25 North Winfield Road
Winfield IL 60190
Medical School: University Of Iowa College Of Medicine - 1997
Accepts Medicare: No
Participates In eRX: Yes
Participates In PQRS: Yes
Participates In EHR: Yes
License #: 036106085
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Awards & Recognitions
Dr. Scott Sporer is associated with these group practices
|HCPCS Code||Description||Average Price||Average Price
Allowed By Medicare
|HCPCS Code:27134||Description:Revise hip joint replacement||Average Price:$17,297.70||Average Price Allowed
|HCPCS Code:27487||Description:Revise/replace knee joint||Average Price:$15,574.65||Average Price Allowed
|HCPCS Code:27447||Description:Total knee arthroplasty||Average Price:$13,525.03||Average Price Allowed
|HCPCS Code:27130||Description:Total hip arthroplasty||Average Price:$12,541.33||Average Price Allowed
|HCPCS Code:20610||Description:Drain/inject joint/bursa||Average Price:$314.10||Average Price Allowed
|HCPCS Code:96372||Description:Ther/proph/diag inj sc/im||Average Price:$191.00||Average Price Allowed
|HCPCS Code:73564||Description:X-ray exam knee 4 or more||Average Price:$194.00||Average Price Allowed
|HCPCS Code:73520||Description:X-ray exam of hips||Average Price:$187.55||Average Price Allowed
|HCPCS Code:77073||Description:X-rays bone length studies||Average Price:$178.79||Average Price Allowed
|HCPCS Code:73510||Description:X-ray exam of hip||Average Price:$172.39||Average Price Allowed
|HCPCS Code:73562||Description:X-ray exam of knee 3||Average Price:$167.15||Average Price Allowed
|HCPCS Code:99203||Description:Office/outpatient visit new||Average Price:$218.73||Average Price Allowed
|HCPCS Code:99214||Description:Office/outpatient visit est||Average Price:$208.57||Average Price Allowed
|HCPCS Code:72170||Description:X-ray exam of pelvis||Average Price:$121.39||Average Price Allowed
|HCPCS Code:73560||Description:X-ray exam of knee 1 or 2||Average Price:$111.86||Average Price Allowed
|HCPCS Code:73550||Description:X-ray exam of thigh||Average Price:$103.94||Average Price Allowed
|HCPCS Code:99213||Description:Office/outpatient visit est||Average Price:$134.43||Average Price Allowed
|HCPCS Code:J1040||Description:Methylprednisolone 80 MG inj||Average Price:$42.00||Average Price Allowed
|HCPCS Code:J1030||Description:Methylprednisolone 40 MG inj||Average Price:$21.00||Average Price Allowed
|HCPCS Code:J0885||Description:Epoetin alfa, non-esrd||Average Price:$14.70||Average Price Allowed
|HCPCS Code:J7325||Description:Synvisc or Synvisc-One||Average Price:$15.00||Average Price Allowed
HCPCS Code Definitions
- Arthrocentesis, aspiration and/or injection; major joint or bursa (eg, shoulder, hip, knee joint, subacromial bursa)
- Arthroplasty, acetabular and proximal femoral prosthetic replacement (total hip arthroplasty), with or without autograft or allograft
- Revision of total hip arthroplasty; both components, with or without autograft or allograft
- Arthroplasty, knee, condyle and plateau; medial AND lateral compartments with or without patella resurfacing (total knee arthroplasty)
- Revision of total knee arthroplasty, with or without allograft; femoral and entire tibial component
- Radiologic examination, pelvis; 1 or 2 views
- Radiologic examination, hip, unilateral; complete, minimum of 2 views
- Radiologic examination, hips, bilateral, minimum of 2 views of each hip, including anteroposterior view of pelvis
- Radiologic examination, femur, 2 views
- Radiologic examination, knee; 1 or 2 views
- Radiologic examination, knee; 3 views
- Radiologic examination, knee; complete, 4 or more views
- Bone length studies (orthoroentgenogram, scanogram)
- Therapeutic, prophylactic, or diagnostic injection (specify substance or drug); subcutaneous or intramuscular
- Office or other outpatient visit for the evaluation and management of a new patient, which requires these 3 key components: A detailed history; A detailed examination; Medical decision making of low complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate severity. Typically, 30 minutes are spent face-to-face with the patient and/or family.
