Jason L. Koh, M.D.

Jason L. Koh, M.D.

Jason L. Koh, M.D.

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Profile

Conditions & Procedures

Conditions

Elbow Injury, Hip Injury, Knee Injury, Shoulder Injury, Sports Medicine

Procedures

Cartilage Transplantation

General Information

Gender

Male

Affiliation

NorthShore Medical Group

Expertise

Shoulder & Knee Injuries, Hip Arthroscopy, Sports Medicine

Academic Rank

Clinical Professor

Languages

English

Board Certified

Orthopaedic Surgery, Sports Medicine

Clinical Service

Sports Medicine

Education, Training & Fellowships

Medical School

Johns Hopkins University Schl of Med, 1994

Internship

Harvard Medical School - Massachusetts General Hospital, 1995

Residency

New York Presbyterian/Weill Cornell Med Ctr, 1999

Fellowship

Cleveland Clinic Foundation, 2000

Locations

A

NorthShore Medical Group

9650 Gross Point Rd.
Suite 2900
Skokie, IL 60076
847.866.7846 224.251.2905 fax Get Directions This location is wheelchair accessible.
B

NorthShore Medical Group

2180 Pfingsten Rd.
Suite 3100
Glenview, IL 60026
847.866.7846 866.954.5787 fax Get Directions This location is wheelchair accessible.

