Trends and risk factors for prolonged opioid use after unicompartmental knee arthroplasty

N A Bedard; D E DeMik; S B Dowdle; J J Callaghan

doi:10.1302/0301-620X.100B1.BJJ-2017-0547.R1

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Trends and risk factors for prolonged opioid use after unicompartmental knee arthroplasty

Journal article

Open access

Peer reviewed

Trends and risk factors for prolonged opioid use after unicompartmental knee arthroplasty

N A Bedard, D E DeMik, S B Dowdle and J J Callaghan

The bone & joint journal, Vol.100-B(1 Supple A), pp.62-67

01/2018

DOI: 10.1302/0301-620X.100B1.BJJ-2017-0547.R1

PMCID: PMC6424443

PMID: 29292342

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Abstract

The purpose of this study was to evaluate trends in opioid use after unicompartmental knee arthroplasty (UKA), to identify predictors of prolonged use and to compare the rates of opioid use after UKA, total knee arthroplasty (TKA) and total hip arthroplasty (THA). We identified 4205 patients who had undergone UKA between 2007 and 2015 from the Humana Inc. administrative claims database. Post-operative opioid use for one year post-operatively was assessed using the rates of monthly repeat prescription. These were then compared between patients with and without a specific variable of interest and with those of patients who had undergone TKA and THA. A total of 4205 UKA patients were analysed. Of these, 1362 patients (32.4%) were users of opioids. Pre-operative opioid use was the strongest predictor of prolonged opioid use after UKA. Opioid users were 1.4 (81.6% 57.7%), 3.7 (49.5% 13.3%) and 5.5 (35.8% 6.5%) times more likely to be taking opioids at one, two and three months post-operatively, respectively (p < 0.05 for all). Younger age and specific comorbidities such as anxiety/depression, smoking, back pain and substance abuse were found to significantly increase the rate of repeat prescription for opioids after UKA. Overall, UKA patients required significantly less opioid prescriptions than patients who had undergone THA and TKA. One-third of patients who undergo UKA are given opioids in the three months pre-operatively. Pre-operative opioid use is the best predictor of increased repeat prescriptions after UKA. However, other intrinsic patient characteristics are also predictive. Cite this article: 2018;100-B(1 Supple A):62-7.

Pain, Postoperative - drug therapy

Drug Utilization - trends

Humans

Middle Aged

Risk Factors

Analgesics, Opioid - therapeutic use

Arthroplasty, Replacement, Hip

Male

Time Factors

Aged, 80 and over

Adult

Arthroplasty, Replacement, Knee

Female

Hemiarthroplasty

Aged

Drug Utilization - statistics & numerical data

Databases, Factual

Details

Title: Subtitle: Trends and risk factors for prolonged opioid use after unicompartmental knee arthroplasty
Creators: N A Bedard - University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
D E DeMik - University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
S B Dowdle - University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
J J Callaghan - University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA
Resource Type: Journal article
Publication Details: The bone & joint journal, Vol.100-B(1 Supple A), pp.62-67
DOI: 10.1302/0301-620X.100B1.BJJ-2017-0547.R1
PMID: 29292342
PMCID: PMC6424443
NLM abbreviation: Bone Joint J
ISSN: 2049-4394
eISSN: 2049-4408
Publisher: England
Language: English
Date published: 01/2018
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Orthopedics and Rehabilitation
Record Identifier: 9984040225702771

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71 Times Cited - Web of Science