- How bad is the shoulder arthritis on x-ray?
- X-rays for shoulder arthritis
- Rotator cuff and rotator cuff tears - what you should know about them.
- Shoulder exercises
- The ream and run for a B2 glenoid at 7 years after surgery
- Arthritis with rotator cuff failure in active people
- Rotator cuff repair, arthroscopic or open?
- Delayed onset of total shoulder pain and stiffness - suspect Propionibacterium
- Dislocations after a reverse total shoulder
- Ream and run at 10 years after surgery
Thursday, November 28, 2013
Narcotics may interfere with bone healing
Postoperative Opioid Administration Inhibits Bone Healing in an Animal Model
The authors observe that opiod medications are the mainstay of orthopaedic pain control. They used a rat fracture model to evaluate the effects of opioid administration on bone union in an operatively stabilized fracture. After a 0.4-mm femoral osteotomy gap was created, rats were randomized to control versus morphine-treated study groups.
There was a statistically significant (p = 0.048) reduction in callus strength in morphine-treated animals 8 weeks postoperatively compared with controls. Radiographic and histological analysis showed delayed callus maturation and lack of remodeling in the morphine group compared with control animals at 8 weeks.
The authors concluded that administration of an opioid pain medication leads to weaker callus and impedes callus maturation compared with controls.
Comment: In fracture cases as well as in shoulder arthroplasty, bone healing and remodeling are important. The authors have given us yet another reason to consider minimizing our use of narcotics.
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