Insurance

Commercial Plans - Employer Sponsored
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Choice POS II
PRIMARY CARE
SPECIALTY CARE
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Aetna Health Network Only
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SPECIALTY CARE
HOSPITALS
Aetna HMO
PRIMARY CARE
SPECIALTY CARE
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Aetna Managed Choice
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Aetna Network Options
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Aetna Open Access Aetna Select
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Aetna Open Access Managed Choice
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Aetna Open Choice PPO
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Aetna Savings Plus
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Aetna Select
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Aetna Sub- Cofinity
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Aetna Sub- First Health
PRIMARY CARE
SPECIALTY CARE
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Aetna Traditional Choice-Indemnity Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago (All Metal Tiers)
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Beechstreet PPO Network
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Blue Advantage HMO
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Blue Cross Blue Shield Blue Choice Options
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SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred PPO Plans (All Metal Tiers)
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Blue Cross Blue Shield Blue Choice Select PPO
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Blue Cross Blue Shield Blue Choice Select Value Choice
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Blue Cross Blue Shield Blue Distinction Total Care Benefit Differentail
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Blue Cross Blue Shield Blue Options (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
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Blue Cross Blue Shield Blue PPO (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
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Blue Cross Blue Shield Blue Precision HMO Plans (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield BlueCare Direct (All Metal Tiers)
PRIMARY CARE
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Blue Cross Blue Shield BlueEdge HSA and BlueEdge HCA
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Blue Cross Blue Shield BluePrint
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Blue Cross Blue Shield Community Participating Option
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Blue Cross Blue Shield HMOI
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Blue Cross Blue Shield PPO
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Blue Cross Blue Shield PPO Value Choice
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Cigna Exclusive Provider Organization EPO
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Cigna Great West Healthcare (GWH) Cigna Network
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Cigna HMO
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Cigna HMO Open Access
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Cigna HMO Open Access POS
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Cigna HMO POS
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Cigna Medical PPO
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Cigna Medical Indemnity
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Cigna Medical LocalPlus
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Cigna Medical LocalPlus In-Network
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Cigna Medical Network
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Cigna Medical Network POS
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Cigna Medical Open Access Plus (OAP)
PRIMARY CARE
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Cigna Medical Open Access Plus (OAP) In-Network
PRIMARY CARE
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Cigna Medical Open Access POS
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Cofinity PPO (an Aetna Company)
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Coventry Consumer Choices (C3)
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Coventry HMO
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Coventry POS
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Coventry PPO
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Galaxy Health Network
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Health Alliance HMO, PPO, POS, POS-C
PRIMARY CARE
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Health Link HMO
If Unicare Affiliate logo present on card
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Health Link PPO
If Unicare Affiliate logo present on card
PRIMARY CARE
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Health Link-Open Access I, II, III
If Unicare Affiliate logo present on card
PRIMARY CARE
SPECIALTY CARE
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Healthcare's Finest Network- FHN 10 & 20
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Healthcare's Finest Network- FHN Platinum
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Healthcare's Finest Network- HFN Community Health Connect
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Healthcare's Finest Network- HFN Community Health Connect Elite
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Healthcare's Finest Network- HFN Community Health Connect Premiere
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Healthcare's Finest Network- HFN-ID
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Humana Advocate Centered EPO
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Humana Advocate Centered HMO
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Humana Choice POS
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Humana Classic Plan (Traditional Indemnity Plan)
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Humana Coinsurance: NPOS
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Humana Coinsurance: PPO
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Humana Coinsurance:HMO
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Humana Condell Custom PPO
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Humana Copay: HMO
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Humana Copay: NPOS
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Humana Copay: PPO
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Humana COT National POS-Open Access
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Humana Edward- Elmhurst Value HMO
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Humana Edward-Elmhurst Advantage HSA/Choice PPO
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Humana High-deductible plans (HDHP) HMO
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Humana High-deductible plans (HDHP) National point of service (NPOS)
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Humana High-deductible plans (HDHP) PPO
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Humana Illinois Coordinated Care
Available In 2017
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Humana Level Funded Premium
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Humana NorthShore Complete Care
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Humana Self Funding: Administrative Services Only (ASO)
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Humana Self-Funding: Level Funded Premium (LFP)
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Humana Self-Funding: Minimum Premium (MP)
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Humana Self-Funding: Stop Loss Insurance
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Humana Simplicity (HMO, POS, PPO)
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Humana Total Health (100 or more employees)
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Multiplan/ PHCS- Health EOS Network
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Multiplan/ PHCS- MultiPlan Complementary
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Multiplan/ PHCS- MultiPlan Limited Benefit Plan
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Multiplan/ PHCS- MultiPlan Practitioner Only
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Multiplan/ PHCS- MultiPlan Shared Savings
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Multiplan/ PHCS- PHCS Healthy Directions
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Multiplan/ PHCS- PHCS Practitioner Only
PRIMARY CARE
SPECIALTY CARE
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Multiplan/ PHCS- PHCS Savility
PRIMARY CARE
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Multiplan/ PHCS- ValuePoint by MultiPlan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
NorthShore Employee Network
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Preferred Network Access
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Preferred Plan- HealthSmart Get Better
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Preferred Plan PPO
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SPECIALTY CARE
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Stratose- National Preferred Provider Network
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Three Rivers Provider PPO Network (TRPN)
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UniCare HMO
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UniCare HMO Performance Select
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Unicare PPO
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UniCare Travel Access
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United Healthcare Catalyst
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United Healthcare Choice
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United Healthcare Choice Plus
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United Healthcare Core
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United Healthcare Heritage
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United Healthcare Multi-Choice
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United Healthcare Navigate and Navigate Plus
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United Healthcare Options Non-Differential PPO
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United Healthcare Options PPO
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United Healthcare Tiered Benefits
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Exchange Plans
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Aetna Whole Health Chicago (All Metal Tiers)
Not Available In 2017
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SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Ambetter Balance Care 10+ Vision+ Adult Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 1+ Vision+ Adult Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2+ Vision+ Adult Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Essential Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Secure Care 1 w/ 3 Free PCP Visits
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Basic 103 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred PPO (Plan #'s 101-107; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Precision HMO (Plan #'s 101-103; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Blue Premier 101 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield BlueCare Direct with Advocate (Plan #'s 101-103; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Solution 102 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry $15 Copay; Silver & Gold
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Coventry Bronze $ 20 Copay
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Coventry Bronze $10 Copay Carelink St. John's
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry Bronze $15 Copay Carelink St. John's
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry Bronze Deductible Only HSA Eligible
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Harken Health - an Affiliate of United Healthcare
Verify physician participation and out of pocket expenses with Harken
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Health Alliance HMO (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Health Alliance POS (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Health Alliance PPO (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Humana Chicago HMOx (All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Land of Lincoln Health Traditional PPO
Plan Ending 9/30/16
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
United Healthcare Compass (All Metal Tiers)
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Medicaid
PRIMARY CARE
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Aetna Better Health FHP
PRIMARY CARE
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Aetna Better Health ICP
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Blue Cross Blue Shield Community FHP
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Blue Cross Blue Shield Community ICP
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Cigna HealthSpring ICP
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Community Care Alliance- ICP
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Family Health Network- FHP
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Harmony/WellCare FHP Plan
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Humana ICP
PRIMARY CARE
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HOSPITALS
 
