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Success Factors and Best Practices for Medical Travel Facilitators: Tips for Benchmarking And Startups
Published in Frederick J. DeMicco, Ali A. Poorani, Medical Travel Brand Management, 2023
Based on the assessments of MTFs, medical tourists traveled to receive a wide variety of treatments, including plastic surgery, oncology, cardiovascular, dental, and other forms of surgery (see Figure 14.5). Over 56% of patients sought orthopedic surgery followed by plastic surgery (38%). Surprisingly, Weightless surgery was the lowest reported (22%). Other forms of treatment, such as stem cells, stress reduction, neurology, and urology were also mentioned.
Anaesthesia in Orthopaedic Surgery
Published in Timothy W R Briggs, Jonathan Miles, William Aston, Heledd Havard, Daud TS Chou, Operative Orthopaedics, 2020
Enhanced recovery is the delivery of a consistent, protocolised pathway of care with the aim to minimise perioperative stress and to expedite recovery. The amount of evidence for each individual element of the enhanced recovery bundle is variable. However, good compliance with enhanced recovery protocols (≥80% compliance) is associated with a shorter median length of stay by one day in orthopaedic surgery. In particular, individualised fluid therapy and early mobilisation were the strongest indicators. This reduction in length of stay represents a clinically important reduction in morbidity and significant cost savings.
Pharmacologic alternatives to blood
Published in Jennifer Duguid, Lawrence Tim Goodnough, Michael J. Desmond, Transfusion Medicine in Practice, 2020
A dose-response relationship of EPO and erythropoiesis that is affected favorably by iron supplementation has important implications for EPO dosage,29 especially if the cost of therapy is taken into account. Current recommended EPO dosage to be administered in patients scheduled for elective surgery range from 1800 u/kg32 to 4200 u/kg total dosage,17,31 which for a 70 kg patient would cost $1300–3000.30 However, an economic analysis of EPO therapy in patients undergoing orthopedic surgery concluded that, even with the lower currently recommended (1800 u/kg) total dosage, EPO therapy is not cost-effective.33 Intravenous iron may potentiate the erythropoietic response in the setting of EPO therapy by improving iron-restricted erythropoiesis induced by EPO.61 Current indications for intravenous iron therapy, along with opportunities for research, are listed in Table 10.2.
Early perioperative versus postoperative meloxicam for pain control in patients undergoing orthopedic surgery: a systematic review and Meta-analysis of randomized controlled trials
Published in Current Medical Research and Opinion, 2023
Abdelrahman Mahmoud, Mohamed Abuelazm, Ali Ashraf Salah Ahmed, Mahmoud Elshinawy, Toka Ashour, Mohamed Abugdida, Basel Abdelazeem
The main role of orthopaedic surgery is to prevent and manage musculoskeletal diseases which are associated with a high incidence of disability1. Orthopaedic operations vary from arthroscopic to open major operations; however, they are associated with severe postoperative pain compared with other surgical procedures1,2, with 58% of total knee replacement patients and 47% of total hip replacement patients reporting moderate to severe pain in the first day after surgery3. Postoperative pain is a serious concern to physicians who use a variety of options, including systemic and intra-articular analgesics, to control it. Furthermore, non-steroidal anti-inflammatory drugs (NSAIDs) are widely used as a potent analgesic, antipyretic, and anti-inflammatory, with subtle evidence confirming their superiority for postoperative pain management4. Despite the usage of analgesics, some patients experience worse episodes of postoperative pain than others, which affect early ambulation, delay restoring of function, and prolong the recovery period5.
Rest-activity daily rhythm and physical activity levels after hip and knee joint replacement: the role of actigraphy in orthopedic clinical practice
Published in Chronobiology International, 2021
Jacopo Antonino Vitale, Giuseppe Banfi, Valentina Tivolesi, Catia Pelosi, Stefano Borghi, Francesco Negrini
Every patient, independently from the type of joint arthroplasty performed, spent the first two days after surgery in the orthopedic surgery ward, where they began rehabilitation since the first day after surgery, when patients were verticalized for the first time. The third day post-surgery, they were moved in the rehabilitation ward, where rehabilitation process was intensified. Every day from PRE to POST10, patients followed a rehabilitation protocol, leaded by physical therapists 6 days per week: 30 minutes/day in the orthopedic surgery ward in POST1, and 70 minutes/day from POST3 to POST10. For both hip and knee joint replacement, the rehabilitative protocol involved also education and instruction about how to behave after joint replacement. Specific physical exercises were performed under the supervision of expert physiotherapists: passive mobilization of the involved joint in order to restore as early as possible range of motion, and active mobilization, strengthening and proprioceptive training of the lower limbs, gait training using two crutches, in order to regain full autonomy as soon as possible.
Compensation claims in pediatric orthopedics in Norway between 2012 and 2018: a nationwide study of 487 patients
Published in Acta Orthopaedica, 2021
Joachim Horn, Hanne Rasmussen, Ida Rashida Khan Bukholm, Olav Røise, Terje Terjesen
Patient injuries due to medical care are a large burden for patients and the healthcare system (OECD 2020) leading to increasing attention on patient safety and prevention of medical errors. In a study by de Vries et al. (2008) the median overall incidence of in-hospital adverse events was 9%, many of these being preventable. In Norway all compensation claims based on public and private healthcare services are handled by a government agency, the Norwegian System of Patient Injury Compensation (NPE). One of the tasks of NPE is to contribute with statistical data to improve quality of care and to prevent patient harm. Recent annual reports show that NPE received 5,695 claims in 2020. In the same year 4,917 decisions were made by NPE, and of these 1,481 (30%) resulted in compensation with total payouts of US$135 million. Orthopedic surgery accounted for nearly one-third (n = 1,443) of all claims that were decided in 2020 and 30% (n = 445) of all claims that were granted, resulting in total payouts of US$30 million. Thus, orthopedic surgery is at especially high risk of claims and there is evidence that claims within the field of pediatric orthopedics are more likely to result in payment compensation than adult cases (Orosco et al. 2012, Oetgen and Parikh 2016).