The Opioid Epidemic in the United States: Where Do Patients Requiring Elective Arthroplasty Stand?

J Am Acad Orthop Surg

From the Hospital for Special Surgery, Adult Reconstruction & Joint Replacement (Premkumar, Krell, and Della Valle), Hospital for Special Surgery, Biostatistics Core (Zhong), Institute for Healthcare Delivery Science, Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai (Liu and Memtsoudis), Hospital for Special Surgery, Department of Anethesiology, Critical Care, and Pain Management, New York, NY (Poeran).

Published: January 2022

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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Source
http://dx.doi.org/10.5435/JAAOS-D-21-00360DOI Listing

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