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  1. AU="Summers, Spencer"
  2. AU="R. Alta Charo"
  3. AU="Patiño-Castiñeira, Berta"
  4. AU=Ryan C F
  5. AU="Perez, F."
  6. AU="Durán, Mercedes"
  7. AU="Wilne, Sophie"
  8. AU="Changjin Lee"
  9. AU="Hyunsoo Lee"
  10. AU=Sinha Ian
  11. AU="Bird, M F"

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  1. Artikel ; Online: Significant Cost Savings and Improved Early Clinical Outcomes in Medicare Patients Utilizing a Clinician-Controlled Telerehabilitation System Following Total Knee Arthroplasty.

    Summers, Spencer H / Gnecco, Tamara / Slotkin, Eric M / Law, Tsun Y / Nunley, Ryan M

    The Journal of arthroplasty

    2024  

    Abstract: Background: The costs and benefits of different rehabilitation protocols following total knee arthroplasty are unclear. The emergence of telerehabilitation has introduced the potential for enhanced patient convenience and cost reduction. The purpose of ... ...

    Abstract Background: The costs and benefits of different rehabilitation protocols following total knee arthroplasty are unclear. The emergence of telerehabilitation has introduced the potential for enhanced patient convenience and cost reduction. The purpose of this study was to assess the cost difference between standard physical therapy (SPT) and a telerehabilitation home-based clinician-controlled therapy system (HCTS).
    Methods: A prospectively enrolled, consecutive series of 109 Medicare patients who received SPT were compared to 101 Medicare patients who were treated with a HCTS. The analysis focused on total rehabilitation costs and the assessment of outcome measures: knee range of motion, visual analog scale pain levels, and Knee Injury and Osteoarthritis Outcome Score for Joint Replacement.
    Results: The HCTS group demonstrated not only statistically significantly lower average costs but also faster and sustained knee range of motion improvements. Furthermore, in comparison to SPT, the HCTS group exhibited superior visual analog scale pain scores and Knee Injury and Osteoarthritis Outcome Score for Joint Replacement functional scores at all assessment points postoperatively, which were statistically significant (all P < .001) and surpassed the minimal clinically important difference thresholds.
    Conclusions: The HCTS used in this study exhibited a remarkable cost-saving advantage of $2,460 per patient compared to standard therapy. As approximately 500,000 primary total knee arthroplasties in the United States are covered by Medicare annually, a switch to HCTS could yield total cost savings of more than $1.23 billion per year for our taxpayer-funded health care system. Furthermore, the HCTS cohort demonstrated superior functional outcomes and improved pain scores across all assessment time points, exceeding the minimal clinically important difference.
    Sprache Englisch
    Erscheinungsdatum 2024-02-22
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 632770-9
    ISSN 1532-8406 ; 0883-5403
    ISSN (online) 1532-8406
    ISSN 0883-5403
    DOI 10.1016/j.arth.2024.02.040
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  2. Artikel ; Online: A Home-Based, Remote-Clinician-Controlled, Physical Therapy Device Leads to Superior Outcomes When Compared to Standard Physical Therapy for Rehabilitation After Total Knee Arthroplasty.

    Summers, Spencer H / Nunley, Ryan M / Slotkin, Eric M

    The Journal of arthroplasty

    2022  Band 38, Heft 3, Seite(n) 497–501

    Abstract: Background: The optimal postoperative rehabilitation regimen following total knee arthroplasty (TKA) is not clearly defined. The advent of telerehabilitation offers potential for increased patient convenience and decreased cost, while maintaining ... ...