 
 
Illinicare Family Health Plan (FHP/ACA)
PRIMARY CARE
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Illinicare ICP
Primary Care- Current Patients Only
PRIMARY CARE
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Illinois Department of Public Aid (IDPA)
PRIMARY CARE
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Meridian FHP/ACA Expansion
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Meridian ICP
PRIMARY CARE
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Molina ICP
PRIMARY CARE
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Next Level ACA/FHP
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Medicare Advantage Plans
PRIMARY CARE
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Aetna Medicare (SM) Plan (HMO)
PRIMARY CARE
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Aetna Medicare (SM) Plan (PPO)
PRIMARY CARE
SPECIALTY CARE
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Aetna Medicare Advantage Group Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare Connect Plus (PPO)/PPO Connect Plus
PRIMARY CARE
SPECIALTY CARE
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Aetna Medicare Standard Plan (PPO)/PPO Standard Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare Value Plan (HMO)/HMO Value
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Medicare Value Plan (PPO)/PPO Value Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Traditional Choice Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Medicare Advantage Basic HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Medicare Advantage Basic Plus HMO-POS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Medicare Advantage Choice Plus PPO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Medicare Advantage Choice Premier PPO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring Advantage HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring Premier HMO-POS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring Primary HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring TotalCare HMO-SNP
PRIMARY CARE
SPECIALTY CARE
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Community Care Alliance Complete HMO-D-SNP
PRIMARY CARE
SPECIALTY CARE
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Community Care Alliance HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare Access (HMO-SNP)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare Choice (HMO-POS)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare Health Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare RX (HMO)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare Value (HMO-POS)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare-Medicare HMO Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Harmony/WellCare-Medicare Special Needs Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Humana Choice PPO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana Community HMO Diabetes and Heart (SNP Program)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana Gold Plus HMO
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana Gold Plus PFFS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Molina Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare - AARP Medicare Complete
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
United Healthcare AARP Medicare Complete Access
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare- AARP Medicare Complete Plus (HMO-POS)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
United Healthcare Medicare Advantage Focus
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
United Healthcare- Medicare Solutions/Medicare Advantage
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Medicare Medicaid Alignment Initiative (MMAI) Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Better Health MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Community MLTSS/LTSS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Community MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Cigna-HealthSpring MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Humana MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Illinicare MLTSS/LTSS
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Illinicare MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Meridian MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Molina MMAI
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Commercial - Individual Plans
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Bronze Deductible Only HSA Eligible Savings Plus OAMC PD
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Savings Plus OAMC PD (All Metal Tiers)
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago (All Metal Tiers)
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Aetna Whole Health Chicago Bronze Deductible Only HSA Eligible
Not available for 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Ambetter Balanced Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 1+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 10+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Balanced Care 2+ Vision+ Dental
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Essential Care 1
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Ambetter Secure Care 1 w/ 3 Free PCP Visits
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred PPO (Plan #'s 101-107; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Choice Preferred Security PPO 100
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Cross Blue Premier 101 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Cross Blue Shield Basic 103 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Blue Precision HMO (Plan #'s 101-103; All Metal Tiers)
Verify PCP Participation
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield Blue Precision Platinum HMO 104
Verify PCP Participation
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Blue Cross Blue Shield BlueCare Direct with Advocate (Plan #'s 101-103; All Metal Tiers)
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Blue Cross Blue Shield Solution 102 Multi-State Plan
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry $15 Copay: Silver & Gold
Not Available In 2017
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
Coventry Bronze $10 Copay Carelink St. John's
PRIMARY CARE
SPECIALTY CARE
HOSPITALS
 
 
 
Coventry Bronze $15 Copay Carelink St. John's
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Publications

  • AAOS Research Symposium Updates and Consensus: Biologic Treatment of Orthopaedic Injuries.

