Cited by 461Opioid Use Disorder TreatmentAnesthesia and Pain ManagementPain Management and Opioid Use

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Trends and predictors of opioid use after total knee and total hip arthroplasty

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Goesling, Jenna, Moser, Stephanie E., Zaidi, Bilal, Hassett, Afton L., Hilliard, Paul, Hallstrom, Brian, Clauw, Daniel J., Brummett, Chad M.·2016·Pain

DOI 10.1097/j.pain.0000000000000516PMC PMC4868627

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Abstract

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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Self-citation
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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: Moser, Stephanie E.
Hassett, Afton L.
Hilliard, Paul
Hallstrom, Brian
Clauw, Daniel J.
Brummett, Chad M.
Venue: Pain
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2016-06
Volume: 157
Issue: 6
Pages: 1259-1265
ISSN: 0304-3959 (ISSN-L)
DOI: 10.1097/j.pain.0000000000000516
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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Trends and predictors of opioid use after total knee and total hip arthroplasty

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