    Abstract Background: The optimal postoperative rehabilitation regimen following total knee arthroplasty (TKA) is not clearly defined. The advent of telerehabilitation offers potential for increased patient convenience and decreased cost, while maintaining similar outcomes to traditional physical therapy (PT). Therefore, we evaluated a novel, home-based, clinician-controlled, multi-modal evaluation and therapy device with telerehabilitation functionality for TKA.
    Methods: A total of 135 consecutive TKA patients receiving standard therapy protocol (STP) were compared to 135 consecutive patients receiving a home-based clinician-controlled therapy system (HCTS). Outcomes were assessed at 2, 6, and 12 weeks, including visual analog scale (VAS) for pain, knee injury and osteoarthritis outcome score JR (KOOS JR), and knee range of motion (ROM) measured by the same certified physical therapists.
    Results: Postoperative knee ROM was greater in the HCTS group at all time points throughout the study period (P < .001 at 2, 6, and 12 weeks). VAS and the KOOS JR functional scores were statistically better (P < .001) in the HCTS group at all time points and exceeded the threshold for minimal clinically important difference (MCID) for both VAS and KOOS JR. There were significantly fewer cases of arthrofibrosis requiring manipulation under anesthesia (MUA) in the HCTS group (1.48 versus 4.44%).
    Conclusion: Following TKA, a novel, home-based, clinician-controlled, multi-modal therapy device was superior to standard PTduring the first 12 weeks postoperatively for ROM, KOOS JR, and VAS (with all scores exceeding the MCID) and had substantially fewer manipulations for arthrofibrosis.
    Mesh-Begriff(e) Humans ; Arthroplasty, Replacement, Knee/adverse effects ; Physical Therapy Modalities ; Knee Joint/surgery ; Joint Diseases/surgery ; Range of Motion, Articular ; Treatment Outcome ; Osteoarthritis, Knee
    Sprache Englisch
    Erscheinungsdatum 2022-10-15
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 632770-9
    ISSN 1532-8406 ; 0883-5403
    ISSN (online) 1532-8406
    ISSN 0883-5403
    DOI 10.1016/j.arth.2022.10.009
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  3. Artikel: Clinical and radiographic outcomes of total hip replacement with a 3-part metaphyseal osseointegrated titanium alloy stem enhanced with low plasticity burnishing: a mean 5-year follow-up study.

    Summers, Spencer / Nigh, Evan / Sabeh, Karim / Robinson, Raymond

    Arthroplasty today

    2019  Band 5, Heft 3, Seite(n) 352–357

    Abstract: Background: This study evaluates midterm results of a 3-part titanium alloy stem with metaphyseal fixation and a neck-metaphyseal taper junction strengthened with low plasticity burnishing (LPB). Our hypothesis is that this multimodular implant with LPB ...

    Abstract Background: This study evaluates midterm results of a 3-part titanium alloy stem with metaphyseal fixation and a neck-metaphyseal taper junction strengthened with low plasticity burnishing (LPB). Our hypothesis is that this multimodular implant with LPB succeeds in offering the advantages of three-part modularity without junctional failure.
    Methods: Twenty-eight of 32 complex primary (n = 9) and revision (n = 9) total hip arthroplasties were accounted for with minimum 2-year follow-up. Clinical and radiographic data were reviewed at a mean follow-up period of 60 months. One stem, removed for failure to osseointegrate, was submitted for sectioning and taper examination.
    Results: There were no modular junction failures despite body mass indices of 20 to 40 and offsets of 34 to 47 mms. Implant survival was 96.3%, with one removal due to aseptic loosening in a patient with chronic renal failure. Taper analyses of the removed implant showed minimal damage. Preoperative and postoperative Harris Hip Scores and Oxford Hip Scores were 20 to 86 and 16 to 41, respectively. Patient satisfaction was 9.7/10. Radiographs showed stem subsidence >2 mm and radiolucencies around the metaphyseal cone only in the hip requiring implant removal.
    Conclusions: This 3-part titanium alloy modular stem with LPB of the neck-metaphyseal taper junction showed good functional and radiographic results at a mean 5 years without junctional failures. Although this follow-up exceeds previously published reports, longer follow-up will be important to confirm our confidence in the additional strengthening provided by LPB.
    Sprache Englisch
    Erscheinungsdatum 2019-08-07
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ISSN 2352-3441
    ISSN 2352-3441
    DOI 10.1016/j.artd.2019.07.004
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  4. Artikel ; Online: Nationwide analysis on the impact of peripheral vascular disease following primary total knee arthroplasty: A matched-control analysis.

    Summers, Spencer / Yakkanti, Ramakanth / Haziza, Sagie / Vakharia, Rushabh / Roche, Martin W / Hernandez, Victor H

    The Knee

    2021  Band 31, Seite(n) 158–163

    Abstract: Background: As the prevalence of peripheral vascular disease (PVD) continues to increase nationwide, studies demonstrating its effects following primary total knee arthroplasty (TKA) are limited. Therefore, the purpose of this study was to evaluate ... ...

