The Experts below are selected from a list of 1344 Experts worldwide ranked by ideXlab platform
James H Lubowitz - One of the best experts on this subject based on the ideXlab platform.
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Basic Knee Arthroscopy Part 4: Chondroplasty, Meniscectomy, and Cruciate Ligament Evaluation
Arthroscopy techniques, 2013Co-Authors: Benjamin D. Ward, James H LubowitzAbstract:Knee arthroscopy is an important diagnostic and therapeutic tool in the management of disorders of the knee. In a series of 4 articles, the basics of knee arthroscopy are reviewed. In this article (part 4), the basics of operative knee arthroscopy are reviewed including Chondroplasty and meniscectomy. Evaluation of the cruciate ligaments is also reviewed. Mastery of these techniques is critical for the treatment of the most common pathology encountered during knee arthroscopy.
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Ex Vivo Comparison of Mechanical Versus Thermal Chondroplasty: Assessment of Tissue Effect at the Surgical Endpoint
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the Internation, 2008Co-Authors: Marie L. Lotto, Emma J. Wright, David Appleby, Steven B. Zelicof, Mark J. Lemos, James H LubowitzAbstract:Purpose: The purpose of this study was to evaluate tissue effect (tissue removal plus underlying cell death) of two Chondroplasty techniques: mechanical debridement (MD) using a rotary shaver blade and thermal Chondroplasty using radiofrequency energy (RFE). Methods: Forty-eight human chondromalacic cartilage samples were treated with either MD or RFE. Pre- and post-treatment arthroscopic images of the cartilage surface were recorded. Samples were incubated with cell viability stain and visualized with confocal laser microscopy to determine tissue effect. Smoothing was quantitated by three surgeons using a visual analog scale (VAS) as well as a subjective rating regarding whether smoothing was "arthroscopically acceptable." Results: Tissue effect at the surgical endpoint of arthroscopically acceptable smoothing was 385 μm for MD versus 236 μm for RFE, a significant difference ( P P Conclusions: Our results shown that Chondroplasty using a RFE probe results in greater smoothing of chondromalacic cartilage in fewer treatment passes and with decreased total tissue effect than MD using a rotary shaver blade. Clinical Relevance: If safety and efficacy can be shown in vivo, thermal Chondroplasty may represent an alternative for treatment of symptomatic chondromalacia.
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osteochondral lesions of the talus randomized controlled trial comparing Chondroplasty microfracture and osteochondral autograft transplantation
Arthroscopy, 2006Co-Authors: Alberto Gobbi, Ramces Francisco, James H Lubowitz, Francesco Allegra, Gianluigi CanataAbstract:Purpose: The purpose of this study was to compare outcomes of Chondroplasty versus microfracture versus osteochondral autologous transplantation (OAT) in patients with osteochondral lesions of the talus (OLT). Methods: After prospective sample size analysis, patients with symptomatic, recalcitrant Ferkel class 2b, 3, and 4 OLT were randomized to Chondroplasty, microfracture, or OAT treatment groups. Outcomes were measured with use of the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale (AHS), the Subjective Assessment Numeric Evaluation (SANE) rating, Numeric Pain Intensity (NPI), and magnetic resonance imaging (MRI). Results: Eleven patients had Chondroplasty, 10 ankles (9 patients) had microfracture, and 12 patients had OAT. Mean time to follow-up was 53 months (range, 24 to 119 months). AHS scores showed no differences at 12 and 24 months, and SANE ratings showed no differences at final follow-up. NPI was significantly lower ( P Conclusion: Our results demonstrate no difference between Chondroplasty, microfracture, and OAT with regard to AHS and SANE ratings in patients with OLT. However, NPI at 24 hours postoperatively was significantly lower in patients who had Chondroplasty and microfracture. Level of Evidence: Level I, Therapeutic study, high-quality randomized controlled trial with no statistically significant differences but narrow confidence interval.
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Partial-Thickness Articular Cartilage Defects: Evaluation and Treatment
Operative Techniques in Orthopaedics, 2006Co-Authors: James H LubowitzAbstract:Existing scientific publications regarding evaluation and treatment of partial-thickness articular cartilage defects report conflicting results. Magnetic resonance imaging is an excellent diagnostic evaluation tool. In the community setting, however, using magnetic resonance imaging to evaluate partial-thickness cartilage defects may have variable or low sensitivity and specificity. Today, diagnostic arthroscopy with visual inspection and probing of the entire articular surface may be the gold standard for diagnostic evaluation of partial-thickness cartilage lesions. However, before surgery, nonsurgical treatment is recommended based on the presumptive diagnosis. Mechanical debridement and lavage using a suction oscillating shaver (Chondroplasty) is the accepted surgical treatment of choice. However, reported outcomes of mechanical Chondroplasty are not so good as might be expected, and basic and clinical research suggests that thermal Chondroplasty using radiofrequency energy may prove superior in the future. In addition, basic research suggests that treatments using growth factors may, in the future, expand management options.
