ISO 13485 Certified | ISO9001 Certified Request more information or an in-office demo (267) 483-8081

CURVEBEAM CONNECT: South American Orthopedics is Making Strides with Dr. Cristian Ortiz

The foot & ankle orthopedic specialty in South America is burgeoning as the number of foot and ankle surgeons continues to increase, said Dr. Cristian Ortiz of the Clinica Universidad de los Andes in Santiago, Chile.

ezgif.com-gif-makerClick here to download the executive summary for this episode of CurveBeam Connect, featuring Dr. Cristian Ortiz of the Clinica Universidad de los Andes.

 

“We are growing up in sports, but we’re also growing up in the practice of all the different areas of medicine and medical care, and especially in orthopedic,” Dr. Ortiz said.

For this month’s episode of CurveBeam Connect, director of marketing Vinti Singh sat down with Dr. Ortiz, a noted foot and ankle orthopedic surgeon and vice president of the International Federation of Foot and Ankle Societies (IFFAS). Every month, Singh interviews doctors, patients, and thought leaders in healthcare technology to discuss how weight bearing CT solutions are changing medicine.

In the last five years, Ortiz said he has seen a growing number of foot and ankle surgeons, especially in Argentina, Brazil, Chile, and Colombia.

“Right now in Chile, we have 60 foot and ankle surgeons who are well-trained or formally trained in the States or Europe,” Dr. Ortiz said. “So it’s a pretty good number for an 18-million-people country.”

More orthopedic surgeons mean an improved level of care and skill for the specialty, he said.

“Medicine is practiced in different ways depending on where you are, which depends on your financial support, level of expertise, and sometimes even if you have the same training, people do things differently,” Dr. Ortiz said.

Dr. Ortiz is preparing for the next meeting of the IFFAS 2020 in Vina del Mar, Chile, where 1,400 surgeons will meet to discuss weight-bearing CT, sports injuries, total ankle replacements, and other hot topics right now in the foot and ankle surgery.

“So it’s very interesting because when you bring speakers talking about the same subjects, you get different ideas because they come from different parts of the world,” Dr. Ortiz said.

Weight Bearing CT Imaging Could Assist in Evaluating Knee Osteoarthritis

Many have long thought that the means of assessing osteoarthritis in the knee are less than ideal.

Although conventional X-ray radiographs are widely considered as gold standard for the assesssment of knee OA, in clinical and scientific settings they increasingly bare significant limitations in situations where high resolution and detailed assessment of cartilage is demanded. – Wick et al, Gereontology. 2014; 60(5).

Current standard of care consists of a series of X-rays on a routine interval basis to assess whether disease is progressing further and corresponding with the patient’s symptoms. There is questionable reliability of joint space width (JSW) measurements from X-ray, and it is difficult to decipher whether there has been a significant change in anatomy to explain the patient’s worsening symptoms.

Watch the video to see a bilateral weight bearing CT dataset of a patient with osteoarthritis in his knees. 

CurveBeam’s cone beam CT technology offers high resolution, axial, coronal, and sagittal views in 0.3mm slices generated from a 30 second scan. This provides 3-dimensional, weight bearing information with radiation exposure levels almost equivalent to the standard series of knee X-rays. The 30 second scan is much faster for the technician to acquire compared to the back and forth for multiple views in an X-ray series.

Incorporating weight bearing CT technology into daily practice could facilitate complete visualization of the joint surface in axial slices and take into consideration the effects of weight bearing at the joint line. In time, clinicians should be able to provide more detailed information on location and progression of disease for their patients, and therefore, determine the best course of care moving forward.

 

CurveBeam Connect: Breaking Down a New Study on Weight-Bearing CT’s Impact on Cost

In this episode of the CurveBeam podcast, host Vinti Singh sat down with Dr. Martinus Richter, MD, Ph.D.to discuss the results of his latest published study: “Results of more than 11,000 scans with weight-bearing CT – Impact on costs, radiation exposure and procedure time.” This first-of-its-kind study examined the economic implications of CT scans versus radiographs for patients.

exec summary screenshot

Click here to download the execuctive summary for this episode of CurveBeam Connect, featuring Dr. Martinus Richter, MD, PhD.