    Abstract Background: As the prevalence of peripheral vascular disease (PVD) continues to increase nationwide, studies demonstrating its effects following primary total knee arthroplasty (TKA) are limited. Therefore, the purpose of this study was to evaluate whether patients with PVD have higher rates of: 1) in-hospital lengths of stay (LOS); 2) readmissions; 3) medical complications; 4) implant-related complications; and 5) costs of care.
    Methods: Using a nationwide database, patients with PVD undergoing primary TKA were identified and matched to controls in a 1:5 ratio by age, sex, and medical comorbidities. The query yielded 1,547,092 between the cohorts. Outcomes analyzed included: in-hospital LOS, readmission rates, complications, and costs of care. A p-value less than 0.004 was considered statistically significant.
    Results: PVD patients had significantly longer in-hospital LOS (4-days vs. 3-days, p < 0.0001). Additionally, the study cohort had a higher incidence and odds (OR) of readmissions (20.5 vs. 15.2%; OR: 1.43, 95% CI: 1.42-1.45, p < 0.0001), medical complications (2.46 vs. 1.32%; OR: 1.88, CI: 1.83-1.94, p < 0.0001), and implant-related complications (3.82 vs. 2.18%; OR: 1.78, CI: 1.26-1.58, p < 0.0001). Additionally, the study found patients with PVD had higher day of surgery (p < 0.0001) and 90-day costs of care (p < 0.0001).
    Conclusions: After adjusting for confounding variables the results of the study show patients with PVD undergoing primary TKA have longer in-hospital LOS; in addition to higher rates of complications, readmissions, and costs of care. The study can be utilized by orthopaedists to adequately counsel patients of the potential complications following their procedure.
    Mesh-Begriff(e) Arthroplasty, Replacement, Hip ; Arthroplasty, Replacement, Knee/adverse effects ; Humans ; Length of Stay ; Patient Readmission ; Peripheral Vascular Diseases ; Postoperative Complications/epidemiology ; Retrospective Studies ; Risk Factors
    Sprache Englisch
    Erscheinungsdatum 2021-06-29
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article
    ZDB-ID 1200476-5
    ISSN 1873-5800 ; 0968-0160
    ISSN (online) 1873-5800
    ISSN 0968-0160
    DOI 10.1016/j.knee.2021.06.004
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  5. Artikel: Calcium and Vitamin D Supplementation in Osteoporosis and Fragility Hip Fracture Patients: A Retrospective NHANES Study

    Nigh, Evan D. / Summers, Spencer H. / Nguyen, Duc M. / Conway, Sheila A.

    The Journal of Hip Surgery

    2021  Band 05, Heft 01, Seite(n) 1–6

    Abstract: Adequate vitamin D and calcium supplementation therapy in osteoporosis reduces the risk of fragility fractures and correlates with improved mortality outcomes in postoperative fragility hip fracture patients. However, the prevalence of adequate ... ...

    Abstract Adequate vitamin D and calcium supplementation therapy in osteoporosis reduces the risk of fragility fractures and correlates with improved mortality outcomes in postoperative fragility hip fracture patients. However, the prevalence of adequate supplementation in this population remains unclear. Our purpose was to describe supplement use among the adult population in United States who have been told they had osteoporosis and identify factors associated with adequate supplementation, particularly in patients with history of hip fracture. The study sample comprised a total of 15,968 respondents from the National Health and Examinations Survey (NHANES 2007–2010, 2013–2014); 1,065 self-reported a diagnosis of osteoporosis and 266 self-reported a history of hip fracture. Additional patient factors were analyzed by multivariable logistic regression to assess associated factors of adequate vitamin D (≥ 600 international unit [IU]/day) and calcium (≥ 1000 mg/day) supplementation. The prevalence of vitamin D and calcium supplementation was significantly higher in the osteoporosis group than without ( p  = 0.001). However, supplemental intake reached adequate levels (≥ 600 IU/day of vitamin D and ≥ 1000mg/day of calcium) in only 28.8% of individuals with osteoporosis for vitamin D, 51.6% for calcium, and 19.2% for both. Of individuals with additional history of hip fracture, only 14% reported adequate intake of both nutrients. Female sex (odds ratio [OR]: 2.35, p  < 0.001), older age (OR: 1.02, p  < 0.001), and Caucasian race (OR: 1.456, p  = 0.004) were positive factors of adequate supplementation, while Hispanic ethnicity was a negative factor (OR: 0.658, p  = 0.009). Unexpectedly, a history of hip fracture did not affect the odds of adequate treatment (OR: 0.685, p  = 0.176). Adults with known osteoporosis in the United States are self-reporting inadequate supplementation therapy, and significant gender and racial disparities exist. There is a broad need for improved supplementation to help manage this disease, particularly among adults with prior hip fracture, a vulnerable population most relevant for orthopaedic surgeons. This study serves as a call-to-action for orthopaedic surgeons to ensure their fragility hip fracture patients receive adequate supplementation postoperatively to maximize their health and recovery. This was a Level III, retrospective cohort study.
    Schlagwörter osteoporosis ; fragility hip fracture ; vitamin supplementation
    Sprache Englisch
    Erscheinungsdatum 2021-01-21
    Verlag Thieme Medical Publishers, Inc.
    Erscheinungsort Stuttgart ; New York
    Dokumenttyp Artikel
    ISSN 2472-8454 ; 2472-8446
    ISSN (online) 2472-8454
    ISSN 2472-8446
    DOI 10.1055/s-0040-1722280
    Datenquelle Thieme Verlag

