Introduction: Over the past decade, awareness about opioid abuse in the general community and among prescribers has increased. This study evaluated how opioid prescribing patterns before and after total hip arthroplasty (THA) and total knee arthroplasty (TKA) may have changed during a recent 5-year period.
Methods: The Truven Health MarketScan database were queried for patients who underwent elective THA and TKA for primary osteoarthritis between 2013 and 2017. The trend analysis evaluated for changes in opioid prescriptions and multivariate regression identified predictors for chronic postoperative opioid use.
Results: Data were available for 27,908 THA patients and 47,220 TKA patients. The proportion of opioid naïve patients before THA or TKA increased significantly (P < 0.001). Median oral morphine equivalents prescribed during the first postoperative year after THA or TKA decreased significantly (P < 0.001). The proportion of patients with chronic postoperative opioid use also decreased for TKA patients (P < 0.001).
Discussion: A notable, downward trend was seen in the proportion of patients who received opioids before elective arthroplasty, in the amount of opioid prescribed after surgery, and in TKA patients, the frequency of chronic opioid use after surgery. These findings reflect the effectiveness of efforts to combat the opioid epidemic after elective arthroplasty surgery.
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http://dx.doi.org/10.5435/JAAOS-D-21-00360 | DOI Listing |
Cochrane Database Syst Rev
January 2025
Division of Pulmonary, Critical Care, Sleep, and Occupational Medicine, Indiana University School of Medicine, Indianapolis, USA.
Background: People undergoing major orthopaedic surgery are at increased risk of postoperative thromboembolic events. Low molecular weight heparins (LMWHs) are recommended for thromboprophylaxis in this population. New oral anticoagulants, including direct factor Xa inhibitors, are recommended as alternatives.
View Article and Find Full Text PDFShoulder Elbow
January 2025
Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA.
Background: Poor sleep quality due to nocturnal pain is increasingly reported as a major symptom in several shoulder pathologies. Sleep disturbance has been reported in up to 89% after rotator cuff tears and is frequently reported as the primary reason for referring patients to surgery. As a result, it is important to understand the impact of shoulder surgery on a patient's sleep quality.
View Article and Find Full Text PDF: The optimal venous thromboembolism (VTE) chemoprophylaxis approach after hip or knee total joint arthroplasty (TJA) remains controversial. This study aimed to characterize antithrombotic-related complications associated with various chemoprophylaxis regimens after TJA and to assess our current institutional risk-stratified prescribing tool. : This retrospective case-control study and regression analysis included elective unilateral TJA patients at a single institution between 1 July 2015 and 31 December 2021.
View Article and Find Full Text PDFInt Orthop
January 2025
Department of Orthopaedic Surgery and Traumatology, Altmühltal Nature Park Clinics, Eichstätt, Germany.
Purpose: The outcome of elective total joint arthroplasty (TJA) in patients with Parkinson's disease (PD) is controversial due to the concomitant risk profile. This study investigated postoperative complications and revision rates following total hip (THA) and knee arthroplasty (TKA) in patients with PD.
Methods: Ninety-six patients with PD undergoing THA or TKA were matched 1:1 with non-PD patients using propensity score matching for age, sex and comorbidity (Charlson Comorbidity index, CCI).
J Arthroplasty
January 2025
Department of Orthopedic Surgery, the 3rd Hospital of Hebei Medical University, Shijiazhuang, Hebei, 050051, P.R. China; Orthopedic Research Institute of Hebei Province, Key Laboratory of Biomechanics of Hebei Province, Shijiazhuang, Hebei, 050051, P.R. China.
Background: Malnutrition is significantly associated with unfavorable outcomes, but the relevant prognostic assessment is not emphasized in patients who have osteonecrosis of the femoral head (ONFH). This study aimed to assess the association between preoperative nutritional status evaluated by the prognostic nutritional index (PNI) and walking independence at one year postoperatively in patients who have ONFH undergoing primary total hip arthroplasty (THA).
Methods: This was a retrospective analysis of prospectively collected data from patients admitted to a tertiary referral hospital who had ONFH and underwent primary unilateral THA from October 30, 2014 to April 26, 2019.
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