Abstract:
BACKGROUND:Since the early 1990s, opioids have been used as a mainstay for pain management surrounding fracture injuries. As opioid dependence has become a major public health issue, it is important to understand what factors can leave patients vulnerable. The purpose of this study was to examine what risk factors, patient or injury severity, contribute most to postoperative opioid dependence following surgical treatment of proximal humerus fractures (PHFs). METHODS:A retrospective review of all patients who underwent an open reduction and internal fixation of PHF was performed within a large multisite hospital system. Recorded variables included age, gender, ASA class, BMI, fracture type, time to surgery, pre- and postoperative opioid prescriptions, physical and psychological comorbidities, smoking status, and complications. Pre- and postoperative opioid dependence was defined as prescription opioid use in the 3 months leading up to or following surgery. Odds ratio calculations were performed for each variable, and a multivariate logistic regression was used to compare all predictors. RESULTS:A total of 198 surgically treated PHFs were included in the cohort with an average age of 59.9 years. Thirty-nine cases were determined to be preoperatively opioid dependent while 159 cases were preoperatively opioid naïve. Preoperative opioid dependence was found to be a significant risk factor for postoperative narcotic dependence, carrying a 2.42 times increased risk. (CI 1.07-5.48, p = 0.034). Fracture type was also found to be a risk factor for postoperative dependence, with complex 3- and 4-part fracture patients being 1.93 times more likely to be opioid dependent postoperatively compared to 2 part fractures (CI 1.010-3.764, p = 0.049). All other factors were not found to have any significant influence on postoperative opioid dependence. CONCLUSIONS:Our results demonstrate that the most important risk factors of postoperative opioid dependence following proximal humerus fractures are preoperative dependence and fracture complexity. It is important for orthopedic surgeons to ensure that patients who have more complex fractures or are preoperatively opioid dependent receive adequate education on their increased risk and support to wean off of opioids following surgery. LEVEL OF EVIDENCE:III.
journal_name
J Orthop Surg Resjournal_title
Journal of orthopaedic surgery and researchauthors
Sabesan VJ,Chatha K,Goss L,Ghisa C,Gilot Gdoi
10.1186/s13018-019-1233-7subject
Has Abstractpub_date
2019-09-26 00:00:00pages
316issue
1issn
1749-799Xpii
10.1186/s13018-019-1233-7journal_volume
14pub_type
杂志文章abstract:BACKGROUND:Infantile patients with congenital scoliosis (CS) can be confronted with increasing risk of mortality and morbidity. To date, the effectiveness of conservative treatment in CS has not been sufficiently investigated. We aimed to evaluate the bracing outcome in patients with CS and to investigate whether weari...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1244-4
更新日期:2019-06-27 00:00:00
abstract:BACKGROUND:Excessive inflammatory response under hyperglycemia can impair alveolar bone defect healing under diabetic conditions. NLRP3 (NACHT [nucleotide-binding oligomerization], LRR [leucine-rich repeat], and PYD [pyrin domain] domains-containing protein 3) inflammasome has been considered to play a crucial role in ...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1215-9
更新日期:2019-05-30 00:00:00
abstract:PURPOSE:The purpose of this study was to compare the interfragmentary compression force across a simulated scaphoid fracture by two commonly used compression screw systems; the Acutrak 2 Standard and the 3.0 mm Synthes headless compression screw. METHODS:Sixteen (8 pairs; 6 female, 2 male) cadaver scaphoids were rando...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/1749-799X-6-27
更新日期:2011-06-07 00:00:00
abstract:BACKGROUND:The objectives of this study are to investigate the clinical curative effect of Gallie technique and atlantoaxial screw-rod constructs (SRC) on atlantoaxial sagittal instability and determine the indication of Gallie technique. METHODS:Data of 49 patients with atlantoaxial sagittal instability from February...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-017-0607-y
更新日期:2017-07-11 00:00:00
abstract:BACKGROUND:Flap transplantation is often needed for soft tissue defects of the fingers that cannot be closed directly. Sensory reconstruction of the fingers is important for patients to recover feelings. In this study, we report clinical outcomes of using free neurovascular transverse wrist crease flap for repairing fi...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章,多中心研究
doi:10.1186/s13018-019-1444-y
更新日期:2019-11-14 00:00:00
abstract:BACKGROUND:This systematic review and meta-analysis assessed the role of nonoperative treatment and volar locking plate (VLP) fixation in elderly patients with distal radial fracture. METHODS:The systematic literature review identified randomized controlled trials (RCTs) and observational studies using VLP and nonoper...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章,评审
