The Opioid Epidemic in the United States: Where Do Patients Requiring Elective Arthroplasty Stand?. Issue 2 (15th January 2022)

• Record Type: Journal Article
• Authors: Premkumar, Ajay; Zhong, Haoyan; Krell, Ethan; Liu, Jiabin; Memtsoudis, Stavros; Poeran, Jashvant; Della Valle, Alejandro Gonzalez
• Is Part Of: Journal of the American Academy of Orthopaedic Surgeons. Volume 30:Issue 2(2022)
• Publication Date: 2022-01-15
• Subjects: Orthopedics -- Periodicals; Orthopedic surgery -- Periodicals; Joint Diseases -- Periodicals; Orthopedics -- Periodicals; Orthopedic surgery; Orthopedics; Periodicals; 616.7005
• DOI: 10.5435/JAAOS-D-21-00360
• Languages: English
• ISSNs: 1067-151X

Abstract

Abstract : 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.