4 recent studies for spine, knee surgeons to know


From new evidence about artificial disc replacement to payment models that may improve disparities in care, here are four recent studies grabbing readers' attention:

1. A study published in the Journal of Neurosurgery: Spine supports the effectiveness of NuVasive's Simplify cervical artificial disc at two levels compared to spinal fusion. The FDA investigational device exemption trial followed up with patients for two years and compared disc replacement patients with anterior cervical discectomy and fusion patients. Researchers found the overall composite success rate was statistically significantly greater in the artificial disc group compared with the fusion group after 24 months.

2. Patient identifiers such as gender, race and ethnicity cannot predict the shape of a person's knee, a study published in The Knee found. The study examined the shapes of about 1,000 knee joints acquired from computed tomography. The study concluded: "After anisotropic normalization by size, which removes size and aspect ratio related differences, the data exhibited no morphotypes. This showed that there are no relevant hidden variables, e.g., gender, body type or ethnicity, which influence the shape of the knee joint. Instead, knee shape is highly individual."

3. Researchers at Icahn School of Medicine at Mount Sinai in New York City found that a bundled care program helped reduce disparities in total joint replacements for Black patients. A study analyzed disparities between Black and white patients undergoing total hip or knee replacement before and after Medicare's Comprehensive Care for Joint Replacement model was implemented in 2016, according to a June 1 news release. The model gives healthcare organizations a single payment for all services in an episode of care. The bundled payment program led to improvements in key outcomes. Black patients saw larger reductions in 90-day and 180-day readmission rates as well as in Medicare payments related to skilled nursing facilities.

4. Premia Spine's Tops spinal arthroplasty system was found to be more cost-effective than a transforaminal lumbar interbody fusion, according to a study published in the Journal of Health Economics and Outcomes Research. Researchers found patients were willing to pay an estimated $100,000 for the benefits of the implant, designed to stabilize the spine without fusing, within a year after surgery, according to the study. The device, which has a $4,000 cost premium over TLIF, also was found to be the dominant strategy after two years.

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