Opioid Use After Total Knee Arthroplasty: Trends and Risk Factors for Prolonged Use

Nicholas A Bedard; Andrew J Pugely; Robert W Westermann; Kyle R Duchman; Natalie A Glass; John J Callaghan

doi:10.1016/j.arth.2017.03.014

Back

Opioid Use After Total Knee Arthroplasty: Trends and Risk Factors for Prolonged Use

Journal article

Peer reviewed

Opioid Use After Total Knee Arthroplasty: Trends and Risk Factors for Prolonged Use

Nicholas A Bedard, Andrew J Pugely, Robert W Westermann, Kyle R Duchman, Natalie A Glass and John J Callaghan

The Journal of arthroplasty, Vol.32(8), pp.2390-2394

08/2017

DOI: 10.1016/j.arth.2017.03.014

PMID: 28413136

View Online

Abstract

The United States is in the midst of an opioid epidemic. Little is known about perioperative opioid use for total knee arthroplasty (TKA). The purpose of this study was to identify rates of preoperative opioid use, evaluate postoperative trends and identify risk factors for prolonged use after TKA. Patients who underwent primary TKA from 2007-2014 were identified within the Humana database. Postoperative opioid use was measured by monthly prescription refill rates. A preoperative opioid user (OU) was defined by history of opioid prescription within 3 months prior to TKA and a non-opioid user (NOU) was defined by no history of prior opioid use. Rates of opioid use were trended monthly for one year postoperatively for all cohorts. 73,959 TKA patients were analyzed and 23,532 patients (31.2%) were OU. OU increased from 30.1% in 2007 to 39.3% in 2014 (P < .001). Preoperative opioid use was the strongest predictor for prolonged opioid use following TKA, with OU filling significantly more opioid prescriptions than NOU at every time point analyzed. Younger age, female sex and other intrinsic factors were found to significantly increase the rate of opioid refilling following TKA throughout the postoperative year. Approximately one-third of TKA patients use opioids within 3 months prior to surgery and this percentage has increased over 9% during the years included in this study. Preoperative opioid use was most predictive of increased refills of opioids following TKA. However, other intrinsic patient characteristics were also predictive of prolonged opioid use.

Humans

Middle Aged

Risk Factors

Pain Management - methods

Postoperative Period

Analgesics, Opioid - therapeutic use

Male

Perioperative Period

Drug Prescriptions - statistics & numerical data

Analgesics, Opioid - adverse effects

Pain Management - adverse effects

Arthroplasty, Replacement, Knee

Female

Opioid-Related Disorders - prevention & control

Aged

Cohort Studies

Preoperative Period

Details

Title: Subtitle: Opioid Use After Total Knee Arthroplasty: Trends and Risk Factors for Prolonged Use
Creators: Nicholas A Bedard - University of Iowa Hospitals and Clinics, Department of Orthopaedics, Iowa City, Iowa
Andrew J Pugely - University of Iowa Hospitals and Clinics, Department of Orthopaedics, Iowa City, Iowa
Robert W Westermann - University of Iowa Hospitals and Clinics, Department of Orthopaedics, Iowa City, Iowa
Kyle R Duchman - University of Iowa Hospitals and Clinics, Department of Orthopaedics, Iowa City, Iowa
Natalie A Glass - University of Iowa Hospitals and Clinics, Department of Orthopaedics, Iowa City, Iowa
John J Callaghan - University of Iowa Hospitals and Clinics, Department of Orthopaedics, Iowa City, Iowa
Resource Type: Journal article
Publication Details: The Journal of arthroplasty, Vol.32(8), pp.2390-2394
Publisher: United States
DOI: 10.1016/j.arth.2017.03.014
PMID: 28413136
ISSN: 0883-5403
eISSN: 1532-8406
Language: English
Date published: 08/2017
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation; Athletic Training Program
Record Identifier: 9984040001702771

Metrics

24 Record Views

181 Times Cited - Web of Science

See more details