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: An expanded problem focused history; An expanded problem focused examination; Medical decision making of low complexity. Counseling and coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of low to moderate severity. Typically, 15 minutes are spent face-to-face with the patient and/or family.
- Office or other outpatient visit for the evaluation and management of an established patient, which requires at least 2 of these 3 key components: A detailed history; A detailed examination; Medical decision making of moderate complexity. Counseling and/or coordination of care with other physicians, other qualified health care professionals, or agencies are provided consistent with the nature of the problem(s) and the patient's and/or family's needs. Usually, the presenting problem(s) are of moderate to high severity. Typically, 25 minutes are spent face-to-face with the patient and/or family.
- Injection, epoetin alfa, (for non-esrd use), 1000 units
- Injection, methylprednisolone acetate, 40 mg
- Injection, methylprednisolone acetate, 80 mg
- Hyaluronan or derivative, synvisc or synvisc-one, for intra-articular injection, 1 mg
Medical Malpractice Cases
Medical Board Sanctions
Physical Medicine And Rehabilitation
Cardiovascular Disease (Cardiology)
Cardiovascular Disease (Cardiology)
*These referrals represent the top 10 that Dr. Sporer has made to other doctors
How do I get out of this jam? Early postoperative problems of primary total hip arthroplasty. - Instructional course lectures
Acute postoperative problems associated with total hip arthroplasty typically require prompt attention. Because the circumstances surrounding these problems provide limited time for consultation or literature review, effective management depends on the surgeon being aware of treatment options and favored treatment methods and executing the best treatments. Surgeons should be aware of management strategies for the most common and difficult early postoperative complications after primary total hip arthroplasty, including wound problems, periprosthetic femur fractures, nerve dysfunction, and venous thromboembolism. State-of-the-art knowledge will help the treating surgeon successfully manage complications.
Extensor mechanism allograft reconstruction for extensor mechanism failure following total knee arthroplasty. - The Journal of bone and joint surgery. American volume
Extensor mechanism disruption following total knee arthroplasty is a rare but devastating complication. The purpose of this study was to report our experience with extensor mechanism allograft reconstruction for chronic extensor mechanism failure.Fifty consecutive extensor mechanism allograft reconstructions were performed in forty-seven patients with a mean age of 67.6 years who were followed for a mean time of 57.6 months (range, twenty-four to 125 months). The operative technique included the use of a fresh-frozen, correctly sized full extensor mechanism allograft that was tensioned tightly in full extension. Patients were evaluated clinically with use of the Knee Society score, and reconstructions were considered failures if the patient had a score of <60 points or a recurrent extensor lag of >30Â° or if they required revision or removal of the allograft.Nineteen reconstructions (38%) were considered failures, including four revised to a second extensor mechanism allograft due to failure of the allograft, five for deep infection, and ten considered clinical failures secondary to a Knee Society score of <60 points or an extensor lag of >30Â°. The mean Knee Society score improved from 33.9 to 75.9 points (p<0.0001). The estimated Kaplan-Meier survivorship with failure for any reason as the end point was 56.2% (95% confidence interval, 39.4% to 70.1%) at ten years.Extensor mechanism disruption following total knee arthroplasty is a difficult complication to treat, with modest outcomes. Extensor mechanism allograft reconstruction is a reasonable option; however, patients must be informed regarding the substantial risk of complications, and although initial extensor mechanism function may be restored, expectations regarding longer-term outcomes are more guarded.Copyright Â© 2015 by The Journal of Bone and Joint Surgery, Incorporated.