    The Journal of the American Academy of Orthopaedic Surgeons 2016 Jul

    Authors: LaPrade RF, Dragoo JL, Koh JL, Murray IR, Geeslin AG, Chu CR
    Abstract
    Strategies that seek to enhance musculoskeletal tissue regeneration and repair by modulating the biologic microenvironment at the site of injury have considerable therapeutic potential. Current and emerging biologic approaches include the use of growth factors, platelet-rich plasma, stem cell therapy, and scaffolds. The American Academy of Orthopaedic Surgeons hosted a research symposium in November 2015 to review the current state-of-the-art biologic treatments of articular cartilage, muscle, tendon, and bone injuries and identify knowledge gaps related to these emerging treatments. This review outlines the findings of the symposium and summarizes the consensus reached on how best to advance research on biologic treatment of orthopaedic injuries.
    PMID: 27227987 [PubMed - as supplied by publisher]
  • Defect type, localization and marker gene expression determines early adverse events of matrix-associated autologous chondrocyte implantation.

    Injury 2015 Oct

    Authors: Angele P, Fritz J, Albrecht D, Koh J, Zellner J
    Abstract
    Since the first description of autologous chondrocyte implantation (ACI) in 1994 different methods and improvements were established for this regenerative treatment option of large chondral defects. This study analyzes safety and short-term clinical results from characterized ACI using a collagen based biphasic scaffold and evaluates prognostic factors.
    433 patients with a mean age of 33.4 years and localized grade III to IV cartilage defects (ICRS classification) in the knee or ankle were included. Mean defect size was 5.9 cm(2). Prior seeding of the scaffold, expanded chondrocytes were characterized by RT-PCR on 6 different marker genes (type I and II collagen, aggrecan, interleukin-1 β (IL-1β), vascular endothelial growth factor receptor 1 (FLT-1) and bone sialoprotein-2 (BSP-2)). Clinical outcome was evaluated using a questionnaire for defect history, basic demographics, time elapsed from surgery, 10-point outcome assessments of pain, function and swelling. Moreover, adverse events (AEs) or subsequent treatments were recorded and analysed.
    Patients improved significantly over baseline (p < 0.0001) in pain, function and swelling. Subjects with later than 12 months follow-up reported nominally greater mean changes. Graft failure incidence was 6% for patients with greater than one year follow-up. Graft-related complications were significantly higher for patellar (p < 0.0001) and degenerative defects (p = 0.005). Elevated expression of FLT-1 (p = 0.02) or IL-1 β mRNA (p = 0.03) was associated with graft-related AEs. A borderline association was found for low collagen type II expression (p = 0.08).
    Early graft-related AEs after ACI with a biphasic collagen scaffold are related to defect type, location and marker gene expression. The levels of significance observed for gene expression with respect to graft-related AEs were subordinate to those identified in the analysis of lesion history and location.
    PMID: 26542862 [PubMed - as supplied by publisher]
  • Obesity is Not Associated with Increased Short-term Complications After Primary Total Shoulder Arthroplasty.

    Clinical orthopaedics and related research 2016 Mar

    Authors: Jiang JJ, Somogyi JR, Patel PB, Koh JL
    Abstract
    Few studies have analyzed the association between elevated BMI and complications after total shoulder arthroplasty (TSA). Previous studies have not consistently arrived at the same conclusion regarding whether obesity is associated with a greater number of postoperative complications. We used a national surgical database to compare the 30-day complication profile and hospitalization outcomes after primary TSA among patients in different BMI categories.
    We asked: (1) Is obesity associated with an increased risk of complications within 30 days of primary TSA? (2) Is obesity associated with increased operative time?
    The American College of Surgeons National Surgical Quality Improvement Program(®) database for 2006 to 2012 was queried to identify all patients who underwent a primary TSA for osteoarthritis of the shoulder. The ACS-NSQIP(®) database was selected for this study as it is a nationally representative database that provides prospectively collected perioperative data and a comprehensive patient medical profile. Exclusion criteria included revision TSA, infection, tumor, or fracture. We analyzed 4796 patients who underwent a primary TSA for osteoarthritis of the shoulder. Patients who underwent a TSA were divided in four BMI categories: normal (18.5-25 kg/m(2)), overweight (25-30 kg/m(2)), obesity Class 1 (30-35 kg/m(2)), and obesity Class 2 or greater (> 35 kg/m(2)). Perioperative hospitalization data and 30-day postoperative complications were compared among different BMI classes. Differences in patient demographics, preoperative laboratory values, and preexisting patient comorbidities also were analyzed among different BMI groups, and multivariate analysis was used to adjust for any potential confounding variables.
    There was no association between BMI and 30-day complications after surgery (normal as reference, overweight group relative risk: 0.57 [95% CI, 0.30-1.06], p = 0.076; obesity Class 1 relative risk: 0.52 [95% CI, 0.26-1.03], p = 0.061; obesity Class 2 or greater relative risk: 0.54 [95% CI, 0.25-1.17], p = 0.117). However, greater BMI was associated with longer surgical times (for normal BMI control group: 110 minutes, SD, 42 minutes; overweight group: 115 minutes, SD, 46 minutes, mean difference to control: 5 minutes [95% CI, -1 to 10 minutes], p = 0.096; obesity Class 1: 120 minutes, SD, 43 minutes, mean difference: 10 minutes [95% CI, 5-15 minutes], p < 0.001; obesity Class 2 or greater: 122 minutes, SD, 45 minutes, mean difference: 12 minutes [95% CI, 6-18 minutes], p < 0.001).
    Although the surgical time increased for patients with greater BMI, the 30-day complications and perioperative hospitalization data after TSA were not different in patients with increased BMI levels. Obesity alone should not be a contraindication for TSA, and obese patients can expect similar incidences of postoperative complications. The preoperative medical optimization plan should be consistent with that of patients who are not obese who undergo TSA.
    Level III, therapeutic study.
    PMID: 26452748 [PubMed - as supplied by publisher]
  • Different roles of the medial and lateral hamstrings in unloading the anterior cruciate ligament.

