A 360° look at orthopedics and sports medicine

When it comes to post-op bracing, it’s the little things that matter!  From ease of use features that allow convenience of application to design “angles” that serve to optimize patient comfort, I suggest that the finer details of a post-op brace won’t be lost on your patients and your practice.

Protected range-of-motion (of the knee) is a pretty common goal during the first few weeks following knee surgery – particularly after surgeries like meniscal repairs – and most post-op braces are made with that primary objective in mind.  But Breg has raised the bar with the new T Scope® Premier.  For example, the use of bright colors to highlight and distinguish the extension stop button and extension and flexion angles for easy reference and readability is a marked improvement over its predecessor, the original T Scope.

Another example of the importance of paying attention to detail is around tenderness over the incision site – post ACL reconstruction.   The T Scope Premier makes a technical leap with the optional BridgeTech™ padding.  You simply remove the small pad(s) – which would ordinarily rest over the site of tenderness – and allow the rest of the pad to bridge over the incision site without compromising suspension of the brace. 

With so much of the news we hear every day involving tragedy and heart break of one sort or another, I thought it a good idea to reflect on some of the reasons that we should be optimistic. Even in the midst of change and anxiety about the future of healthcare, we have a lot of positives that we should be mindful of as we reflect on the state of our industry:

I think it's a safe bet that most everyone reading this blog has sprained an ankle at some point in their lives. About 25,000 people in the U.S. suffer an ankle sprain every day. I don't think many would disagree with the suggestion that it's one of the most common orthopedic injuries. Whether sedentary or an athlete, we most likely share the painful experience of our ankle rolling over on us unexpectedly.

While the anguish of a mild or moderate ankle sprain is effectively treated with the standard approach of rest, ice, compression, and elevation (R.I.C.E.), there are a variety of conservative approaches to stabilizing the more severe ankle sprain. In the acute phase, designs and devices like the ankle stirrup and walking boots provide you a lot of treatment choices as a clinician. These products are all quite similar with some interesting design angles aimed at patient comfort and compliance.

Off-loading knee braces are a commonly prescribed treatment option for patients with osteoarthritis of the knee. The success of which is determined by a few factors as you can see below:

1. The prescribing physician has a positive attitude about the how the brace can help the patient.
2. The patient has a positive outlook on what knee bracing can do for his/her condition.
3. The patient has tried other conservative therapies and is not satisfied with the results.
4. The patient has unicompartmental OA changes (in the knee) – not bi-compartmental.
5. If the patient is a young athlete, he/she shows some degree of damage to the articular cartilage on one side of the knee and the physician wants to off-load that compartment.
6. The patient leads a very active lifestyle, and he or she does not want partial or total knee replacement surgery at this time.
7. The patient is properly educated on how to apply and when to wear the product (to get the optimal results).
8. The brace fits and stays in place on the leg.
9. The brace is comfortable enough to wear for hours at a time.
10. The color of the brace matches the tennis outfit!

Off-loading knee braces offer the health care professional a non-operative treatment option for osteoarthritis of the knee that can deliver benefits to the patient – as long as it starts with a positive attitude on the part of the patient and the physician.

While I was at the Fall AANA (Arthroscopy Association of North America) meeting and exhibition held last week in Phoenix, I was reminded of how difficult it might be for health care professionals to tell one device company from the next. At a glance, a lot of their products seem to look alike. Moreover, every exhibit booth has sales people waiting to "pounce" on you as you attempt to find yourself a mere cup of coffee!

"Don't forget that it (your product or service) is not differentiated until the customer understands the difference." Tom Peters

As Tom Peters suggests, the responsibility of each company is to educate you on these distinctions and a trade show is the perfect venue to do so. The challenge, particularly for a rehab company in the midst of surgical companies showing their devices, is to represent a significant value to the physician or health care professional to warrant them stopping and discovering the differences. There is no better place than an exhibit hall to do some comparative shopping.

Optimizing patient care is an objective that all manufacturers pursue with admittedly different approaches and, sometimes, varying results. Not unlike other industries, we each bring various philosophies and styles to this common pursuit along with strong beliefs that the finished product will deliver both patient and customer satisfaction. In our efforts to differentiate our products (for a competitive advantage) with the use of new materials and technologies, can we continue to deliver on this patient care promise in a cost effective manner?

Where's the balance between delivering a superior, reliable, and effective product that reimburses at a reasonable level and that patients can afford as well?

Fortunately (for the customer), there are market forces that continue to place downward pressure on pricing including competitors (looking for an easy sale and market share gain) and the reduction in Medicare reimbursement (and the private payers following suit).

One of the things I like to do for exercise is run. It's a great form of cardio fitness and it requires little or no training or preparation. You can simply step out your door and get started. A word of caution, though, for those who have osteoarthritis and who have been told to lose weight. You should take this on in stages by walking first and progressing to fast walking before contemplating running — being overweight can cause too much stress to your knees while running. Along with a good diet, though, you can graduate to running after you're successful in reducing your weight!

Even though running is a fairly simple form of exercise, you can still find yourself with overuse injuries. For example, if you're experiencing IT band, take a read of the following suggestions/recommendations from a local physical therapist here in San Diego:

Q: Why does the outside of my knee feel tight or hurt after running? Sometimes I have to stop and stretch my legs before I can go on.

A: These problems may be due to a tightness of the Iliotibial Band (ITB) that is a fibrous band of tissue that stretches from the outside of the knee to the Tensor Fascia Lata (TFL) muscle on the outside of your hip.