus/Valgus Constrained Knee and Primary Hinge
    Adolph V. Lombardi Jr., MD, FACS
  7. Case Presentations with Questions and Answers
    Adolph V. Lombardi Jr., MD

Disclosures

To view faculty disclosures, click the following link: Disclosure List.

A Case-Based Approach to Unicondylar Knee Arthroplasty – Recording

Moderators:  Adolph V. Lombardi, Jr., MD and Kevin D. Plancher, MD
Date: September 25, 2018

Description

This webinar took place on September 25, 2018. It included discussion of partial knee arthroplasty (UKA) and its increased growth in the last several years. Patient selection along with an understanding of which ancillary tests are necessary has generated much discussion on this topic. Medial and Lateral UKA can be a technically demanding procedure for the surgeon if not performed frequently. This symposium provided up to date information allowing for success in performing a unicompartmental knee arthroplasty and dispelled mistaken thoughts as to its outcome and longevity. Illustrative cases and audience participation were important aspects in this webinar.

Objectives

  • Describe the current indications and understand proper patient selection for medial and lateral unicompartmental knee arthroplasty.
  • Identify the clinical presentation as well as radiographic evaluation and imaging studies which should be obtained preoperatively to determine patient selection for partial knee arthroplasty.
  • Review Tips and tricks for a Medial Unicompartmental Knee Arthroplasty.
  • Review Tips and tricks for a Lateral Unicompartmental Knee Arthroplasty.
  • Plan the execution of a Revision of Partial Knee Arthroplasty to a Total Knee Arthroplasty.

Presentations and Faculty

  1. Selecting the Proper Patient for Medial and Lateral Unicompartmental Knee Arthroplasty.
    Adolph V. Lombardi, Jr., MD
  2. What You Need to Know for Successful Execution of a Medial Unicompartmental Knee Arthroplasty.
    Andrew A. Freiberg, MD
  3. What You Need to Know for Successful Execution of a Lateral Unicompartmental Knee Arthroplasty.
    William Jiranek, MD
  4. How Successful are Partial Knee Arthroplasties: What Have We Learned from the Literature?
    Michael E. Berend, MD
  5. Technique of Converting a Partial Knee Arthroplasty to a Total Knee Arthroplasty
    Michael P. Bolognesi, MD
  6. Case Presentations with Q&A
    Adolph V. Lombardi, Jr., MD

Disclosures

To view faculty disclosures, click the following link: Disclosure List.

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