ABSTRACT
PURPOSE: To quantify the use of 5 mg oxycodone by patients who have undergone knee arthroscopy. METHODS: Patients who underwent knee arthroscopy at 2 institutions between May 2018 and May 2019 were identified retrospectively. Patients were called and queried about the following metrics: total postoperative opioid consumption, preoperative opioid consumption (defined as within 3 months of surgery), smoking status, and history of depression. The total number of opioids prescribed and number of refills were determined according to each patient's chart. State databases were reviewed for additional opioid prescriptions. RESULTS: A total of 100 patients were included in this study. Patients were prescribed a median of 5 pills (range, 5 to 40). Median postoperative opioid consumption was 0 pills, with a mean of 1.9 pills (14.3 oral morphine equivalents) and a range of 0 to 25 pills of oxycodone 5 mg. Of the patients, 97% did not obtain refills, and 58% of the patients did not consume any opioids. Overall, 90% of all patients consumed ≤ 5 pills. CONCLUSIONS: Of the patients, 90% o consumed 5 or fewer opioid pills (oxycodone 5 mg) following knee arthroscopy, with more than half of the patients consuming 0 pills. As a result, we recommend that 5 oxycodone 5 mg pills serve as an objective guideline for opioid prescription following knee arthroscopy. LEVEL OF EVIDENCE: Level IV, retrospective case series.
ABSTRACT
With over 500,000 bone grafting procedures performed annually in the United States, the advancement of bone regeneration technology is at the forefront of medical research. Many tissue-engineered approaches have been explored to develop a viable synthetic bone graft substitute, but a major challenge is achieving a load-bearing graft that appropriately mimics the mechanical properties of native bone. In this study, sintered hydroxyapatite (HAp) was used to structurally reinforce a scaffold and yield mechanical properties comparable to native bone. HAp was packed into a cylindrical framework and processed under varying conditions to maximize its mechanical properties. The resulting HAp columns were further tested in a 6-week degradation study to determine their physical and mechanical response. The cellular response of sintered HAp was determined using a murine preosteoblast cell line, MC3T3-E1. Cell viability and morphology were studied over a one-week period and MC3T3-E1 differentiation was determined by measuring the alkaline phosphatase levels. Finite element analysis was used to determine the columns' geometric configuration and arrangement within our previously developed composite bone scaffold. It was determined that incorporating four cylindrical HAp columns, fabricated under 44 MPa of pressure and sintered at 1200°C for 5 hr, led to load-bearing properties that match the yield strength of native whole bone. These preliminary results indicate that the incorporation of a mechanically enhanced HAp structural support system is a promising step toward developing one of the first load-bearing bone scaffolds that can also support cell proliferation and osteogenic differentiation. © 2018 Wiley Periodicals, Inc. J Biomed Mater Res Part A: 107A: 732-741, 2019.