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Determination of Factors Influencing Tissue Effect of Thermal Chondroplasty: An Ex Vivo Investigation
Arthroscopy : the journal of arthroscopic & related surgery : official publication of the Arthroscopy Association of North America and the Internation, 2006Co-Authors: Mathew E. Mitchell, Marie L. Lotto, Emma J. Wright, Dan Kidd, Douglas M. Lorang, Dwayne M. Dupree, James H LubowitzAbstract:Purpose: Scientific investigation of thermal Chondroplasty using radiofrequency energy (RFE) is confounded by multiple factors associated with the technique. Our purpose was to determine the relative importance of the following factors on tissue effect (depth of tissue debridement plus depth of underlying cell death) of thermal Chondroplasty: probe design, generator power setting, speed, force, and number of passes of the probe over treated tissue. We hypothesized the relative importance of these factors would be (from most to least important) power, passes, speed, force, and design. Methods: Bovine patellae were treated using monopolar RFE. Sample size was based on a 2-level, half-factorial design. Low and high extremes of the factors tested were power setting (50 W v 110 W), passes (1 v 5), speed (3 mm/sec v 10 mm/sec), force (0.15 N v and 0.59 N), and probe design (electrode protrusion 25 μm v 125 μm). Samples were incubated with cell viability stain and examined using confocal laser microscopy to determine tissue effect. Data were analyzed using multiple regression. Results: All factors that were tested significantly influenced tissue effect ( P Conclusions: The least tissue effect of thermal Chondroplasty was achieved with lower power using a probe with minimal electrode protrusion while performing a rapid, single, lower force pass of the probe over treated tissue. Clinical Relevance: Power and probe design have the greatest influence among the factors tested; selecting these parameters preoperatively could control tissue effect.
Anil S. Ranawat - One of the best experts on this subject based on the ideXlab platform.
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Cost-effectiveness analysis of Coblation versus mechanical shaver debridement in patients following knee Chondroplasty.
Cost effectiveness and resource allocation : C E, 2020Co-Authors: Ayoade Adeyemi, L Nherera, Paul Trueman, Anil S. RanawatAbstract:To compare costs and outcomes following knee Chondroplasty with Coblation versus mechanical shaver debridement (MSD) in patients with grade III articular cartilage lesions of the knee. A decision-analytic model was developed to compare costs and outcomes of the two methods from a US payer perspective. We used published clinical data from a single-center randomized clinical trial (RCT) designed to compare outcomes between Coblation and MSD in patients with grade III articular cartilage lesions of the medial femoral condyle. Following primary knee Chondroplasty, patients experienced either treatment success (no additional surgery required) or required a revision over the 4 year follow-up period. Costs associated with the initial Chondroplasty, physical therapy sessions through the 6 week postoperative period, and revision rates at 4 years post-surgery were estimated using 2018 US Medicare Physician Fee Schedule. Sensitivity analyses including a 10 year time horizon and threshold analyses were performed to test the robustness of the model. The estimated total cost per patient was $4614 and $7886 for Coblation and MSD, respectively, resulting in cost-savings of $3272 in favor of Coblation, making it a dominant strategy because of lower costs and improved clinical outcomes. Threshold analysis showed that Coblation remained dominant even when revision rates were assumed to increase from the base case rate of 14-66%. Sensitivity analyses showed that cost-saving results were insensitive to variations in revision rates, number of physical therapy sessions and the time horizon used. Coblation Chondroplasty is a cost-saving procedure compared with MSD in the treatment of patients with grade III articular cartilage lesions of the knee. © The Author(s) 2020.
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Cost-effectiveness analysis of Coblation versus mechanical shaver debridement in patients following knee Chondroplasty.