Dr. Richter is department head of the foot and ankle orthopedic surgery section at Hospital Rummelsberg in Rummelsberg, Germany and has published numerous studies in orthopedic journals.

Dr. Richter oversaw a study, which was conducted over more than five years. to assess the benefits of using weight bearing CT (WBCT) instead of a combination of weight bearing radiographs (R) and conventional CT (CT). The study looked at the modalities’ impacts on costs, radiation exposure and procedure time.

In the study, 11,009 scans, taken from July 2013 through March of 2019, were obtained from 4987 patients—45% (4,897) before treatment; 55% (6,022) at follow-up—with a yearly average of 1,957 WBCTs (bilateral scans). These were compared to 1,850 Rs (bilateral feet, dorsoplantar and lateral, metatarsal head skyline view) and 254 CTs obtained from 885 patients (RCT group) in 2012.

The conclusions help to solidify that not only can WBCT more precisely measure bone position than conventional R and CT scans, but also decreases the time needed for image acquisition by 77% and radiation dosage by 10%, while increasing institution financial profitability by $57.19 (51€) per patient.

AAOS: “Ortho Surgeons are Fully Competent to Interpret Imaging Studies”

Imaging technology has increased the convenience and quality of the diagnosis and treatment of musculoskeletal diseases and injuries. However, some recent studies question the excessive or inappropriate utilization of this technology, leading insurers to restrict reimbursement for specific imaging techniques, including computed tomography.

The the American Academy of Orthopaedic Surgeons (AAOS) issued a position stating insurers’ policies “undermine both the quality and convenience of musculoskeletal care for patients being treated by orthopedic surgeons…The quality and accuracy of imaging studies and interpretations performed by orthopaedists are consistently high.”

Click here to access the full position statement.

Radiologists  interpret plain radiographs and other images in descriptive terms. In contrast, orthopaedic surgeons add functional, anatomical, and clinical assessments, resulting in patient-specific information not likely provided by the radiologist. This impacts issues including course of treatment and responsibility for patient care, according to the position paper.

Timeliness is crucial in imaging.

  • When patients have to travel to another imaging facility, it can place undue burden on them and their family members.
  • More than one visit may be required to make appropriate treatment decisions, especially if the outside facility is unfamiliar with the patient’s condition.
  • Often the ideal time for imaging is just after immobilization is removed, but before subsequent casting or splinting. To have the patient leave the office under these circumstances is “dangerous and ill-advised,” according to AAOS.
  • Additional and sometimes special views may be needed for adequate patient care at the time of the office visit, making the use of outside facilities untenable.

The AAOS believes the responsibility for orthopaedic patient care, including immediate performance and interpretation of diagnostic imaging studies,  should reside with the orthopaedic physician.  Any policy that prohibits orthopaedists from performing and interpreting diagnostic imaging studies in their offices reduces patient care. Such a policy would inflate prices put patients requiring comprehensive management at risk.

Medical Care May Have Swayed Kevin Durant’s Decision to Join the Nets

What’s worse than losing your patient’s confidence? Probably having it announced throughout national media coverage. This scenario just played out for the medical staff of the Golden State Warriors basketball team as one of the most popular faces within the NBA, Kevin Durant, suffered a season, and possibly career ending Achilles tear injury.

Durant’s Achilles tear took place in Game 5 of a 7 Game series after he was previously evaluated for a calf strain. It appears that both Durant and head coach, Steve Kerr, “didn’t think he could get injured worse”by returning to play. After feeling mislead or possibly misdiagnosed by the Warriors’ physicians, Durant chose to return to his former foot & ankle surgeon, Dr. Martin O’Malley, MD, at Hospital for Special Surgery in New York, to operate on his ruptured tendon, according to the New York Post. Dr. O’Malley performed surgery on Durant’s broken foot four years ago.

