ABSTRACT
Background@#We evaluated and compared South Korea’s total knee arthroplasty (TKA) reimbursement criteria set by Health Insurance Review and Assessment Service (HIRA) with other TKA appropriateness criteria to find additional criterion to improve its appropriateness by reviewing TKA inappropriate cases. @*Methods@#Two TKA appropriateness criteria and HIRA’s reimbursement criteria for TKA were adapted for use on patients undergoing TKA in one institute from December 2017 to April 2020. Preoperative data including 9 validated questionnaires on knee jointspecific parameters, age, and radiography were used. We categorized cases into appropriate, inconclusive, inappropriate groups and analyzed each group. @*Results@#Data on 448 cases that underwent TKA were examined. According to the HIRA’s reimbursement criteria, 434 cases (96.9%) were appropriate and 14 cases (3.1%) were inappropriate; superior to other TKA appropriateness criteria. The inappropriate group had Knee Injury and Osteoarthritis Outcome score (KOOS) pain, KOOS symptoms, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) total score, and Korean Knee score total score with worse symptoms compared to the appropriate group classified by HIRA’s reimbursement criteria. @*Conclusions@#In terms of insurance coverage, HIRA’s reimbursement criteria was more effective in providing healthcare access to patients who had the most pressing need for TKA compared to other TKA appropriateness criteria. However, we found the lower age limit and patient-reported outcome measures of other criteria as useful tools in improving appropriateness of the current reimbursement criteria.
ABSTRACT
Anatomical total shoulder arthroplasty (TSA) has been used widely in treatment of glenohumeral osteoarthritis and provides excellent pain relief and functional results. Reverse total shoulder arthroplasty (RSA) was created to treat the complex problem of rotator cuff tear arthropathy. RSA also has been performed for glenohumeral osteoarthritis even in cases where the rotator cuff is preserved and has shown good results comparable with TSA. The indications for RSA are expanding to include tumors of the proximal humerus, revision of hemiarthroplasty to RSA, and revision of failed TSA to RSA. The purposes of this article were to describe comprehensively the conditions under which RSA should be considered in glenohumeral osteoarthritis, to explain its theoretical background, and to review the literature.
ABSTRACT
BACKGROUNDS: Behavioral and psychological symptoms as well as cognitive impairement are very disturbing symptoms in dementia. It is important in managing dementia patient to control these behavioral and psychological symptoms. In this study, we examined the effect of risperidone and optimal therapeutic dosage on controlling these behavioral and psychological symptoms of dementia (BPSD). METHODS: 57 patients (male: 19, female: 38) with dementia, aged 65 and older in Buyeo geriatric hospital located in Buyeo-gun, chung-nam, were finally included in this study. risperidone was administrated to these subjects for 10 weeks to control BPSD. Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD) was rated before administration of risperidone and after administration of risperidone for 10 weeks to evaluate the improvement of BPSD. Global Deterioration Scale (GDS) was rated before administration of risperidone. The correlation between baseline GDS score and the change of sum score of BEHAVE-AD was analyzed. RESULT: The mean dose of resperidone at the endpoint was 0.706+/-0.522 mg/d. The significant reduction of the sum score of BEHAVE-AD was observed in subjects after administration of risperidone for 10 weeks. Clinical improvement (> or =50% reduction of sum score of BEHAVE-AD from baseline sum score) was showed in 32 subjects (56.1%) among 57 subjects. Also there was weakly negative correlation between baseline GDS score and the change of sum score of BEHAVE0AD. CONCLUSION: Risperidone was effective in controlling BPSD of dementia patients at 0.706+/-0.522 mg/d.