Cost effectiveness and resource allocation : C E, 2020Co-Authors: Ayoade Adeyemi, L Nherera, Paul Trueman, Anil S. RanawatAbstract:To compare costs and outcomes following knee Chondroplasty with Coblation versus mechanical shaver debridement (MSD) in patients with grade III articular cartilage lesions of the knee. A decision-analytic model was developed to compare costs and outcomes of the two methods from a US payer perspective. We used published clinical data from a single-center randomized clinical trial (RCT) designed to compare outcomes between Coblation and MSD in patients with grade III articular cartilage lesions of the medial femoral condyle. Following primary knee Chondroplasty, patients experienced either treatment success (no additional surgery required) or required a revision over the 4 year follow-up period. Costs associated with the initial Chondroplasty, physical therapy sessions through the 6 week postoperative period, and revision rates at 4 years post-surgery were estimated using 2018 US Medicare Physician Fee Schedule. Sensitivity analyses including a 10 year time horizon and threshold analyses were performed to test the robustness of the model. The estimated total cost per patient was $4614 and $7886 for Coblation and MSD, respectively, resulting in cost-savings of $3272 in favor of Coblation, making it a dominant strategy because of lower costs and improved clinical outcomes. Threshold analysis showed that Coblation remained dominant even when revision rates were assumed to increase from the base case rate of 14–66%. Sensitivity analyses showed that cost-saving results were insensitive to variations in revision rates, number of physical therapy sessions and the time horizon used. Coblation Chondroplasty is a cost-saving procedure compared with MSD in the treatment of patients with grade III articular cartilage lesions of the knee.
Ayoade Adeyemi - One of the best experts on this subject based on the ideXlab platform.
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Cost-effectiveness analysis of Coblation versus mechanical shaver debridement in patients following knee Chondroplasty.
Cost effectiveness and resource allocation : C E, 2020Co-Authors: Ayoade Adeyemi, L Nherera, Paul Trueman, Anil S. RanawatAbstract:To compare costs and outcomes following knee Chondroplasty with Coblation versus mechanical shaver debridement (MSD) in patients with grade III articular cartilage lesions of the knee. A decision-analytic model was developed to compare costs and outcomes of the two methods from a US payer perspective. We used published clinical data from a single-center randomized clinical trial (RCT) designed to compare outcomes between Coblation and MSD in patients with grade III articular cartilage lesions of the medial femoral condyle. Following primary knee Chondroplasty, patients experienced either treatment success (no additional surgery required) or required a revision over the 4 year follow-up period. Costs associated with the initial Chondroplasty, physical therapy sessions through the 6 week postoperative period, and revision rates at 4 years post-surgery were estimated using 2018 US Medicare Physician Fee Schedule. Sensitivity analyses including a 10 year time horizon and threshold analyses were performed to test the robustness of the model. The estimated total cost per patient was $4614 and $7886 for Coblation and MSD, respectively, resulting in cost-savings of $3272 in favor of Coblation, making it a dominant strategy because of lower costs and improved clinical outcomes. Threshold analysis showed that Coblation remained dominant even when revision rates were assumed to increase from the base case rate of 14-66%. Sensitivity analyses showed that cost-saving results were insensitive to variations in revision rates, number of physical therapy sessions and the time horizon used. Coblation Chondroplasty is a cost-saving procedure compared with MSD in the treatment of patients with grade III articular cartilage lesions of the knee. © The Author(s) 2020.
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Cost-effectiveness analysis of Coblation versus mechanical shaver debridement in patients following knee Chondroplasty.
Cost effectiveness and resource allocation : C E, 2020Co-Authors: Ayoade Adeyemi, L Nherera, Paul Trueman, Anil S. RanawatAbstract:To compare costs and outcomes following knee Chondroplasty with Coblation versus mechanical shaver debridement (MSD) in patients with grade III articular cartilage lesions of the knee. A decision-analytic model was developed to compare costs and outcomes of the two methods from a US payer perspective. We used published clinical data from a single-center randomized clinical trial (RCT) designed to compare outcomes between Coblation and MSD in patients with grade III articular cartilage lesions of the medial femoral condyle. Following primary knee Chondroplasty, patients experienced either treatment success (no additional surgery required) or required a revision over the 4 year follow-up period. Costs associated with the initial Chondroplasty, physical therapy sessions through the 6 week postoperative period, and revision rates at 4 years post-surgery were estimated using 2018 US Medicare Physician Fee Schedule. Sensitivity analyses including a 10 year time horizon and threshold analyses were performed to test the robustness of the model. The estimated total cost per patient was $4614 and $7886 for Coblation and MSD, respectively, resulting in cost-savings of $3272 in favor of Coblation, making it a dominant strategy because of lower costs and improved clinical outcomes. Threshold analysis showed that Coblation remained dominant even when revision rates were assumed to increase from the base case rate of 14–66%. Sensitivity analyses showed that cost-saving results were insensitive to variations in revision rates, number of physical therapy sessions and the time horizon used. Coblation Chondroplasty is a cost-saving procedure compared with MSD in the treatment of patients with grade III articular cartilage lesions of the knee.
Adi Primovfever - One of the best experts on this subject based on the ideXlab platform.
