Patient perceptions regarding physician reimbursements, wait times, and out-of-pocket payments for anterior cruciate ligament reconstruction in Ontario

Abstract

BackgroundCurrently, there is a lack of knowledge regarding patient perceptions surrounding physician reimbursements, appropriate wait times, and out-of-pocket payment options for anterior cruciate ligament reconstruction (ACLR). Our objective was to determine the current state of these perceptions in an Ontario setting.MethodsA survey was developed and pretested to address patient perceptions about physician reimbursements, appropriate wait times, and out-of-pocket payment options for ACLR using a focus group of experts and by reviewing prior surveys. The survey was administered to patients in a waiting room setting.ResultsTwo hundred and fifty completed surveys were obtained (79.9% response rate). Participants responded that an appropriate physician reimbursement for ACLR was $1000.00 and that the Ontario Health Insurance Plan (OHIP) reimbursed physicians $700.00 for ACLR. Seventy-four percent of participants responded that the OHIP reimbursement of $615.20 for the procedure was either lower or much lower than what they considered to be an appropriate reimbursement for ACLR. Over 90% of participants responded that an ACLR should occur within 90 days of injury. Thirty-five percent of participants were willing to pay $750.00 out-of-pocket to have an ACLR done sooner, while 16.4% of participants were willing to pay $2500.00 out-of-pocket to travel outside of Canada for expedited surgery.ConclusionThis survey study demonstrates that patients’ estimates of both appropriate and actual physician reimbursements were greater than the current reimbursement for ACLR. Further, the majority of individuals report that the surgical fee for ACLR is lower than what they consider to be an appropriate amount of compensation for the procedure. Additionally, nearly all respondents believe that a ruptured ACL should be reconstructed within 90 days of injury. Consequently, a number of patients are willing to pay out-of-pocket for expedited surgery either in Canada or abroad. However, patients’ preferences for shorter wait times must be balanced with the known risk of arthrofibrosis associated with early ACLR.Electronic supplementary materialThe online version of this article (doi:10.1186/s40634-017-0076-6) contains supplementary material, which is available to authorized users.

A Review on 3D-Printed Templates for Precontouring Fixation Plates in Orthopedic Surgery

“…This 3D-printed replica is used for pre-contouring the plate by assuming body symmetry [ 16 , 17 , 18 , 20 , 21 , 22 , 25 , 27 , 28 , 35 , 36 , 37 , 38 , 39 , 40 ]; Virtual model of injured bone/zone is reconstructed and then 3D-printed. Surgeons use this tangible model to perform reduction and then to pre-contour the plate [ 13 , 14 , 15 , 19 , 29 , 33 , 41 ];…”

“…Besides the fact that acromion fracture is uncommon, there is a high inter-individual variability in its shape [ 56 ]. The 3D-printed model enhances surgeon ability to choose the right implant among the available clavicle plates, and the proper location to achieve good fixation [ 15 ]. It can offer a good alternative to other fixation techniques as cannulated screws or tension band technique, especially in cases with small fragments.…”

“…As the surgeon will have a better understanding of the situation, he will need to measure less, and a shorter surgical and general anesthesia time will be achieved. Reported results are good for acromion fracture and more variable for os-acromiale [ 15 ].…”

“…Kim et al [ 27 ] reported 2–3 days for the entire process (CT scanning, anatomical reconstruction, 3D printing, sterilization and delivery). Therefore, Belien et al [ 15 ] recommended ‘in-house’ 3D printing for circumventing some of the additional costs. The reported 3D printing time for large models such as the pelvis is up to 10h [ 29 ].…”

Regeneration of a full-thickness defect of rotator cuff tendon with freshly thawed umbilical cord-derived mesenchymal stem cells in a rat model

“…Rotator cuff disease is a major cause of shoulder pain, and approximately 300,000 operations are performed each year in the USA [ 1 , 2 ]. After conservative treatments such as rest, non-steroidal anti-inflammatory drugs, physical therapy, and various kinds of injections [ 3 ], at least 45% patients suffer from persistent symptoms even after 12 months [ 4 ].…”