Impact of Preoperative Opioid Use on Total Knee Arthroplasty Outcomes

The Journal of Bone and Joint Surgery. American Volume
Savannah R SmithElena Losina

Abstract

There is growing concern about the use of opioids prior to total knee arthroplasty (TKA), and research has suggested that preoperative opioid use may lead to worse pain outcomes following surgery. We evaluated the pain relief achieved by TKA in patients who had and those who had not used opioids use before the procedure. We augmented data from a prospective cohort study of TKA outcomes with opioid-use data abstracted from medical records. We collected patient-reported outcomes and demographic data before and 6 months after TKA. We used the Pain Catastrophizing Scale and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) to quantify the pain experiences of patients treated with TKA who had had a baseline score of ≥20 on the WOMAC pain scale (a 0 to 100-point scale, with 100 being the worst score), who provided follow-up data, and who had not had another surgical procedure within the 2 years prior to TKA. We built a propensity score for preoperative opioid use based on the Pain Catastrophizing Scale score, comorbidities, and baseline pain. We used a general linear model, adjusting for the propensity score and baseline pain, to compare the change in the WOMAC pain score 6 months after TKA between persons wh...Continue Reading

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Citations

Feb 23, 2018·Geriatric Orthopaedic Surgery & Rehabilitation·Christopher P ChildersMelinda Maggard-Gibbons
Apr 4, 2018·The Journal of Bone and Joint Surgery. American Volume·Thomas Parker Vail
Jul 19, 2018·The Journal of Bone and Joint Surgery. American Volume·Jack WeickHue H Luu
Dec 19, 2018·The Journal of Bone and Joint Surgery. American Volume·Yuvraj AgrawalBassam A Masri
Jan 31, 2018·Drugs·Arnaud Steyaert, Patricia Lavand'homme
Aug 8, 2019·Clinical Orthopaedics and Related Research·Daniel B C ReidAlan H Daniels
Jul 16, 2019·The American Journal of Sports Medicine·Anita G RaoGregory B Maletis
Mar 5, 2019·The Journal of the American Academy of Orthopaedic Surgeons·Bryant E BonnerYoung-Min Kwon
Jul 10, 2019·The Journal of the American Academy of Orthopaedic Surgeons·William CurtisReza Omid
Jan 18, 2018·The Journal of Bone and Joint Surgery. American Volume·Gwo-Chin Lee
Jun 20, 2019·The Physician and Sportsmedicine·Azeem Tariq MalikSafdar N Khan
Jan 25, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Tyler E CalkinsCraig J Della Valle
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Nov 23, 2020·World Journal of Surgery·Nick C LevinskyRobert M Van Haren
Sep 15, 2020·The Journal of the American Academy of Orthopaedic Surgeons·Kerri L BellAntonia F Chen

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