Even worse for the Warriors, the Brooklyn Nets hoped to capitalize on Durant’s lack of confidence in the medical staff to sway Durant to join their squad since Dr. O’Malley is their team foot and ankle specialist. And they succeeded. Kevin Durant confirmed in June that he would be signing a four-year contract with the Brooklyn team.

Why have Durant and the Nets chosen Dr. O’Malley? Well, not only do they have a relationship from a prior injury and surgical repair, but Dr. O’Malley has remained committed to offering the most cutting-edge technology and diagnostics to his patients. One of his most valued tools is the pedCAT, a weight bearing cone beam CT imaging system ,which allows him to perform the scans in his office and review the results with the patients the same day using 3D rendering software. The pedCAT allows him to gather 3D information similar to traditional CT with radiation exposure levels almost equivalent to a standard set of X-Rays.

Watch the video above to hear how Dr. Martin O’Malley, MD, utilizes the pedCAT in his Manhattan orthopedic practice. 

As a patient, wouldn’t you always want your doctor to have more information to help tailor your treatment plan? As a physician, wouldn’t you rather be certain about your diagnosis rather than agonize over equivocal X-Rays? Utilizing software that provides talas_curvebeam1a 3D rendering of the patient’s anatomy provides the physician with an opportunity to discuss the nuances of that patient’s case right then and there in the office. It also allows the patient to better understand their treatment options and feel more engaged in the decision-making process. Ultimately, the patient feels that they have greater ownership of their care and assurance that their physician has done all he/she could to get to the true source of the problem.

CURVEBEAM CONNECT: Getting to Know Dr. Cesar de Cesar Netto

For a premier orthopedic surgeon, you might be surprised to learn Dr. Cesar de Cesar Netto, has never broken a bone. Even as an athlete playing soccer, the founding member of the Weight Bearing CT Society never sustained an injury like the ones he sees from his patients in his orthopedic work. “I was a goalkeeper,” he says chuckling.

On today’s episode of Curvebeam Connect, host Vinti Singh, Curvebeam Marketing Manager, sits down with Dr. Cesar de Cesar Netto, M.D., Ph.D. of the University of Iowa Carver School of Medicine to learn more about the Brazilian surgeon and researcher and discuss advancements in extremity CT scans.

Since the WBCT Society held its first meeting in Berlin in 2016, the organization has presented at several conferences and made significant strides towards its mission, Dr. de Netto says.

Specifically, a recent imaging study of patients with adult-acquired flat foot, or flat foot deformity, found that 70 percent of those patients had some degree of subtalar joint subluxation and sinus tarsi impingement. Dr. de Netto was a co-author of the study that used weight bearing CT imaging and MRI, as opposed to two-dimension x-ray imaging.

“The foot is such a beautiful biomechanical machine with so many joints that I always thought X-Rays couldn’t really demonstrate to you what the deformity consisted of,” he says.

Click here to watch a YouTube video of Dr. de Netto discussing how weight bearing CT permits further research into flat foot deformities.

El Equipo de Chile y la Clínica de la Universidad de los Andes Firman Acuerdo para el Cuidado de Atletas de Alto Rendimiento

En Abril, el Comité Olímpico de Chile firmo un nuevo acuerdo con la Clínica de la Universidad de los Andes.

signed a new agreement

La Clínica de la Universidad de Los Andes provee servicios de ortopedia a un gran numero de los mejores miembros del Equipo Olímpico de Chile. El acuerdo consolida un pacto entre el centro medico y el Comité Olímpico Chileno, nombrando la clínica como el Centro de Recuperación Oficial del Equipo de Chile.

