The Physiological Effects, Including Risks and Potential Benefits, of Cannabis for Patients Undergoing Elective Orthopedic Procedures.

Given the evolving regulations regarding and availability of cannabis in the United States, physicians should understand the risks and benefits associated with its use. Patients are interested in learning about the use of cannabis for the management of orthopedic pain and any potential risks associated with it when undergoing elective surgery. Edible and topical cannabis products appear to have fewer side effects than inhaled cannabis products. A review of the literature was performed regarding different modes of administration and their related risks and potential benefits specifically regarding perioperative concerns for elective orthopedic procedures. Larger studies are necessary to further determine the efficacy, safety, and side effect profile of cannabis. [Orthopedics. 2021;44(3):e314-e319.].

Eikenella corrodens septic hip arthritis in a healthy adult treated with arthroscopic irrigation and debridement.

We present the case of a seemingly spontaneous septic hip arthritis in a patient with no pertinent medical history. Our patient presented with persistent and worsening sharp lower back pain and underwent arthrocentesis of the hip joint, yielding purulent fluid positive for Eikenella corrodens. Our patient's treatment consisted of arthroscopic irrigation with debridement and limited synovectomy that used a supine 2-incision technique. To our knowledge, this is the first reported case of an E corrodens septic hip arthritis.

Biomechanical properties of double- and single-row suture anchor repair for surgical treatment of insertional Achilles tendinopathy.

BACKGROUND: Because of intratendinous ossifications, retrocalcaneal bursitis, or intratendinous necrosis commonly found in insertional tendinosis, it is often necessary to detach the tendon partially or entirely from its tendon-to-bone junction. HYPOTHESIS: Double-row repair for insertional Achilles tendinopathy will generate an increased contact area and demonstrate higher biomechanical stability. STUDY DESIGN: Controlled laboratory study. METHODS: Eighteen cadaver Achilles tendons were split longitudinally and detached, exposing the calcaneus; an ostectomy was performed and the tendon was reattached to the calcaneus in 1 of 2 ways: 2 suture anchors (single row) or a 4-anchor (double row) construct. Footprint area measurements over time, displacement after cyclic loading (2000 cycles), and final load to failure were measured. RESULTS: The double-row refixation technique was statistically superior to the single-row technique in footprint area measurement initially and 5 minutes after repair (P = .009 and P = .01, respectively) but not after 24 hours (P = .713). The double-row construct demonstrated significantly improved measures for peak load (433.9 ± 84.3 N vs 212.0 ± 49.7 N; P = .042), load at yield (354.7 ± 106.2 N vs 198.7 ± 39.5 N; P = .01), and slope (51.8 ± 9.9 N/mm vs 66.7 ± 16.2 N/mm; P = .021). Cyclic loading did not demonstrate significant differences between the 2 constructs. CONCLUSION: Double-row construct for reinsertion of a completely detached Achilles tendon using proximal and distal rows resulted in significantly larger contact area initially and 5 minutes after repair and led to significantly higher peak load to failure on destructive testing. CLINICAL RELEVANCE: In treatment for insertional Achilles tendinosis, the tendon often has to be detached and anatomically reattached to its insertion at the calcaneus. To our knowledge there is a lack of biomechanical studies supporting either a number or a pattern of suture anchor fixation. Because the stresses going across the insertion site of the Achilles tendon are significant during rehabilitation and weightbearing activities, it is imperative to have a strong construct that allows satisfactory healing during the early postoperative process.

Arthroscopic rotator cuff repair: impact of diabetes mellitus on patient outcomes.

INTRODUCTION: Arthroscopic repair of rotator cuff tears has been associated with satisfactory improvement in pain and function. The goal of this study was to compare the results of patients with diabetes and patients without diabetes after the 2 cohorts underwent arthroscopic rotator cuff repair (RCR). METHODS: We performed a retrospective review of 56 patients with type 1 diabetes mellitus or type 2 diabetes mellitus and 67 patients without diabetes, all of whom underwent arthroscopic RCR with 1 year of follow-up. Changes in range of motion (ROM), American Shoulder and Elbow Surgeons (ASES) score, and Penn Shoulder Score (PSS) were compared between both groups at 1 year postoperatively. RESULTS: There was a statistically significant improvement in ROM for both groups. However, patients without diabetes had greater forward flexion (P = 0.02), abduction (P = 0.04), and external rotation (P = 0.004). Both groups noted significant improvement in their respective ASES score and PSS. However, patients with diabetes had a lower ASES score (P < 0.01) and PSS (P < 0.01). There were no differences in recurrent tears or complications. CONCLUSION: Arthroscopic RCR in patients with diabetes resulted in improved postoperative ROM and function.