Total Knee Replacement - Doctor Payouts

I just came across this item about "deferred prosecution agreements a US Attorney made with four makers of orthopedic devices (Biomet, DePuy Orthopaedics (a unit of Johnson & Johnson), Zimmer Holdings, and Smith & Nephew), and an agreement allowing federal supervision of Stryker Orthopedics (a unit of Stryker Inc)."

It seems that the four companies have been making large payouts to doctors. as "consultants" to use their products. I'm talking about payouts of up to six million dollars to individual doctors.

The companies were charged with violating anti-kickback laws. The upshot is the companies agreed to post the names of every doctor who recieved "consulting" fees. In total we are talking about 1805 doctors, including 46 doctors or organizations that received individual payouots of over a million dollars. Read more about it here.

Health Care Renewal: A Few Answers, and Many More Questions About Device Manufacturers' Payments to Orthopedic Surgeons

Now, my doctors name wasn't on the list. On the other hand, I don't know the details of the agreement reached with the companies. Maybe it was only to reveal the names of American doctors/organizations, since only they could be charged with an American violation.

At any rate, have a look for yourself. Don't be afraid to question your own orthopedic surgeon about his affiliation, if his name is on the list.

Total Knee Replacement - Surgery Minus 50 Days

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Total Knee Replacement

I finally get a call the first week in August. September 20th was going to be the big day. Good enough. I let them know at work. I have no clue how long I will be off. I didn’t bother asking in my first visit with Dr. Blastorah. But a total knee replacement would have to require what…4 to 5 weeks recovery time wouldn’t you think? Once the decision was made, I became strangely uncurious. I don’t spend hours pouring over the Stryker website, reading up about knee replacement procedures, or their artificial knee, the Stryker Triathlon.

I have found a location, during some non-serious cruising, where you can see the whole process illustrated, with video footage right there, streaming on the website:

http://www.youtube.com/watch?v=HhFtd6XSIi0

Not for me. I’m not particularly squeamish, but now I’ve decided to get it done, I don’t need the gory details. I mean it truly is kind of freaky to think about them cutting the end right off one bone, capping it with a new artificial end, and fitting a matching piece onto the end of your other leg bone. The less imagining, the better, as far as I am concerned.

You can find an interactive cartoon version of the process at:

http://www.edheads.org/activities/knee/

Very easy to understand explanations for the whole procedure.

Total K ee Replacement - Surgery Minus 101 Days

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My surgeons face had a surprised look on it the first time we met in his examining room.

‘From the look of the X-rays, I thought you were an 80 year old man.’ Dr. Bernard Blastorah, orthopedic surgeon extraordinaire. Master of total knee replacement surgery.

I found out later he installed the very first ‘Stryker Triathlon’ artificial knee in Canada, about two years previous. That was the model I was going to get. Incorporating the best features of two different previous favorites, Stryker had high hopes for the Triathlon. Me too.

Dr. Bernie left me no doubt that I was getting a new knee…or at least needed one. Go for it now or suffer through months of aggravation and pain and go for it later. Those were my options.

Twelve years ago, I was at the York University Sports Injury Clinic and Doctor Bull, at that time team doctor for Canada’s national hockey team laid it all out. “Give up jogging, give up basketball and be a little careful and you can go for a knee replacement when you’re 65. That way you’ll be dead before you need another. This isn’t the sort of thing you want to do twice.”

The way Dr. Bull explained it, everything I did from that day forward would just wear out the knee a little more. Jogging and basketball would wear it faster. Sitting on my ass in an easy chair watching TV or reading would have very little impact on it. I gave up jogging. I couldn’t give up basketball. I mean, it was just old-timers leagues. Twice a week, starting in October and running through till the end of March. I mean the Thursday night crowd was a little competitive, and they also had a spring league that tended to attract younger guys since there wasn’t a lot of other ball being played in Peterborough. But how much could that hurt.

So I’ve missed Dr. Bulls target by 9 years. I always kind of hoped I wouldn’t need a total knee replacement. Surely somebody would come along with a new artificial cartilage or something. It didn’t happen, so here we are.

Dr. Blastorah has some good news for me. “The Stryker Triathlon has some real advantages over the old models. There’s a little wear pad in there. In the older models, the wear would release larger particles that got wedged in where they weren’t supposed to be. Over the years that created leverage that could loosen the attachment points. That’s one of the reasons people having total knee replacements needed new ones. This new model wears with much finer particles. They don’t expect the same problem. So 20 years after your knee replacement, we might be able to get away with just replacing the wear pad.”

Dr. Bernie goes on to say how knee replacements had first started getting done in a big way about 12 years ago. At that time the expected life of a knee replacement was anywhere from 12 years up to 20. So this year he had kind of expected to start seeing patients coming in, in large numbers, for new ones. But it wasn’t happening. The numbers were much lower than expected. The knees were lasting longer than expected.

“Your new one is expected to be good for 20 years, but it might last years past that. We’ll know for sure in 20 years.”

Well, I’d take that.

Total Knee Replacement