Prospective Study Examines the Effect of Preoperative Oral Carbohydrates on Insulin Resistance in Older Adults
A prospective trial published in the Oct. 15 issue of the Journal of the AAOS ® investigated the effects of carbohydrate (CHO) drinks on insulin resistance and gastric volume. Fifty-six patients aged >65 years undergoing total knee or hip arthroplasty were randomized to a CHO or control group. The CHO group received a 400 mL CHO drink two to three hours before anesthesia. Blood glucose and insulin levels were measured preoperatively and one-hour postsurgery. Pre- and postoperatively, there were no significant differences observed regarding insulin resistance between the control and CHO groups. Preoperative gastric volume was also comparable between groups.
Study: Effect of Multimodal Opioid-sparing Protocol versus Standard Opioid Prescribing on Postoperative Opioid Consumption
According to a randomized trial published in JAMA, a multimodal opioid-sparing pain management protocol resulted in significantly reduced postoperative opioid consumption after six weeks compared with standard opioid prescribing. Overall, 193 knee and shoulder arthroplasty patients were included. The primary outcomes were postoperative oral morphine equivalent (OME) consumption and quantity of OMEs prescribed at hospital discharge. Patients in the opioid-sparing group had a significantly lower mean opioid consumption compared to the control group (0 mg versus 40.0 mg). The mean amount of OMEs prescribed in the opioid-sparing group was 40.4 mg compared with 300.8 mg in the control group.
Study Compares Gait Analysis after Single and Simultaneous Bilateral THA
BMC Musculoskeletal Disorders published a prospective study online analyzing the impact on walking after single and simultaneous bilateral total hip arthroplasties (THA). Comparing two matched groups of 15 patients with hip osteoarthritis treated with unilateral THA (UTHA) or simultaneous bilateral THA (SBTHA), 3D gait analysis was assessed pre- and six months postsurgery. Recovery and pelvis sagittal balance improved in the UTHA group; however, external and total work decreased after six months. In the SBTHA group, speed, step length, range of motion of knee sagittal stance, and internal work were significantly higher postsurgery.
Study Analyzes Utilization and Reoperation Rates Associated with Autologous Chondrocyte Implantation in the Knee
A retrospective cohort study published online in Arthroscopy investigated the utilization of autologous chondrocyte implantation (ACI) procedures in the knee over the last 10 years. The PearlDiver database was queried for studies involving ACI performed in any knee location, and 2,010 patients were included. The 90-day and overall reoperation rates were 2.24 percent and 30.4 percent, respectively. Chondroplasty, meniscectomy, and microfracture were the most common reoperations. Older age and tobacco use were associated with increased risk of conversion to arthroplasty, and male sex was associated with decreased rates of reoperation.
Study: Early versus Late Lumbar Disk Herniation Resorption in Symptomatic Patients
A prospective study published online in The Spine Journal assessed the determinants that may predict early versus late lumbar disk herniations (LDH) resorption. Twenty-three patients with early resorption LDH (<3 months) and 67 patients with late resorption LDH (>3 months) were included in the analysis. Lumbar MRIs were performed every three months for one year. Patients in the early resorption group experienced a greater percent reduction of disk herniation, reduction of herniation size, and percent resorption per day compared to the late resorption group; however, no statistically significant difference were observed between groups.
Police Chief Louis M. Dekmar Offers Guidance for Improving Safety in the Healthcare Workplace
Acts of healthcare workplace violence, such as the recent passing of orthopaedic surgeon Preston Phillips, MD, FAAOS, at his workplace at the hands of a former patient, have drawn increased attention to the topic of workplace safety in healthcare settings. AAOS Now interviewed Louis M. Dekmar, chief of police and chief of public safety at the LaGrange, Ga., police department, who shared his insights into how to craft a safer working and learning environment in the healthcare system.
OrthoInfo, the Academy’s patient education website, is here to provide your patients with in-depth information—all written, reviewed, and regularly updated by orthopaedic experts. This includes a full range of articles about arthritis to help your patients understand their condition, as well as nonsurgical and surgical treatment options to manage symptoms.