Seleccionado por el sobresaliente cuidado que su equipo medico le provee a atletas profesionales y de élite, la Clínica de la Universidad de los Andes realizara consultas, exámenes, procedimientos, cirugías, y tratamiento traumatologico.

outstanding care for elite athletes

La Clínica invierte en la tecnología necesaria para que esto sea posible, uniéndose a CurveBeam para darle a los atletas acceso a LineUp, una  solución bilateral para las tomografías, que toma imágenes de las rodillas y extremidades inferiores en 3D.

tech

Utilizando esta tecnología, los cuidados de la Clínica tendrán un enfoque muy personal y humano con el atleta/paciente y su familia, ayudando a simplificar los cuidados médicos y el proceso de recuperación de los atletas nacionales de Chile.

Rodrigo Rojas, medallista de oro en karate, Rodrigo Toti Miranda, medallista de oro en ski acuático, Diego Moya y Macarena Salazar, medallistas en triatlón, Tomas Briseño, medallista de Judo, así como otros prominentes atletas nacionales buscan diagnosticarse en esta prestigiosa institución.

athletes

Ahora los atletas de alto rendimiento del país tienen acceso a un nivel de cuidados que los ayudara a desatollar sus carreras con apoyo medico de clase mundial.

tour

Después de la firma, los atletas hicieron un tour del centro medico y no solo estaban contentos con las instalaciones de primera clase, sino también el hermoso ambiente de la clínica.

Mira el video completo de CDO a continuación:

Luminary South American Hospital Named Official Recovery Site for Chilean Olympic Athletes; Will Provide Weight Bearing CT Imaging

The Olympic Committee of Chile signed a new agreement with the Clinica Universidad de los Andes in Santiago, Chile, earlier this year.

signed a new agreement

The Clinica Universidad de Los Andes provides orthopedic services for numerous top members of Chile’s Olympic Team. The agreement solidifies a pact between the medical center and the Chilean Olympic Committee, naming the clinic as the official recovery site of Team Chile.

Chosen because of its medical team’s outstanding care for elite and professional athletes, the Clinica Universidad de los Andes will provide consultations, examinations, procedures, surgeries, and traumatological treatment.

outstanding care for elite athletes

The Clinic invests in state-of-the-art technology to make this possible, and it recently partnered with CurveBeam to furnish athletes with access to the LineUP CT imaging system, a bilateral, weight-bearing  solution that quickly images knees and lower extremities in 3D.

tech

Leveraging technology, the Clinic’s care will center around a very personalized and humanized focus on the athlete/patient and his or her family, helping to streamline the medical care and recovery processes of Chile’s national athletes.

World karate gold medalist Rodrigo Rojas, water skiing gold medalist Rodrigo Toti Miranda, triathlete medalists Diego Moya and Macarena Salazar, judo medalist Tomas Briseno, as well as other prominent national athletes already seek care at this prestigious institution.

athletes

Now, the country’s high-performance athletes have access to a level of care that will help them to develop their careers on a foundation of world-class medical support.

tour

After the signing, the athletes toured the medical center and were not only pleased with the first-class offerings of the facility, but the clinic’s beautiful setting as well.

Watch the full clip from CDO below:

CURVEBEAM CONNECT: A FOCUSED APPROACH TO TECHNOLOGY IN HEALTHCARE

Dr. Bob Baravarian Advocates a Focused Approach to Technology in Healthcare

Dr. Babak (Bob) Baravarian has been at the forefront of technological innovation since the beginning of his career. CurveBeam Marketing Manager Vinti Singh recently had an enlightening conversation with Dr. Baravarian on CurveBeam Connect about his approach to technology in patient care, with an emphasis on the use of the pedCAT weight bearing CT imaging solution.

 

Baravarian Exec Summary

Click here to download the executive summary for this episode of CurveBeam Connect, featuring Dr. Bob Baravarian, DPM, FACFAS.

Dr. Baravarian Embraced Technology from the Beginning of His Career

Dr. Bob Baravarian, DPM, FACFAS,  is a board-certified podiatric foot and ankle specialist and one of the few foot and ankle surgeons to have both foot and reconstructive rearfoot and ankle certifications as a Fellow of the American College of Foot and Ankle Surgeons. He also serves as Editor Emeritus of the international medical journal, Foot and Ankle Specialist.

