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Stretches and exercises are one of the most effective methods of treating many types of back pain. By learning a few safe, effective stretches and exercises, most people can find relief of their low back pain.

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Orthopedics Spotlight10

Price for a New Hip

Monday April 14, 2014

Well, according to a recent survey of hospitals throughout the United States, many don't know!

And those hospitals that could offer a price, offer from a range of just over $10,000, to well over $100,000.  So why the discrepancy?

Most hospitals are used to dealing with insurance companies and Medicare, not consumers.  Most hospitals don't think much about price competition for services.  Therefore, charges are often arbitrary, and don't make much sense.

In this survey, a caller asked for the price of a hip replacement.  She said on the phone that her grandmother needed a new hip, and was willing to pay out of pocket.  She just wanted to know how much?  Many hospitals couldn't provide an answer, and those that could provided quite a range.

The truth is, that there is little variation in what is done to perform a hip replacement.  Some hospitals may have more cost associated with their service, but the differences should be minimal.  But the differences in price were anything but minimal!

In order to control the cost of healthcare, there must be pressure to compete on price.  That pressure cannot impact the quality of care, but there has never been any evidence to show that a hospital that charges 10 times the amount for a hip replacement does a better job.

Over time, I would guess that this information becomes more widespread, and consumers will be asked to pay attention to the price of the service they are being offered.

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Source: Price for a New Hip? Many Hospitals Are Stumped

Study Shows ACL Grafts Best When Your Own

Saturday April 12, 2014

ACL reconstruction surgery is often the best treatment for an ACL tear.  When reconstructing the torn ligament, a new ligament needs to be made.  Unfortunately, the ACL cannot be repaired, and therefore the reconstruction is the best option.

Surgeons have debated for decades about the best option for the ACL graft.  Options include either using tissue from somewhere in your body (commonly the patellar tendon or hamstring tendon), or using tissue from a donor (cadaver tissue).  Recent research has clearly shown that your own tissue is better.  In fact, a recent analysis of all the best studies on this subject found patellar tendon autografts (your own tissue) had all of the following advantages when compared to donor graft:

  • Less repeat ruptures (tears of the graft)
  • Stronger ACL (less laxity)
  • Improved knee function (measured by single-leg hop test)
  • More satisfied patients

While there may be some reasons to perform ACL reconstruction with donor tissue, more evidence is pointing towards use of your own tissue.

Related: Safety of Donor Grafts

Source: Bone-Patellar Tendon-Bone Autograft Versus Allograft in Outcomes of Anterior Cruciate Ligament Reconstruction

Choosing the Right Anesthesia

Saturday April 5, 2014

For many types of orthopedic surgery, there are options for anesthesia.  Choosing the right option for your surgery may depend on personal preference, medical issues, or surgical considerations.

Recent studies have shown that with joint replacement surgery, specifically hip and knee replacement, spinal anesthesia is the best option if it is determined to be safe for the patient.  While personal preference is an important consideration, getting the best outcome from surgery is also important.  If the surgery can have better results, patients should know about the best choice of anesthesia.

Bad Orthopedic Travel Advice

Thursday April 3, 2014

I read a column on the Internet recently advocating patients with implanted metal bring x-rays to the airport to assist the TSA in screening. My opinion: Bad idea.

Many patients with implanted metal will set off airport metal detectors. Implants including plates, screws, rods, and joint replacements can all set off airport metal detectors. However, the TSA is staffed by security specialists, not doctors. Taking x-rays to the security personnel is a waste of your time and effort. Here are the problems:

  • Identity Issues
    Security personnel cannot (and should not) assume that an x-ray belongs to the person holding it. If that were the case, anyone could simply bring an x-ray of a metal implant as their reason for setting off the metal detector.
  • Hospital Records
    X-rays are part of your hospital record, and removing them makes your record less complete. If those x-rays get lost on your trip it could affect your medical care down the road. Sometimes having previous x-rays for comparisons is essential, especially when dealing with implants.
  • Cost
    Every time an x-ray is taken, and printed, medical costs go up. If patients are constantly getting extra x-rays taken and printed for travel purposes, this wastes medical resources.

I think this column has great tips for travel security--except the advice to bring your x-rays to the airport. Instead, use the advice of the TSA, and leave your x-rays at your doctor's office.

Related: Do metal implants cause metal detectors to go off? | TSA Recommendations

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