Self-Reported Marijuana Use Is Associated with Increased Use of Prescription Opioids Following Traumatic Musculoskeletal Injury
Cannabinoids are among the psychoactive substances considered as alternatives to opioids for the alleviation of acute pain. We examined whether self-reported marijuana use was associated with decreased use of prescription opioids following traumatic musculoskeletal injury.
Overlapping surgery occurs when a single surgeon is the primary surgeon for >1 patient in separate operating rooms simultaneously. The surgeon is present for the critical portions of each patient’s operation although not present for the entirety of the case. While overlapping surgery has been widely utilized across surgical subspecialties, few large studies have compared the safety of overlapping and nonoverlapping orthopaedic surgery.
The long-term effect of distal radial fracture malunion on activity limitations is unknown. https://bit.ly/2qYgOMh #JBJS
New subspecialty CME exams are now available from The Journal of Bone & Joint Surgery in the following topic areas:
- Adult Hip Reconstruction
- Adult Knee Reconstruction
- Shoulder and Elbow
- Sports Medicine
Each exam consists of 10 questions based on articles published in JBJS within the past 12 months. Exams can be used for study purposes at no cost. Each exam activity may be submitted for a maximum of 5 AMA PRA Category 1 Credits™.
Three years ago today, the 2013 Boston Marathon was stolen from the athletes and the city by two terrorist bombs, which led to four deaths and hundreds of injuries. In March 2014, in conjunction with our friends at the Journal of Orthopaedic and Sports Physical Therapy (JOSPT), JBJS published It Takes a Team, a special report on the emergency preparedness, long-term care, and outcomes for many of those caught up in the Marathon bombings. This report is available online for free.
Not a single bombing victim who reached a hospital alive on April 15, 2013 died, a stunning result of years of preparation and teamwork. It Takes a Team provides a behind-the-scenes look at how the level 1 trauma centers involved that day ensured that their staffs had the emotional backing, resources, and systems in place so they could focus on their seriously injured patients.
As runners and spectators prepare for the 2016 Boston Marathon, we remember those we lost, those who survived, and the countless number of people who are helping those affected face the future with hope and dignity. We also thank the many people whose dedication to disaster-preparedness helps ensure that the 2016 and forthcoming Boston Marathons will go on.
Executive Publisher, JBJS
OrthoBuzz has reported previously on the 3D printing of implantable skeletal structures (click here for an example), but the materials used were metallic. Now, two new accomplishments with 3D printing have produced material that mimics the physiochemical properties and porous structure of real bone.
First, students from California State University in Long Beach created the LuxNova OsBot 3D printer. The students say that the OsBot can replicate the unique and complex structure of human bone tissue down to the micro and nano levels.
Meanwhile, in China, the Xi’an Particle Cloud Advanced Materials Technology Co. has wrapped up animal testing on a similar bioprinting device and is poised to enter human trials. The device uses both UV light and heat to “laminate” binder material until a bonelike structure is fabricated. In rabbits, the 3D-printed bone exhibited new bone-cell activity on its surface almost immediately after implantation.
Theoretically, surgeons could use 3D-printed bone grafts to replace cancerous or severely traumatized bone tissue, obviating the need for amputation or cadaver grafts.
A study in the August 6, 2014 JBJS revealed that the prevalence of postoperative “doctor shopping” among a cohort of 130 orthopaedic trauma patients in Tennessee was a surprisingly high 20.8%. This study used the state-controlled substance monitoring database to identify the narcotic prescriptions filled by patients three months prior to surgery and up to six months after discharge. The study segmented the test group into those who received prescriptions only from the treating surgeon or healthcare extender and those who got prescriptions from multiple doctors and extenders.
According to the study, patients who doctor shopped received an average of seven prescriptions for narcotics compared to an average of two prescriptions among those who got prescriptions from a single provider. Those with a high-school education or less were three times more likely to seek out multiple providers. According to Dr. Douglas Lundy, a spokesperson for the American Academy of Orthopedic Surgeons, “I think what the study tells us is there is a subgroup of patients you need to be a little more vigilant on, that they may be taking more drugs than you think they’re taking.”