Do serologic and synovial tests help diagnose infection in revision hip arthroplasty with metal-on-metal bearings or corrosion? - Clinical orthopaedics and related research
The diagnosis of periprosthetic joint infection (PJI) in patients with failed metal-on-metal (MoM) bearings and corrosion reactions in hip arthroplasties can be particularly difficult, because the clinical presentation of adverse local tissue reactions may mimic that of PJI, because it can also occur concurrently with PJI, and because common laboratory tests used to diagnose PJI may be elevated in patients with MoM THAs.We sought to determine the test properties of the serum erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), synovial fluid white blood cell (WBC) count, and synovial fluid differential (percent polymorphonuclear cells [PMNs]) in diagnosing PJI in either MoM hips undergoing revision for a variety of indications or in non-MoM hips undergoing revision for either corrosion reaction or full-thickness wear. Additionally, we sought to describe how MoM bearings, metal debris, and corrosion reactions can confound the analysis of the synovial fluid WBC count and affect its diagnostic use for PJI.We reviewed 150 revision hips meeting specified inclusion criteria (92 MoM total hips, 19 MoM hip resurfacings, 30 non-MoM bearings with corrosion, and nine full-thickness bearing surface wear with metallosis). In our review, we diagnosed 19 patients as infected using Musculoskeletal Infection Society (MSIS) criteria. Mean laboratory values were compared between infected and not infected patients and receiver operator characteristic curves were generated with an area under the curve (AUC) to determine test performance and optimal cutoffs.After excluding the inaccurate synovial fluid samples, the synovial fluid WBC count (performed accurately in 102 patients) was the best test for the diagnosis of PJI (AUC=98%, optimal cutoff 4350 WBC/Î¼L) followed by the differential (performed accurately in 102 patients; AUC=90%, optimal cutoff 85% PMN). The ESR (performed in 131 patients) and CRP (performed in 129 patients) both had good sensitivity (83% and 94%, respectively). Patients meeting MSIS criteria for PJI had higher mean serum ESR, CRP, synovial fluid WBC count, and differential than those not meeting MSIS criteria (p<0.05 for all). An observer blinded to the MSIS diagnosis of the patient assessed the synovial fluid samples for inaccuracy secondary to metal or cellular debris. Synovial fluid sample "inaccuracy" was defined as the laboratory technician noting the presence of metal or amorpous material, fragmented cells, or clots, or the sample having some defect preventing an automated cell count from being performed. Of the 141 patients who had a synovial fluid sample initially available for review, 47 (33%) had a synovial fluid sample deemed to be inaccurate. A synovial fluid WBC count was still reported; however, 35 of these 47 hips (75%) and 11 of these 35 (31%) were falsely positive for infection.The diagnosis of PJI is extremely difficult in patients with MoM bearings or corrosion and the synovial fluid WBC count can frequently be falsely positive and should be relied on only if a manual count is done and if a differential can be performed. A more aggressive approach to preoperative evaluation for PJI is recommended in these patients to allow for careful evaluation of the synovial fluid specimen, the integration of synovial fluid culture results, and repeat aspiration if necessary.Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
Modular tapered implants for severe femoral bone loss in THA: reliable osseointegration but frequent complications. - Clinical orthopaedics and related research
Modular tapered stems have been suggested as the optimal implants for patients with severe femoral bone loss (Paprosky Type IIIB and IV) undergoing revision total hip arthroplasty (THA); however, there are few data describing survivorship and hip scores associated with this treatment.At minimum 2 years, we sought to determine the (1) survivorship of these implants; (2) radiographic evidence of osseointegration; and (3) the Harris hip scores of patients revised with a modular tapered stem for severe femoral bone loss including the complications associated with their use.Between 1999 and 2010, we performed 1124 femoral revisions; of those, 135 (12%) were performed using a modular tapered stem. General indications for use of this