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thyroid Chondroplasty smoothing the thyroid cartilage a retrospective study of thyroid Chondroplasty for feminine neck appearance
International Journal of Transgenderism, 2017Co-Authors: Noga Lipschitz, Michael Wolf, Ofer Amir, Doron Sagiv, Adi PrimovfeverAbstract:ABSTRACT Background: Thyroid Chondroplasty is a surgical intervention for reduction of the Adam's apple, performed in trans women to achieve a more feminine appearance of the neck. This procedure is necessary since hormonal therapy given as part of gender affirming medical interventions has no effect on the mature larynx.Objectives: We aim to describe our thyroid Chondroplasty surgical technique and outcome of all thyroid chondroplasties performed during the study period.Methods: A retrospective chart review of all thyroid Chondroplasty procedures performed in a tertiary referral center between 2006 and 2015. Patients' clinical characteristics and surgical outcome were recorded and analyzed.Results: Twenty-seven trans women underwent thyroid Chondroplasty in our institution. Post-operative complications included a single patient who suffered from false vocal fold (ventricular folds) hematoma that resolved spontaneously. Five other patients had an erythematous scar. No other complications were observed.Con...
L Nherera - One of the best experts on this subject based on the ideXlab platform.
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Cost-effectiveness analysis of Coblation versus mechanical shaver debridement in patients following knee Chondroplasty.
Cost effectiveness and resource allocation : C E, 2020Co-Authors: Ayoade Adeyemi, L Nherera, Paul Trueman, Anil S. RanawatAbstract:To compare costs and outcomes following knee Chondroplasty with Coblation versus mechanical shaver debridement (MSD) in patients with grade III articular cartilage lesions of the knee. A decision-analytic model was developed to compare costs and outcomes of the two methods from a US payer perspective. We used published clinical data from a single-center randomized clinical trial (RCT) designed to compare outcomes between Coblation and MSD in patients with grade III articular cartilage lesions of the medial femoral condyle. Following primary knee Chondroplasty, patients experienced either treatment success (no additional surgery required) or required a revision over the 4 year follow-up period. Costs associated with the initial Chondroplasty, physical therapy sessions through the 6 week postoperative period, and revision rates at 4 years post-surgery were estimated using 2018 US Medicare Physician Fee Schedule. Sensitivity analyses including a 10 year time horizon and threshold analyses were performed to test the robustness of the model. The estimated total cost per patient was $4614 and $7886 for Coblation and MSD, respectively, resulting in cost-savings of $3272 in favor of Coblation, making it a dominant strategy because of lower costs and improved clinical outcomes. Threshold analysis showed that Coblation remained dominant even when revision rates were assumed to increase from the base case rate of 14-66%. Sensitivity analyses showed that cost-saving results were insensitive to variations in revision rates, number of physical therapy sessions and the time horizon used. Coblation Chondroplasty is a cost-saving procedure compared with MSD in the treatment of patients with grade III articular cartilage lesions of the knee. © The Author(s) 2020.
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Cost-effectiveness analysis of Coblation versus mechanical shaver debridement in patients following knee Chondroplasty.
Cost effectiveness and resource allocation : C E, 2020Co-Authors: Ayoade Adeyemi, L Nherera, Paul Trueman, Anil S. RanawatAbstract:To compare costs and outcomes following knee Chondroplasty with Coblation versus mechanical shaver debridement (MSD) in patients with grade III articular cartilage lesions of the knee. A decision-analytic model was developed to compare costs and outcomes of the two methods from a US payer perspective. We used published clinical data from a single-center randomized clinical trial (RCT) designed to compare outcomes between Coblation and MSD in patients with grade III articular cartilage lesions of the medial femoral condyle. Following primary knee Chondroplasty, patients experienced either treatment success (no additional surgery required) or required a revision over the 4 year follow-up period. Costs associated with the initial Chondroplasty, physical therapy sessions through the 6 week postoperative period, and revision rates at 4 years post-surgery were estimated using 2018 US Medicare Physician Fee Schedule. Sensitivity analyses including a 10 year time horizon and threshold analyses were performed to test the robustness of the model. The estimated total cost per patient was $4614 and $7886 for Coblation and MSD, respectively, resulting in cost-savings of $3272 in favor of Coblation, making it a dominant strategy because of lower costs and improved clinical outcomes. Threshold analysis showed that Coblation remained dominant even when revision rates were assumed to increase from the base case rate of 14–66%. Sensitivity analyses showed that cost-saving results were insensitive to variations in revision rates, number of physical therapy sessions and the time horizon used. Coblation Chondroplasty is a cost-saving procedure compared with MSD in the treatment of patients with grade III articular cartilage lesions of the knee.