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Does Preoperative Opioid Consumption Increase the Risk of Chronic Postoperative Opioid Use After Total Joint Arthroplasty?

Samuel T. Kunkel, James J. Gregory, Matthew J. Sabatino, Tracy M. Borsinger, Yale A. Fillingham, David S. Jevsevar, Wayne E. Moschetti

2021Arthroplasty Today15 citationsDOIOpen Access PDF

Abstract

BACKGROUND: Risk-factor identification related to chronic opioid use after surgery may facilitate interventions mitigating postoperative opioid consumption. We evaluated the relationship between opioid use preceding total hip arthroplasty (THA) and total knee arthroplasty (TKA), and chronic use postoperatively, and the risk of chronic opioid use after total joint arthroplasty. METHODS: < .05. RESULTS: = .024). Five of 43 (11.6%) THA and 4 of 22 (18.2%) TKA patients with preoperative opioid use had continued use for >90 days postoperatively. For opioid naïve patients, 2.6% (4/156) of THA and 4.9% (6/122) of TKA patients had chronic use postoperatively. CONCLUSIONS: Preoperative opioid use was associated with nearly 5-fold and 4-fold increase in percentage of patients with chronic opioid use after THA and TKA, respectively. Surgeons should counsel patients regarding this risk and consider strategies to eliminate preoperative opioid use.

Topics & Concepts

MedicineJoint arthroplastyOpioidAnesthesiaArthroplastySurgeryInternal medicineReceptorOpioid Use Disorder TreatmentSubstance Abuse Treatment and OutcomesAnesthesia and Pain Management