device included bone loss, poor quality bone, leg length discrepancy, difficulty adjusting version, proximal femoral remodeling, and ectatic medullary canals in the setting of revision THA. This report reviewed 70 of those that were performed in Type IIIB and IV femurs. Of those 70 patients, 11 had died and one was lost before 2-year followup; the remaining 58 (83%, 33 with a Type IIIB femur and 25 with a Type IV femur) were followed for a minimum of 24 months (average, 67 months; range, 24-151 months). Survivorship free from revision, radiographic analysis for signs of subsidence or stem loosening, and Harris hip scores were tallied.One patient underwent stem revision for early subsidence followed by failure of ingrowth for a survivorship free from repeat revision of 98% (57 of 58 patients). Five other stems (for a total of six [10%]) subsided early but nonetheless achieved radiographic signs of ingrowth and were not revised again. All other stems demonstrated osseointegration without subsidence and remained radiographically well fixed. In patients with surviving implants, the mean Harris hip score improved from 34 (range, 11-49) preoperatively to 74 (range, 14-100; p<0.001) postoperatively. Overall, 15 of 58 patients (26%) experienced a complication, of whom 10 (17%) underwent reoperation.We found that modular tapered stems resulted in 98% survivorship at a mean of 67 months in patients with Type IIIB and IV femurs undergoing femoral revision, although the overall complication rate in this complex subset of patients is high.Level IV, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Revising an HTO or UKA to TKA: is it more like a primary TKA or a revision TKA? - The Journal of arthroplasty
Forty-nine patients revised from UKA to TKA and 43 from HTO to TKA were matched to 43 aseptic, both component revision TKAs (rTKA) and 97 primary TKAs. At a mean of 4.8 years, the KSS and function scores in the UKA to TKA, HTO to TKA and primary TKA cohorts were similar. Total operative times were significantly higher in the HTO to TKA and rTKA groups. LOS was shorter in the primary TKA cohort. The rate of complications and reoperations were higher in HTO to TKA and rTKA compared to UKA to TKA and primary TKA. Thus, revising an HTO and UKA both had functional outcomes more similar to a primary TKA, however, the complication rate of revising an HTO was similar to an rTKA.Copyright Â© 2014 Elsevier Inc. All rights reserved.
The inter-observer and intra-observer reliability of the Paprosky femoral bone loss classification system. - The Journal of arthroplasty
The Paprosky classification provides a straightforward algorithm for defining bone loss and directing treatment for femoral revision. The purpose of this study was to test the inter-observer and intra-observer reliability of this system. Four arthroplasty surgeons reviewed radiographs of 205 consecutive femoral revisions. For each radiograph, the pattern of femoral bone loss was classified by Paprosky type on two separate occasions. A kappa value was used to calculate the reliability, which demonstrated an inter-observer reliability of 0.61, indicating substantial agreement between surgeons. The intra-observer reliability for each of the 4 participating surgeons was 0.81, 0.78, 0.76, and 0.75, indicating substantial to almost perfect agreement. There is substantial agreement among experienced arthroplasty surgeons when using the Paprosky Classification to characterize femoral bone loss.Copyright Â© 2014 Elsevier Inc. All rights reserved.
Acute hematogenous infection following total hip and knee arthroplasty. - The Journal of arthroplasty
Forty consecutive patients (42 joints; 22 TKA, 20 THA) treated for acute hematogenous infections were reviewed. All patients underwent irrigation and debridement and exchange of the modular components. At a mean of 56 months (range, 25-124 months) recurrent infection, requiring surgery, developed in 9 of the 42 joints (21%); 8 of the 9 recurrent infections were in patients with a staphylococcal infection (P = 0.0004). Ten of the 40 patients (25%) died within 2 years of infection. Irrigation and debridement for the treatment of an acute hematogenous infection was successful in the majority of patients (76% survivorship at 2 years). Non-staphylococcal infections had a particularly low failure rate (96% survivorship at 2 years). The 2 year mortality rate among this subset of patients was strikingly high.Â© 2013.