Dr. Baravarian opened the University Foot & Ankle Institute in Santa Monica, Cali., in 2003 with Dr. Gary Briskin, DPM, FACFAS. The partners wanted to start their own practice so they would have the ability to treat patients from start to finish without outsourcing. Dr. Baravarian says, “We wanted to make sure we offered state-of-the-art care, and the patient was able to get everything done in a cost-efficient, appropriate manner. That’s what drove the innovation.” The practice was paperless from day one, and was one of the first in  the country to invest in podiatric digital X-Ray technology. They now have 10 locations, offering their own physical therapy, surgery, MRI, and CT scans in-house.

Weight Bearing CT Scans Offer a Number of Benefits

University Foot and Ankle was also one of the first podiatric practices in the country to get a pedCAT weight bearing CT system. “We knew the pedCAT was going to be a significant benefit to patients and a significant benefit for us in being able to take care of patients better,” says Dr. Baravarian. The decision came down to three criteria. Was this something that will benefit the patient? Would it allow them to practice better? And does the payment of the machine compared to payments from insurance make sense? The pedCAT checked all three boxes.

Taking the Practice to Another Level

The intangibles were just as important, Dr. Baravarian says. “From a marketing standpoint, the idea of having a weight bearing CT scanner that does 3D renderings of the foot and allows for proper analysis of the foot is something that sets you apart.” When a patient is referred to a practice for a 3D scan of their foot and is then able to see those images live – rotated and in multiple planes – they better understand what’s wrong with their foot. A 3D CT scan also changes the practice because it allows doctors to have as much information as possible when caring for a patient, so that they can offer the absolute best care with the least risk. “I think that’s a really important part of being able to grow your practice substantially and offer best practices to patients,” says Baravarian, adding, “It just takes your practice to another level.”

A Better Alternative to X-Rays

The University Foot & Ankle Institute uses weight bearing CT scans in complement to X-Ray exams. Dr. Baravarian believes the latter is becoming increasingly obsolete as new and more effective equipment arises. “The two areas where we’re using the pedCAT the most are one, for pre-operative planning and two, for post-operative assessment,” says Dr. Baravarian. For example, he thinks CT scanning is a must for flat foot reconstruction because it allows doctors to see the structure in three dimensions and better determine the nature of the deformity. That enables a doctor to plan surgery and make better decisions. Not a traditional application for CT scanning, but just as useful in Dr. Baravarian’s opinion, is hallux rigidus surgery because it allows the surgeon to have more confidence when creating a game plan, reduces surprises, and saves time during the procedure. And finally, when doing a fusion on any joint, he will get a CT scan before allowing them to become weight bearing. The confidence provided from the information gathered during this 3D view has improved results enormously.

Click here to see additional indications for weight bearing CT imaging.

The Future of Healthcare

Of course, Dr. Baravarian knows technology is only one part of the healthcare equation. Other changes are needed to the system to better serve patients. “What is wrong with our healthcare system is that the dollar is going into the wrong pockets,” Dr. Baravarian says, citing the amount of administration that goes into healthcare. “In both in the hospital setting and the health insurance company setting, you used to have one doctor to four administrators. Now you have one doctor to somewhere around 200 administrators.” He says servicing Medicare patient is easier than servicing a private care patient, because with private insurance companies, you have to jump through hoops, including pre-authorizations and approvals. Dr. Baravarian believes universal healthcare would be cheaper, better, and faster by eliminating many of the inefficiencies in the system, allowing him to reach his goals. “We want to start to grow to 30, 40, 50 locations and so I think of things much more on a larger scale of practice than seeing one patient at a time.”

To listen to the full podcast, visit https://marketscale.com/industries/healthcare/focused-healthcare-technology/. And to find out more about the pedCAT CT Imaging Scanner from CurveBeam, visit https://www.curvebeam.com/products/pedcat/.