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  6. Artikel ; Online: Extended Postoperative Prophylactic Antibiotics for Primary and Aseptic Revision Total Joint Arthroplasty: A Systematic Review.

    Yakkanti, Ramakanth R / Vanden Berge, Dennis / Summers, Spencer H / Mansour, Kailey L / Lavin, Alessia C / Hernandez, Victor H

    The Journal of the American Academy of Orthopaedic Surgeons

    2022  Band 30, Heft 11, Seite(n) e822–e832

    Abstract: Introduction: Limited literature is available about the effects of extended (>24 hours) antibiotic use after primary and aseptic revision total joint arthroplasty (TJA) on rates of periprosthetic joint infection (PJI). The purpose of this study was to ... ...

    Abstract Introduction: Limited literature is available about the effects of extended (>24 hours) antibiotic use after primary and aseptic revision total joint arthroplasty (TJA) on rates of periprosthetic joint infection (PJI). The purpose of this study was to systematically review the outcomes of extended prophylactic antibiotic use.
    Methods: A systematic search on PubMed and EMBASE databases was done in August 2021 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles that met inclusion criteria were screened by two separate authors. Basic patient demographics, route of delivery, type, dose, frequency of the antibiotic, rates of PJI, and length of stay were extracted.
    Results: A total of 11 articles published from 1979 to 2021 were included in the final analysis. Two studies evaluated aseptic revisions, seven evaluated primary TJA, and two studies evaluated both. Five studies were randomized controlled trials, one multicenter nonrandomized trial, and five retrospective cohort studies. All 11 studies used a cephalosporin or a penicillin antibiotic in both the control and cohort groups. Five studies used intravenous (IV) antibiotics, one study used oral (PO) antibiotics, and the other five studies used both IV and PO antibiotics. Length of stay was reported in three studies, all using IV antibiotics. All 11 studies evaluated rates of PJI, while four studies evaluated included rates of superficial surgical site infections. Four studies showed a statistically significant decrease in PJI when compared with a control group, while seven studies showed no statistically significant difference.
    Conclusion: There is conflicting evidence regarding the benefit of extended (>24 hours) antibiotics, IV or PO, after TJA. As of now, current guidelines do not support the use of extended antibiotics; future prospective clinical trials are needed to help support these claims.
    Mesh-Begriff(e) Humans ; Anti-Bacterial Agents/therapeutic use ; Arthritis, Infectious/drug therapy ; Arthroplasty ; Multicenter Studies as Topic ; Prosthesis-Related Infections/prevention & control ; Retrospective Studies ; Controlled Clinical Trials as Topic ; Antibiotic Prophylaxis
    Chemische Substanzen Anti-Bacterial Agents
    Sprache Englisch
    Erscheinungsdatum 2022-03-02
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Systematic Review
    ZDB-ID 1200524-1
    ISSN 1940-5480 ; 1067-151X
    ISSN (online) 1940-5480
    ISSN 1067-151X
    DOI 10.5435/JAAOS-D-21-00977
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  7. Artikel ; Online: Volatile Hypertension Following Anterior Cervical Discectomy and Fusion: A Case Report.

    Summers, Spencer H / Sabeh, Karim / Gottlieb, Jonathan

    JBJS case connector

    2017  Band 6, Heft 1, Seite(n) e12

    Abstract: Case: A sixty-one-year-old man underwent anterior cervical discectomy and fusion (ACDF) from C4 to C7 for the treatment of cervical spondylosis. Postoperatively, the patient experienced paroxysmal surges in blood pressure with associated diaphoresis and ...