doi:10.1186/s13018-020-01734-2
更新日期:2020-07-14 00:00:00
abstract:BACKGROUND:Kashin-Beck disease (KBD) is an endemic and chronic osteoarthropathy. At present, the diagnosis of KBD mainly depends on the X-ray examination and which could not reflect early damage of cartilage sensitively. So, the aim of this study was to find effective and sensitive biomarkers for early diagnosis of ped...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章,多中心研究
doi:10.1186/s13018-018-1057-x
更新日期:2019-01-11 00:00:00
abstract:OBJECTIVES:The aim of this study was to evaluate the efficacy of local infiltration anaesthesia (LIA) during primary total hip arthroplasty (THA) via a posterolateral approach under general anaesthesia and to compare the efficacy of LIA in all layers with LIA in the deep and superficial fascia. PATIENTS AND METHODS:On...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-020-02182-8
更新日期:2021-01-22 00:00:00
abstract:BACKGROUND:The aim of this study was to assess the feasibility and efficacy of proximal radioulnar derotational osteotomy followed by internal fixation for the treatment of congenital radioulnar synostosis (CRUS). METHODS:Between May 2008 and August 2016, 31 patients (36 forearms) with CRUS who underwent derotational ...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1130-0
更新日期:2019-03-20 00:00:00
abstract:BACKGROUND:Lumbar floating fusion occasionally causes postoperative adjacent segment disorder (ASD) at lumbosacral level, causing L5 spinal nerve disorder by L5-S1 foraminal stenosis. The disorder is considered to be one of the major outcomes of L5-S1 ASD, which has not been evaluated yet. The present study aimed to ev...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-015-0307-4
更新日期:2015-10-17 00:00:00
abstract:BACKGROUND:Extensile lateral approach had been recognized as the gold standard technique for displaced intra-articular calcaneus fractures (DIACFs) while sinus tarsi approach had been increasingly valued by surgeons and comparative clinical outcome was shown in both techniques. Appropriate decisions could be made by th...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-020-01963-5
更新日期:2020-09-18 00:00:00
abstract:BACKGROUND:Matrix metalloproteinase (MMPs) synthesized and secreted from connective tissue cells have been thought to participate in degradation of the extracellular matrix. Increased MMPs activities that degrade proteoglycans have been measured in osteoarthritis cartilage. This study aims to suppress the expression of...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/1749-799X-4-45
更新日期:2009-12-24 00:00:00
abstract:BACKGROUND:A large number of cases of pneumonia caused by novel β-coronavirus emerged in Hubei Province, China, at the end of 2019 and demonstrated great potential for transmission. At present, known independent risk factors include age, diabetes, and other chronic diseases, which may be similar to the patients with ch...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-020-01976-0
更新日期:2020-10-02 00:00:00
abstract:BACKGROUND:There are controversies about platelet-rich plasma (PRP) as an established treatment option for rotator cuff (RC) tendinopathy. The purpose of the study was to find the relation of cellular component with clinical efficacy in RC tendinopathy and to find the composition of PRP in treating RC tendinopathy. ME...
journal_title:Journal of orthopaedic surgery and research
pub_type: 临床试验,杂志文章
doi:10.1186/s13018-019-1406-4
更新日期:2019-12-02 00:00:00
abstract:BACKGROUND:Nasal Staphylococcus aureus (S. aureus) screening and decolonization has been widely used to reduce surgical site infections (SSIs) prior to total knee and hip arthroplasty (TKA and THA). However, it remains considerably controversial. The aim of this study was to ascertain whether this scheme could reduce S...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章,meta分析
doi:10.1186/s13018-020-01601-0
更新日期:2020-02-19 00:00:00
abstract:BACKGROUND:Long-term results of the 'classic' low contact stress (LCS) total knee replacement (TKR) have been satisfactory; nonetheless, design changes have been made which resulted in the 'complete' LCS TKR. The aim of this study is to compare the 5-year incidence of revision and midterm clinical performance before an...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/1749-799X-9-7
更新日期:2014-02-06 00:00:00
abstract:BACKGROUND:Sensory nerve endings in ligaments play an important role for the proprioceptive function. Clinical trials show that the sense of body position does not fully recover in the knee joint after reconstructive surgery of the ruptured anterior cruciate ligament. The aim of this study is to identify sensory corpus...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-020-01785-5
更新日期:2020-07-17 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze and compare the surgical data, clinical outcomes, and complications between three-column osteotomy (3-COS) and standard surgical management (SSM) for the treatment of adult spine deformity (ASD). METHODS:A total of 112 patients who underwent consecutive 3-COS (n = 48) an...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-015-0154-3
