Postdischarge Opioid Use after Total Hip and Total Knee Arthroplasty

Authors

Keenan Atwood, West Virginia University
Taylor Shackleford, West Virginia University
Wesley Lemons, West Virginia University
Jennifer L. Eicher, West Virginia University
Brock A. Lindsey, West Virginia University
Adam E. Klein, West Virginia University

Author ORCID Identifier

N/A

N/A

N/A

https://orcid.org/0009-0002-4174-5247

https://orcid.org/0000-0002-1073-5372

https://orcid.org/0000-0002-6684-6389

Document Type

Article

Publication Date

2021

College/Unit

School of Medicine

Department/Program/Center

Orthopaedics

Abstract

Background

As America’s third highest opioid prescribers, orthopedic surgeons have contributed to the opioid abuse crisis. This study evaluated opioid use after primary total joint replacement. We hypothesized that patients who underwent total hip arthroplasty (THA) use fewer opioids than patients who underwent total knee arthroplasty (TKA) and that both groups use fewer opioids than prescribed.

Methods

A prospective study of 110 patients undergoing primary THA or TKA by surgeons at an academic center during 2018 was performed. All were prescribed oxycodone 5 mg, 84 tablets, without refills. Demographics, medical history, and operative details were collected. Pain medication consumption and patient-reported outcomes were collected at 2 and 6 weeks postoperatively. Analysis of variance was performed on patient and surgical variables.

Results

Sixty-one patients scheduled for THA and 49 for TKA were included. THA patients consumed significantly fewer opioids than TKA patients at 2 weeks (28.1 tablets vs 48.4, P = .0003) and 6 weeks (33.1 vs 59.3, P = .0004). Linear regression showed opioid use decreased with age at both time points (P = .0002). A preoperative mental health disorder was associated with higher usage at 2 weeks (58.3 vs 31.4, P < .0001) and 6 weeks (64.7 vs 39.2, P = .006). Higher consumption at 2 weeks was correlated with worse outcome scores at all time points.

Conclusions

TKA patients required more pain medication than THA patients, and both groups received more opioids than necessary. In addition, younger patients and those with a preexisting mental health disorder required more pain medication. These data provide guidance on prescribing pain medication to help limit excess opioid distribution.

Digital Commons Citation

Atwood, Keenan; Shackleford, Taylor; Lemons, Wesley; Eicher, Jennifer L.; Lindsey, Brock A.; and Klein, Adam E., "Postdischarge Opioid Use after Total Hip and Total Knee Arthroplasty" (2021). Faculty & Staff Scholarship. 2995.
https://researchrepository.wvu.edu/faculty_publications/2995

Source Citation

Atwood, K., Shackleford, T., Lemons, W., Eicher, J. L., Lindsey, B. A., & Klein, A. E. (2021). Postdischarge Opioid Use after Total Hip and Total Knee Arthroplasty. Arthroplasty Today, 7, 126–129. https://doi.org/10.1016/j.artd.2020.12.021

Comments

© 2020 The Authors. Published by Elsevier Inc. on behalf of The American Association of Hip and Knee Surgeons. Creative Commons Attribution – NonCommercial – NoDerivs (CC BY-NC-ND 4.0) | How you can reuse.

This article received support from the WVU Libraries' Open Access Author Fund.