    The Knee 2016 Jan

    Authors: Guelich DR, Xu D, Koh JL, Nuber GW, Zhang LQ
    Abstract
    Anterior cruciate ligament injuries are closely associated with excessive loading and motion about the off axes of the knee, i.e. tibial rotation and knee varus/valgus. However, it is not clear about the 3-D mechanical actions of the lateral and medial hamstring muscles and their differences in loading the ACL. The purpose of this study was to investigate the change in anterior cruciate ligament strain induced by loading the lateral and medial hamstrings individually.
    Seven cadaveric knees were investigated using a custom testing apparatus allowing for six degree-of-freedom tibiofemoral motion induced by individual muscle loading. With major muscles crossing the knee loaded moderately, the medial and lateral hamstrings were loaded independently to 200N along their lines of actions at 0°, 30°, 60° and 90° of knee flexion. The induced strain of the anterior cruciate ligament was measured using a differential variable reluctance transducer. Tibiofemoral kinematics was monitored using a six degrees-of-freedom knee goniometer.
    Loading the lateral hamstrings induced significantly more anterior cruciate ligament strain reduction (mean 0.764 [SD 0.63] %) than loading the medial hamstrings (mean 0.007 [0.2] %), (P=0.001 and effect size=0.837) across the knee flexion angles.
    The lateral and medial hamstrings have significantly different effects on anterior cruciate ligament loadings. More effective rehabilitation and training strategies may be developed to strengthen the lateral and medial hamstrings selectively and differentially to reduce anterior cruciate ligament injury and improve post-injury rehabilitation.
    The lateral and medial hamstrings can potentially be strengthened selectively and differentially as a more focused rehabilitation approach to reduce ACL injury and improve post-injury rehabilitation. Different ACL reconstruction procedures with some of them involving the medial hamstrings can be compared to each other for their effect on ACL loading.
    PMID: 26256427 [PubMed - as supplied by publisher]
  • A review of surgical and nonsurgical outcomes of medial knee injuries.

    Sports medicine and arthroscopy review 2015 Jun

    Authors: Smyth MP, Koh JL
    Abstract
    Medial-sided knee injuries can result in pain, instability, and loss of function. Many clinical studies have been written on the treatment of medial-sided knee injuries; however, the vast majority are isolated case series of surgical or nonoperative treatment regimens, and only a few randomized prospective clinical trials can be found in the literature that compare different treatment modalities. Comparison of these treatments is challenging due to the variety of medial-sided structures that can be involved, the multiple different approaches to treatment, and the variability of how objective and subjective clinical outcomes are reported. In this paper we report on the injuries by extent and type of anatomic structures damaged including partial medial-sided injuries, completed isolated medial-sided knee injuries, and combined injuries. In general, most authors concur that isolated partial or complete medial collateral ligament (MCL) injuries can be treated nonoperatively with a brace and early motion with good clinical outcomes. Prospective, randomized trials support nonoperative treatment of the MCL in combined anterior cruciate ligament-MCL injuries. Knee dislocations and posterior medial corner injuries appear to have better results with surgical management including reconstruction. Multiple reconstructive techniques have been described for chronic injuries but it is difficult to compare their results.
    PMID: 25932882 [PubMed - as supplied by publisher]
  • Patellar instability.

