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Trends and predictors of opioid use after total knee and total hip arthroplasty
Open accessAbstract
Few studies have assessed postoperative trends in opioid cessation and predictors of persistent opioid use after total knee arthroplasty (TKA) and total hip arthroplasty (THA). Preoperatively, 574 TKA and THA patients completed validated, self-report measures of pain, functioning, and mood and were longitudinally assessed for 6 months after surgery. Among patients who were opioid naive the day of surgery, 8.2% of TKA and 4.3% of THA patients were using opioids at 6 months. In comparison, 53.3% of TKA and 34.7% of THA patients who reported opioid use the day of surgery continued to use opioids at 6 months. Patients taking >60 mg oral morphine equivalents preoperatively had an 80% likelihood of persistent use postoperatively. Day of surgery predictors for 6-month opioid use by opioid-naive patients included greater overall body pain (P = 0.002), greater affected joint pain (knee/hip) (P = 0.034), and greater catastrophizing (P = 0.010). For both opioid-naive and opioid users on the day of surgery, decreases in overall body pain from baseline to 6 months were associated with decreased odds of being on opioids at 6 months (adjusted odds ratio [aOR] = 0.72, P = 0.050; aOR = 0.62, P = 0.001); however, change in affected joint pain (knee/hip) was not predictive of opioid use (aOR = 0.99, P = 0.939; aOR = 1.00, P = 0.963). In conclusion, many patients taking opioids before surgery continue to use opioids after arthroplasty and some opioid-naive patients remained on opioids; however, persistent opioid use was not associated with change in joint pain. Given the growing concerns about chronic opioid use, the reasons for persistent opioid use and perioperative prescribing of opioids deserve further study.
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“Notably, many of the above risk factors for CPSP are also associated with persistent opioid use after surgery, including mood disorders,57 anxiety,57 pain catastrophizing,58 preoperative neuropathic and nonneuropathic pain,57 and greater pain intensity on the day of surgery.58”
From Chronic postsurgical pain: From risk factor identification to multidisciplinary management at the Toronto General Hospital Transitional Pain Service (2019) · cites this paper as [58]
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New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults
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Metadata
- Authors
- Goesling, J., Moser, S. E., Zaidi, B., Hassett, A. L., Hilliard, P., Hallstrom, B., Clauw, D. J., & Brummett, C. M.
- Affiliations
- University of Michigan (US)
- ORCID
- Venue
- Pain
- Published
- 2016-06
- Volume
- 157
- Issue
- 6
- Pages
- 1259-1265
- ISSN
- 0304-3959 (ISSN-L)
- PMC
- PMC4868627
- OpenAlex
- W2405020007
- Cited by
- 461
- References
- 23
- Citations by year
- 2026: 17 · 2025: 30 · 2024: 34 · 2023: 34 · 2022: 65 · 2021: 56 · 2020: 76 · 2019: 66 · 2018: 42 · 2017: 36 · 2016: 4
- FWCI
- 48.92
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Pain (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01AR060392)
- Topics
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Opioid Use Disorder Treatment
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Anesthesia and Pain Management
- Health Sciences › Medicine › Anesthesiology and Pain Medicine › Pain Management and Opioid Use
- Keywords
- opioid use, total knee arthroplasty, total hip arthroplasty, persistent opioid use, opioid cessation, opioid-naive patients, preoperative opioid use, morphine milligram equivalents, pain catastrophizing, joint pain, bodily pain, predictors of opioid use, chronic opioid use
- MeSH terms
- Aged, Analgesics, Opioid, Female, Hip Joint, Humans, Knee Joint, Male, Middle Aged, Morphine, Postoperative Pain, Pain, Postoperative, Risk Factors, Treatment Outcome, Arthroplasty, Replacement, Hip, Arthroplasty, Replacement, Knee, Self Report
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