The effect of payer type on clinical outcomes in total knee arthroplasty. - The Journal of arthroplasty
This was a retrospective cohort analysis of 112 patients undergoing primary total knee arthroplasty, wherein baseline demographics, resource utilization, and outcomes were compared by insurance type: Medicaid, Medicare, or private. At the time of surgery, Medicaid patients were younger (P<.0001) and had lower preoperative Knee Society Scores than Medicare and private patients (P=.0125). Medicaid postoperative scores were lower than those of private patients (P=.0223). The magnitude of benefit received by Medicaid patients was similar to Medicare and private patients. Medicaid patients had a higher number of cancelled (P=.01) and missed (P=.0022) appointments relative to Medicare and private patients. Medicaid patients also had shorter average follow-up periods compared to private patients (P=.0003). Access to care and socioeconomic factors may be responsible for these findings.Â© 2013.
The 2013 Frank Stinchfield Award: Diagnosis of infection in the early postoperative period after total hip arthroplasty. - Clinical orthopaedics and related research
Diagnosis of periprosthetic joint infection (PJI) can be difficult in the early postoperative period after total hip arthroplasty (THA) because normal cues from the physical examination often are unreliable, and serological markers commonly used for diagnosis are elevated from the recent surgery.The purposes of this study were to determine the optimal cutoff values for erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), synovial fluid white blood cell (WBC) count, and differential for diagnosing PJI in the early postoperative period after primary THA.We reviewed 6033 consecutive primary THAs and identified 73 patients (1.2%) who underwent reoperation for any reason within the first 6 weeks postoperatively. Thirty-six of these patients were infected according to modified Musculoskeletal Infection Society criteria. Mean values for the diagnostic tests were compared between groups and receiver operating characteristic curves generated along with an area under the curve (AUC) to determine test performance and optimal cutoff values to diagnose infection.The best test for the diagnosis of PJI was the synovial fluid WBC count (AUC = 98%; optimal cutoff value 12,800 cells/Î¼L) followed by the CRP (AUC = 93%; optimal cutoff value 93 mg/L), and synovial fluid differential (AUC = 91%; optimal cutoff value 89% PMN). The mean ESR (infected = 69 mm/hr, not infected = 46 mm/hr), CRP (infected = 192 mg/L, not infected = 30 mg/L), synovial fluid WBC count (infected = 84,954 cells/Î¼L, not infected = 2391 cells/Î¼L), and differential (infected = 91% polymorphonuclear cells [PMN], not infected = 63% PMN) all were significantly higher in the infected group.Optimal cutoff values for the diagnosis of PJI in the acute postoperative period were higher than those traditionally used for the diagnosis of chronic PJI. The serum CRP is an excellent screening test, whereas the synovial fluid WBC count is more specific.
Correlation of aspiration results with periprosthetic sepsis in revision total hip arthroplasty. - The Journal of arthroplasty
A retrospective chart review was performed of all patients who had undergone revision total hip arthroplasty with a synovial aspiration with greater than 100 WBC since the institution of our electronic medical record. Infection was defined using a combination of criteria. A diagnosis of periprosthetic sepsis was established in 52 of the 253 included hips. No significant differences existed with respect to gender, age, BMI, Deyo-Charlson Comorbidity Index, or the cause of initial hip degeneration. Using receiver-operating characteristic curves accuracy was maximized for WBC of 745 or segmented cell count of 73.5% with a sensitivity of 98%, specificity of 37%, negative predictive value of 99% and accuracy of 50%. Application of the current American Academy of Orthopaedic Surgery Clinical Practice Guidelines (AAOS CPG) thresholds revealed a similar accuracy of 49%.Â© 2013.
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25 North Winfield Road Winfield, IL 60190
25 N. Winfield Rd.
27W130 Roosevelt Rd Suite 203