    The Orthopedic clinics of North America 2015 Jan

    Authors: Koh JL, Stewart C
    Abstract
    Patellar instability is a common injury that can result in significant limitations of activity and long-term arthritis. There is a high risk of recurrence in patients and operative management is often indicated. Advances in the understanding of patellofemoral anatomy, such as knowledge about the medial patellofemoral ligament, tibial tubercle-trochlear groove distance, and trochlear dysplasia may allow improved surgical management of patellar instability. However, techniques such as MPFL reconstruction are technically demanding and may result in significant complication. The role of trochleoplasty remains unclear.
    PMID: 25435044 [PubMed - as supplied by publisher]
  • A biodegradable tri-component graft for anterior cruciate ligament reconstruction.

    Journal of tissue engineering and regenerative medicine 2014 Nov 21

    Authors: Chung EJ, Sugimoto MJ, Koh JL, Ameer GA
    Abstract
    Bone-patellar tendon-bone (BPTB) autografts are the gold standard for anterior cruciate ligament (ACL) reconstruction because the bony ends allow for superior healing and anchoring through bone-to-bone regeneration. However, the disadvantages of BPTB grafts include donor site morbidity and patellar rupture. In order to incorporate bone-to-bone healing without the risks associated with harvesting autogenous tissue, a biodegradable and synthetic tri-component graft was fabricated, consisting of porous poly(1,8-octanediol-co-citric acid)-hydroxyapatite nanocomposites (POC-HA) and poly(l-lactide) (PLL) braids. All regions of the tri-component graft were porous and the tensile properties were in the range of the native ACL. When these novel grafts were used to reconstruct the ACL of rabbits, all animals after 6 weeks were weight-bearing and showed good functionality. Histological assessment confirmed tissue infiltration throughout the entire scaffold and tissue ingrowth and interlocking within the bone tunnels, which is favourable for graft fixation. In conclusion, this pilot study suggests that a tri-component, biodegradable graft is a promising strategy to regenerate tissue types necessary for ACL tissue engineering, and provides a basis for developing an off-the-shelf graft for ACL repair. Copyright © 2014 John Wiley & Sons, Ltd.
    PMID: 25414080 [PubMed - as supplied by publisher]
  • Effect of diabetes mellitus on perioperative complications and hospital outcomes after ankle arthrodesis and total ankle arthroplasty.

    Foot & ankle international 2015 Mar

    Authors: Schipper ON, Jiang JJ, Chen L, Koh J, Toolan BC
    Abstract
    The aim of this investigation was to analyze a nationally representative admissions database to evaluate the effect of diabetes mellitus on the rate of perioperative complications and hospitalization outcomes after ankle arthrodesis (AAD) and total ankle arthroplasty (TAA).
    Using the Nationwide Inpatient Sample database, 12 122 patients who underwent AAD and 2973 patients who underwent TAA were identified from 2002 to 2011 based on ICD-9 procedure codes. The perioperative complications and hospitalization outcomes were compared between diabetic and nondiabetic patients for each surgery during the index hospital stay.
    The overall complication rate in the AAD group was 16.4% in diabetic patients and 7.0% in nondiabetic patients (P < .001). Multivariate analysis demonstrated that diabetes mellitus was independently associated with an increased risk of myocardial infarction (relative risk [RR] = 3.2, P = .008), urinary tract infection (RR = 4.6, P < .001), blood transfusion (RR = 3.0, P < .001), irrigation and debridement (RR = 1.9, P = .001), and overall complication rate (RR = 2.7, P < .001). Diabetes was also independently associated with a statistically significant increase in length of hospital stay (difference = 0.35 days, P < .001), more frequent nonhome discharge (RR = 1.69, P < .001), and higher hospitalization charges (difference = $1908, P = .04). The overall complication rate in the TAA group was 7.8% in diabetic patients and 4.7% in nondiabetic patients. Multivariate analysis demonstrated that diabetes was independently associated with increased risk of blood transfusion (RR = 9.8, P = .03) and overall complication rate (RR = 4.1, P = .02). Diabetes was also independently associated with a statistically significant increase in length of stay (difference = 0.41 days, P < .001) and more frequent nonhome discharge (RR = 1.88, P < .001), but there was no significant difference in hospitalization charges (P = .64).
    After both AAD and TAA, diabetes mellitus was independently associated with a significantly increased risk of perioperative complications, nonhome discharge, and length of hospital stay during the index hospitalization.
    PMID: 25413307 [PubMed - as supplied by publisher]
  • Improving residency training in arthroscopic knee surgery with use of a virtual-reality simulator. A randomized blinded study.