    Abstract Case: A sixty-one-year-old man underwent anterior cervical discectomy and fusion (ACDF) from C4 to C7 for the treatment of cervical spondylosis. Postoperatively, the patient experienced paroxysmal surges in blood pressure with associated diaphoresis and anxiety that were difficult to control. He had additional episodes after discharge, requiring a second hospital admission. He was ultimately diagnosed with baroreflex failure syndrome and was managed with a three-drug regimen. He gradually improved and was symptom-free at seven months.
    Conclusion: Baroreflex failure syndrome should be considered in the setting of volatile hypertension following ACDF. Prompt recognition of this condition can lead to early referral to a specialist and may reduce patient morbidity.
    Sprache Englisch
    Erscheinungsdatum 2017-11-24
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ISSN 2160-3251
    ISSN (online) 2160-3251
    DOI 10.2106/JBJS.CC.O.00154
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  8. Artikel ; Online: Achilles Injury and Access to Care in South Florida.

    Boden, Allison L / Geller, Joseph S / Granger, Caroline J / Summers, Spencer H / Kaplan, Jonathan / Aiyer, Amiethab

    Foot & ankle specialist

    2020  Band 15, Heft 2, Seite(n) 105–112

    Abstract: ... ...

    Abstract Introduction
    Mesh-Begriff(e) Achilles Tendon/injuries ; Achilles Tendon/surgery ; Aged ; Ankle Injuries ; Florida/epidemiology ; Health Services Accessibility ; Humans ; Medicare ; Retrospective Studies ; Rupture/surgery ; Tendon Injuries/surgery ; United States
    Sprache Englisch
    Erscheinungsdatum 2020-07-24
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2488579-4
    ISSN 1938-7636 ; 1938-6400
    ISSN (online) 1938-7636
    ISSN 1938-6400
    DOI 10.1177/1938640020943711
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  9. Artikel ; Online: Innovation in Orthopaedic Surgery Education: Novel Tools for Modern Times.

    Agyeman, Kofi Dwirah / Summers, Spencer H / Massel, Dustin H / Mouhanna, Joelle / Aiyer, Amiethab / Dodds, Seth D

    The Journal of the American Academy of Orthopaedic Surgeons

    2020  Band 28, Heft 18, Seite(n) e782–e792

    Abstract: Orthopaedic residency training has and will continue to evolve with a wide variety of changes. Hands-on surgical simulation "boot camps," computerized simulation of surgical process, and even virtual reality simulators, all can help trainees acquire ... ...

    Abstract Orthopaedic residency training has and will continue to evolve with a wide variety of changes. Hands-on surgical simulation "boot camps," computerized simulation of surgical process, and even virtual reality simulators, all can help trainees acquire surgical experience without compromising patient care. Low-cost training modules help remedy the rising costs associated with teaching complex orthopaedic surgery skills. Motion tracking and checklists help refine standardization of assessment. As technology and healthcare systems continue to grow, we encourage training programs to keep pace by considering engagement of these tools.
    Mesh-Begriff(e) Clinical Competence ; Computer Simulation ; Education, Medical, Graduate/economics ; Education, Medical, Graduate/methods ; Educational Measurement/methods ; Humans ; Internship and Residency ; Orthopedic Procedures/education ; Simulation Training/economics ; Simulation Training/methods ; Virtual Reality
    Sprache Englisch
    Erscheinungsdatum 2020-07-10
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ZDB-ID 1200524-1
    ISSN 1940-5480 ; 1067-151X
    ISSN (online) 1940-5480
    ISSN 1067-151X
    DOI 10.5435/JAAOS-D-19-00411
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Artikel ; Online: Analgesia in Total Knee Arthroplasty: Current Pain Control Modalities and Outcomes.

    Summers, Spencer / Mohile, Neil / McNamara, Colin / Osman, Brian / Gebhard, Ralf / Hernandez, Victor Hugo

    The Journal of bone and joint surgery. American volume

    2020  Band 102, Heft 8, Seite(n) 719–727

    Mesh-Begriff(e) Analgesia/methods ; Arthroplasty, Replacement, Knee ; Humans ; Pain Management/methods ; Pain Measurement ; Pain, Postoperative/prevention & control ; Patient Satisfaction ; Recovery of Function
    Sprache Englisch
    Erscheinungsdatum 2020-01-24
    Erscheinungsland United States
    Dokumenttyp Journal Article ; Review
    ZDB-ID 220625-0
    ISSN 1535-1386 ; 0021-9355
    ISSN (online) 1535-1386
    ISSN 0021-9355
    DOI 10.2106/JBJS.19.01035
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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