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影响老年肌肉骨骼护理的骨科三大医疗趋势。

Top Three Healthcare Trends in Orthopaedics Affecting Musculoskeletal Care in the Elderly.

作者信息

Lorio Morgan P, Lewandrowski Kai-Uwe, Blum Kenneth

机构信息

Cancer Institute Florida, 499 East Central Parkway, Altamonte Springs, FL 32701, on behalf of the International Society for the Advancement of Spine Surgery, USA.

President Elect, ISASS.

出版信息

Curr Aging Sci. 2025;18(2):87-94. doi: 10.2174/0118746098309054240721180720.

Abstract

Several trends toward patient-centered multi-care models employing translational research strategies are currently emerging in orthopaedics. These align seamlessly with epigenetics discussions in pain, a clinical approach to pain management that prioritizes tailoring healthcare to individual needs, preferences, and circumstances. Recognizing the unique genetic and epigenetic factors influencing pain perception, healthcare providers can integrate personalized insights into their patient-centered approach, offering more targeted and effective pain management strategies tailored to each individual's experience. Custom 3D-printing technologies may also become increasingly relevant to more effectively and reliably treat painful degenerative structural abnormalities. They are expected to go hand-in-hand with the precision medicine redefinition of musculoskeletal care. More effective analysis of surgeons' clinical decision-making and patients' perception of high-value orthopaedic care is needed. Shared Decision Making (SDM) is critical to identifying the best solution for each patient and improving stakeholders' understanding of factors influencing the diverse prioritizing values of surgical or non-surgical treatments by payers, systems, and other providers. Identifying high-value orthopaedic surgeries via effective SDM in orthopedic surgery requires more than just presenting patients with information. The Rasch analysis of patient expectations can provide this nuanced approach that involves understanding patient values, addressing misconceptions, and aligning surgical recommendations with patient-specific goals. Optimizing orthopaedic treatment within the patient-centered framework can drive innovation in reimbursement policies that support the field more broadly. Research on separating high-value from low-value orthopaedic procedures may likely impact healthcare decision- makers' resource allocation.

摘要

目前,骨科领域正出现几种采用转化研究策略的以患者为中心的多护理模式趋势。这些趋势与疼痛领域的表观遗传学讨论无缝契合,疼痛管理的临床方法优先考虑根据个体需求、偏好和情况量身定制医疗保健。认识到影响疼痛感知的独特遗传和表观遗传因素后,医疗服务提供者可以将个性化见解融入以患者为中心的方法中,提供更具针对性和有效的疼痛管理策略,以适应每个人的经历。定制3D打印技术可能也会在更有效、可靠地治疗疼痛性退行性结构异常方面发挥越来越重要的作用。它们有望与肌肉骨骼护理的精准医学重新定义携手并进。需要对外科医生的临床决策以及患者对高价值骨科护理的认知进行更有效的分析。共同决策(SDM)对于为每个患者确定最佳解决方案以及提高利益相关者对影响支付方、医疗系统和其他提供者对手术或非手术治疗不同优先级价值观因素的理解至关重要。在骨科手术中通过有效的共同决策来确定高价值骨科手术,不仅仅是向患者提供信息。对患者期望的拉施分析可以提供这种细致入微的方法,包括理解患者价值观、消除误解以及使手术建议与患者特定目标保持一致。在以患者为中心的框架内优化骨科治疗可以推动报销政策的创新,从而更广泛地支持该领域。区分高价值和低价值骨科手术的研究可能会影响医疗决策者的资源分配。

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