    The Journal of bone and joint surgery. American volume 2014 Nov 5

    Authors: Cannon WD, Garrett WE
    Abstract
    There is a paucity of articles in the surgical literature demonstrating transfer validity (transfer of training). The purpose of this study was to assess whether skills learned on the ArthroSim virtual-reality arthroscopic knee simulator transferred to greater skill levels in the operating room.
    Postgraduate year-3 orthopaedic residents were randomized into simulator-trained and control groups at seven academic institutions. The experimental group trained on the simulator, performing a knee diagnostic arthroscopy procedure to a predetermined proficiency level based on the average proficiency of five community-based orthopaedic surgeons performing the same procedure on the simulator. The residents in the control group continued their institution-specific orthopaedic education and training. Both groups then performed a diagnostic knee arthroscopy procedure on a live patient. Video recordings of the arthroscopic surgery were analyzed by five pairs of expert arthroscopic surgeons blinded to the identity of the residents. A proprietary global rating scale and a procedural checklist, which included visualization and probing scales, were used for rating.
    Forty-eight (89%) of the fifty-four postgraduate year-3 residents from seven academic institutions completed the study. The simulator-trained group averaged eleven hours of training on the simulator to reach proficiency. The simulator-trained group performed significantly better when rated according to our procedural checklist (p = 0.031), including probing skills (p = 0.016) but not visualization skills (p = 0.34), compared with the control group. The procedural checklist weighted probing skills double the weight of visualization skills. The global rating scale failed to reach significance (p = 0.061) because of one extreme outlier. The duration of the procedure was not significant. This lack of a significant difference seemed to be related to the fact that residents in the control group were less thorough, which shortened their time to completion of the arthroscopic procedure.
    We have demonstrated transfer validity (transfer of training) that residents trained to proficiency on a high-fidelity realistic virtual-reality arthroscopic knee simulator showed a greater skill level in the operating room compared with the control group.
    We believe that the results of our study will stimulate residency program directors to incorporate surgical simulation into the core curriculum of their residency programs.
    PMID: 25378507 [PubMed - as supplied by publisher]
  • Computer-assisted anterior cruciate ligament (ACL) reconstruction: the US perspective.

    Sports medicine and arthroscopy review 2014 Dec

    Authors: Koh J, Marcus MS
    Abstract
    Computer-assisted anterior cruciate ligament (ACL) reconstruction in the United States has been used to help improve clinical outcomes and investigate tunnel placement and kinematic activity. Computer-assisted techniques were developed to improve accuracy of tunnel placement, because of concerns about the accuracy of manual tunnel placement causing revisions. Several authors have demonstrated improved tunnel location with computer assistance, although others have demonstrated little or no difference. More recently, American investigators have used computer assistance to evaluate the position and biomechanical behavior and kinematics of theoretical tunnel placement and also to assess in vitro and in vivo knee stability following ligament reconstruction. Computer assistance of anterior ligament reconstruction has demonstrated its value as a research and clinical tool in the United States.
    PMID: 25370875 [PubMed - as supplied by publisher]

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Featured Videos

Dr. Jason Koh,  Chairman of the Department of Orthopaedic Surgery and Director of the NorthShore Orthopaedic Institute, speaks about the collaborative care offered by the Department of Orthopaedic Surgery.

Dr. Jason Koh, Chairman of the Department of Orthopaedic Surgery and Director of the NorthShore Orthopaedic Institute, speaks about the collaborative care offered by the Department of Orthopaedic Surgery.