St. Louis Joint Replacement Institute Team Wins Ranawat Award

A group of researchers from the St. Louis Joint Replacement Institute in Bridgeton, Missouri, has won the prestigious Chitranjan S. Ranawat Award for 2019 for work on understanding the role of nutrition on joint arthroplasty outcomes.

Their program, which studied the effects of a high protein/low inflammatory food diet on arthroplasty patients, was so novel that it was selected to receive the award named for Chitranjan S. Ranawat.

Dr. Ranawat was born in Sarwania, in the Indian state of Madhya Pradesh and did his early medical education at Mahatma Gandhi Memorial Medical College, Indore and his schooling from The Daly College, Indore before moving to the US for advanced training. There, he worked at St. Peters Hospital, Albany and Albany Medical Center and received certification as an orthopedic surgeon by the American Board of Orthopedic Surgery in 1969.

Later, Dr. Ranawat moved to Lenox Hill Hospital where he became the chairman and director of the Orthopedic department. He has also served as a professor at the Weill Medical College of Cornell University and as a visiting faculty at other universities. Ranawat and Albert Burstein of the Hospital for Special Surgery, also in New York City, invented a hip replacement implant marketed by Biomet.

In 1986 he founded the Ranawat Foundation, a philanthropic organization. and in 2001 he received the Padma Bhushan, the third highest Indian civilian award. Each year at its annual meeting, the Knee Society presents the “Chitranjan S. Ranawat, MD Award” and two other awards for the best research papers that year.

The winning 2019 study, “Elective joint arthroplasty outcomes improve in malnourished patients with nutritional intervention: a prospective population analysis demonstrates a modifiable risk factor,” appears in June 30, 2019 edition of The Bone and Joint Journal.

The researchers “evaluated differences in the hospital length of stay (LOS), rate of re-admission, and total patient charges for a malnourished patient study population who received a specific nutrition protocol before surgery.” Using results from a five-hospital network joint arthroplasty patient data set between 2014 and 2017, the team examined 4,733 patients who underwent joint arthroplasty and had preoperative measurement of albumin levels.

The authors wrote, “Malnourished patients with nutritional intervention at the study hospital had shorter hospital LOS beginning in 2017 than malnourished patients at control hospitals during the same period. Similarly, this cohort had significantly lower primary hospitalization charges, charges associated with hospital re-admissions, and 90-day total charges. Inclusion of covariant potential confounders (age, anemia, diabetes, and obesity) did not alter the conclusions of the primary statistical analysis.”

Study co-author William Schroer, M.D. told OTW, “We are very excited to receive the recognition from the Knee Society for this research. For the past several years, different research groups (including our own) have demonstrated poor surgical outcomes associated with six modifiable risk factors (MRF): anemia, obesity, diabetes, smoking, narcotic use, and malnutrition. While these studies demonstrated higher complications and increased costs associated with these MRF, few studies demonstrate how to improve surgical outcomes by improving patient care.”

“This study is the first to demonstrate that improved outcomes in malnourished patients were obtained through a patient education program focusing on a high protein/low inflammatory food diet. This dietary intervention was initiated in our routine pre-operative class, reinforced prior to surgery in malnourished patients, and focused on throughout the patient’s hospital stay and discharge. It did not require special visits or cause delay in surgical scheduling.”