Preoperative Opioid Use Is Associated with Higher Readmission and Revision Rates in Total Knee and Total Hip Arthroplasty

The Journal of Bone and Joint Surgery. American Volume
Jack WeickHue H Luu

Abstract

Prescription opioid use is epidemic in the U.S. Recently, an association was demonstrated between preoperative opioid use and increased health-care utilization following abdominal surgeries. Given that primary total knee arthroplasty (TKA) and total hip arthroplasty (THA) are 2 of the most common surgical procedures in the U.S., we examined the association of preoperative opioid use with 30-day readmission and early revision rates. We reviewed 2003 to 2014 data from 2 Truven Health MarketScan databases (commercial insurance and Medicare plus commercial supplemental insurance). Subjects were included if they had a Current Procedural Terminology (CPT) code for primary TKA or THA and were continuously enrolled in the database for at least 6 months prior to the index procedure. Preoperative opioid prescriptions were identified using National Drug Codes (NDCs). Rates of 30-day readmissions and revision arthroplasty were identified and compared among patients with stratified durations of preoperative opioid use in the 6 months preceding TKA or THA. The study included 324,154 patients in the 1-year follow-up group and 159,822 patients in the 3-year follow-up group. Opioid-naive TKA patients had a lower revision rate than did those wit...Continue Reading

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