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Briguglio M, Wainwright TW, Latella M, Ninfa A, Cordani C, Colombo C, Banfi G, Francetti L, Corbella S. A Proposal for a Multidisciplinary Integrated Oral Health Network for Patients Undergoing Major Orthopaedic Surgery (IOHN-OS). Geriatrics (Basel) 2024; 9:39. [PMID: 38525756 PMCID: PMC10961760 DOI: 10.3390/geriatrics9020039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 03/13/2024] [Accepted: 03/15/2024] [Indexed: 03/26/2024] Open
Abstract
The passing of the years of life physiologically leads to the accumulation of changes in tissues in the oral cavity, influencing dentition, chewing and swallowing mechanisms, and the oral microbiota. Some diseases and medications can aggravate oral symptoms and negatively influence eating behaviours, increasing the likelihood of becoming malnourished. This could make older individuals more vulnerable to complications when undergoing major orthopaedic surgery. Hidden infection foci in the oral cavity are a recognised cause of post-operative periprosthetic joint infections. Dysfunctional oral problems might also compromise feeding after surgery when good nutrition represents a fundamental aspect of a proper recovery. To manage these shortcomings, in this article, the authors hypothesise a multidisciplinary path of care named the Integrated Oral Health Network applied to major Orthopaedic Surgery (IOHN-OS). This peri-operative initiative would include pre-operative oral health screening and risk management by a dental team, patient education programmes before and after surgery, and bedside gerodontology actions like oral care and meal and eating support for fragile individuals. The IOHN-OS has the potential to reshape the concept of suitability for major orthopaedic surgery and generate momentum for designing community-based surveillance programmes that can keep the mouths of older subjects healthy for a long time.
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Affiliation(s)
- Matteo Briguglio
- Laboratory of Nutritional Sciences, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy
| | - Thomas W. Wainwright
- Orthopaedic Research Institute, Bournemouth University, Bournemouth BH8 8FT, UK
- Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Bournemouth BH7 7DW, UK
| | - Marialetizia Latella
- Laboratory of Nutritional Sciences, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy
| | - Aurora Ninfa
- Operational Unit of Phoniatry, ASST Fatebenefratelli-Sacco, 20154 Milan, Italy
| | - Claudio Cordani
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy
- Scientific Direction, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy
| | - Cecilia Colombo
- Orthopaedic Biotechnology Laboratory, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy
| | - Giuseppe Banfi
- Scientific Direction, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, 20132 Milan, Italy
| | - Luca Francetti
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy
- Operational Unit of Odontostomatology, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy
| | - Stefano Corbella
- Department of Biomedical, Surgical, and Dental Sciences, Università degli Studi di Milano, 20122 Milan, Italy
- Operational Unit of Odontostomatology, IRCCS Orthopedic Institute Galeazzi, 20161 Milan, Italy
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Briguglio M, Sirtori P, Mangiavini L, Buzzi S, Cordani C, Zerni MF, Wainwright TW, Ursino N, Peretti GM, Banfi G. How Do Older Patients with End-Stage Osteoarthritis of the Hip Eat Prior to Hip Replacement? A Preliminary Snapshot That Highlights a Poor Diet. Nutrients 2023; 15:4868. [PMID: 38068726 PMCID: PMC10708412 DOI: 10.3390/nu15234868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/18/2023] Open
Abstract
Diet quantity and quality in older adults is critical for the proper functioning of the musculoskeletal system. In view of hip surgery, old patients should consume 1.2-1.5 g of proteins and 27-30 kcal per kilo of body weight daily, and adhere to healthy eating habits. In this analytical study, we studied diet quantity and quality in relation to the clinical chemistry and functional status of 57 older adults undergoing elective hip replacement. Nine in ten patients did not meet suggested protein and energy intakes and only one in ten patients exhibited high adherence to the Mediterranean diet. Legume consumption adjusted for sex, age, body mass index, and health status successfully forecasted haemoglobin levels (p < 0.05), and patients regularly consuming olive oil reported minor hip disability compared to those using it less frequently (p < 0.05). Patients who reported daily ingestion of <1 serving of meat versus those consuming >1.5 servings had greater cumulative comorbidity (p < 0.05), with meat consumption independently predicting walking ability, mobility, and balance in the fully adjusted model (p < 0.01). In conclusion, our patients seem to eat poorly. There is room for improvement in pre-operative pathways to make older adults eat better, but there is a need to plan an interventional study to fully understand the cause-effect of a dietary pattern or specific food in enhancing recovery after surgery.
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Affiliation(s)
- Matteo Briguglio
- Laboratory of Nutritional Sciences, IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Paolo Sirtori
- E.U.O.R.R. Unit, IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy (G.M.P.)
| | - Laura Mangiavini
- E.U.O.R.R. Unit, IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy (G.M.P.)
- Department of Biomedical Sciences for Health, University “La Statale” of Milan, 20133 Milan, Italy
| | - Sara Buzzi
- Department of Biomedical Sciences for Health, University “La Statale” of Milan, 20133 Milan, Italy
| | - Claudio Cordani
- Department of Biomedical, Surgical, and Dental Sciences, University “La Statale” of Milan, 20141 Milan, Italy;
- IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Maria Francesca Zerni
- Laboratory of Nutritional Sciences, IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Thomas W. Wainwright
- Orthopaedic Research Institute, Bournemouth University, Bournemouth BH8 8FT, UK
- Physiotherapy Department, University Hospitals Dorset NHS Foundation Trust, Bournemouth BH7 7DW, UK
| | - Nicola Ursino
- C.A.S.C.O. Unit, IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
| | - Giuseppe M. Peretti
- E.U.O.R.R. Unit, IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy (G.M.P.)
- Department of Biomedical Sciences for Health, University “La Statale” of Milan, 20133 Milan, Italy
| | - Giuseppe Banfi
- IRCCS Orthopedic Institute Galeazzi, Via Riccardo Galeazzi 4, 20161 Milan, Italy
- Faculty of Medicine and Surgery, Vita-Salute San Raffaele University, Via Olgettina 58, 20132 Milan, Italy
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