Earlier this year, Dr. Christopher Kaeding became the first surgeon to use Google Glass during live surgery. He used the new technology to consult remotely with a colleague who, thanks to the head-mounted computer/camera, could see the procedure live from the surgeon’s point of view. Several students at The Ohio State University College of Medicine also watched the successful ACL surgery. Google Glass could conceivably give surgeons the ability to instantly call up radiographs, MRIs, and pathology reports during surgery, while giving a unique perspective of surgical procedures to others in remote locations. A thousand people in the U.S. have been chosen to test Google Glass as a part of Google’s Explorer Program.
It may seem counterintuitive, but runners have a lower risk of knee orthoarthritis than walkers do. A July 2013 study followed more than 75,000 runners and 14,000 walkers and found that runners had a lower overall risk of developing arthritis than walkers. Runners generate greater knee forces than walkers, but due to the longer strides of running, the net result is less overall load on the runners’ knees than on walkers’ knees. Although running doesn’t decrease the cause of ‘wear’ on the knee, it seems better than walking for delaying development of osteoarthritis.
Belgian doctors have identified a “new” knee ligament in humans, although a French surgeon speculated on its existence as far back as 1879. The anterolateral ligament or ALL, is a narrow band of tissue originating at the lateral femoral epicondyle and traveling obliquely to the anterolateral aspect of the proximal tibia. Researchers think the ALL functions to stabilize the outer part of the knee and prevent it from collapsing inward. When people tear their ACL doctors presume that the ALL is also torn, and that its rupture and subsequent withering may have contributed to its obscurity. There’s still a lot to learn about the ALL as surgeons are now in the initial stages of planning and practicing surgical procedures for treating all tears.
David Glaser, JD, alerts us to proposed changes in the healthcare reimbursement model that would make employing physicians less appealing for hospitals. MedPAC, the Medicare Payment Advisory Commission, issued a report that details a discrepancy between higher reimbursements for services rendered in hospitals relative to those for the same services provided in clinics. Simply put, more Medicare money is available to compensate physicians when they are in a hospital outpatient setting. This MedPAC report proposes an end to the added “facility fee” that drives the discrepancy by leveling reimbursements across the board in all settings. MedPAC recommendations are not binding, and Congress has the final say about Medicare reimbursements. But in Glaser’s opinion, “the days of additional facility fee payments are numbered.”
BoneStress is a new free app that allows orthopaedic surgeons to look at the effects of action and joint loading for different hip stem designs. One of many factors considered when determining a hip implant is the angle of the neck of the femur. This app shows an interactive model for different hip stem designs and how they affect radial load in the bone. The app is designed specifically for orthopaedic surgeons who have a desire to better understand hip biomechanics and stem length implications, but it cannot be used for operative planning for individual patients.