更新日期:2015-02-03 00:00:00
abstract:BACKGROUND:Exact knowledge of the sacral anatomy is crucial for the percutaneous insertion of iliosacral screws. However, dysplastic anatomical patterns are common. In addition to a preoperative computed tomography (CT) analysis, conventional radiographic measures may help to identify upper sacral dysplasia and to avoi...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1472-7
更新日期:2019-12-09 00:00:00
abstract:BACKGROUND:This study was aimed at investigating the causes of lower extremity weaknesses after posterior lumbar spine fusion surgery and looking at subsequent treatment strategies. METHODS:Patients who underwent posterior lumbar spine fusion surgery in the Peking University First Hospital between January 2009 and Dec...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-020-01948-4
更新日期:2020-09-22 00:00:00
abstract:BACKGROUND:Evaluation of knee and lower limb function alone is not sufficient to assess gait. For accurate assessment of gait abnormality, gait oscillation should also be measured. The goal of this analysis was to assess the influence of the knee joint on gait oscillation during gait and stair-stepping in patients with...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1064-6
更新日期:2019-01-16 00:00:00
abstract:OBJECTIVE:To evaluate the short-term in vivo dynamic motion characteristics of the lower lumbar spine (L3-S1) after unilateral pedicle screw fixation (UPSF) or bilateral pedicle screw fixation (BPSF) combined with TLIF for treatment of L4-5 lumbar degenerative disc diseases (DDD). METHODS:Twenty-eight patients were re...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1198-6
更新日期:2019-06-07 00:00:00
abstract:INTRODUCTION:The OTA/AO type 31 A3 intertrochanteric fracture has a transverse or reverse oblique fracture at the lesser trochanteric level, which accentuates the varus compressive stress in the region of the fracture and the implant. Intramedullary fixation using different types of nails is commonly preferred. The pur...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-019-1431-3
更新日期:2019-11-12 00:00:00
abstract:BACKGROUND:Meniscocapsular separation (MCS) is a lesion of the area which is attached from the peripheral section of the meniscus to the capsule and is seen less often than other meniscus injuries. The aim of this study was to investigate which of the different side applications of all-inside MCS repair of the meniscus...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-017-0591-2
更新日期:2017-06-09 00:00:00
abstract:BACKGROUND:Intervertebral disk degeneration (IDD) is a degenerative disease characterized by cytoplasm loss and extracellular matrix degradation. Numerous evidence reported that miRNAs participated in IDD development. Nevertheless, the function of miR-142-3p in IDD development remains unknown. This study mainly explore...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-020-02194-4
更新日期:2021-01-14 00:00:00
abstract:BACKGROUND:The aim of this study was to analyze the pattern and types of sensory nerve endings in ankle collateral ligaments using histological techniques, in order to observe the morphology and distribution of mechanoreceptors in the collateral ligaments of cadaver ankle joint, and to provide the morphological evidenc...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-015-0215-7
更新日期:2015-06-12 00:00:00
abstract::In the original publication of this article [1], Chinese text of the Figs. 3, 4, 5 has not been converted to English. ...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章,已发布勘误
doi:10.1186/s13018-020-01612-x
更新日期:2020-03-09 00:00:00
abstract:BACKGROUND:Limited-incision total hip arthroplasty (THA) preserves hip abductors, posterior capsule, and external rotators potentially diminishing dislocation risk. However, potential complications also exist, such as component malposition. Specific implants have been manufactured that enhance compatibility with this t...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-016-0383-0
更新日期:2016-04-22 00:00:00
abstract:BACKGROUND:Osteoporosis implies an increased risk of complications after orthopedic surgery. For the mostly elderly group of patients undergoing lumbar spinal stenosis surgery (LSS), it is important to include skeletal health evaluation in the preoperative planning. The aim of this study was to assess spine and femoral...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-018-0964-1
更新日期:2018-10-16 00:00:00
abstract:BACKGROUND:Closed reduction and percutaneous fixation are considered as the optional treatments for displaced supracondylar humerus fractures. However, there was no published report about the biomechanical analysis in Orthofix® external fixator. In this study, we developed a model of supracondylar humerus fractures and...
journal_title:Journal of orthopaedic surgery and research
pub_type: 杂志文章
doi:10.1186/s13018-018-0893-z
更新日期:2018-07-28 00:00:00