Evidence map›Paper›PMID 31103029›Full record

SynthesisBMC musculoskeletal disorders2019

Preoperative opioid use is associated with worse patient outcomes after Total joint arthroplasty: a systematic review and meta-analysis.

C Michael Goplen, Wesley Verbeek, Sung Hyun Kang, C Allyson Jones, Donald C Voaklander, Thomas A Churchill, Lauren A Beaupre

Abstract readComparative StudyMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC musculoskeletal disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 107 papers, 28 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
107citing papers in PubMed, 28 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

107 citing papers in PubMed, 28 syntheses or guidelines pooled it.

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  3. Laparoscopic Versus Robot-Assisted Sacrocolpopexy: A Systematic Review and Meta-Analysis.BJOG : an international journal of obstetrics and gynaecology · 2026
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  4. Impact of Different Types of Sedentary Behaviour on Cognitive Function in Older Adults: A Systematic Review.Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals · 2026
    Pooled it
  5. Ventriculosubgaleal shunt for post-infectious hydrocephalus in pediatric patients: a systematic review.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2026
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  12. The intergenerational association of preterm birth: A systematic review and meta-analysis.BJOG : an international journal of obstetrics and gynaecology · 2025
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  15. The Worldwide Prevalence of Internet Addiction among Medical Students: A Systematic Review and Meta-Analysis.International journal of environmental research and public health · 2024
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  20. Cancer Incidence in Volcanic Areas: A Systematic Review.Asian Pacific journal of cancer prevention : APJCP · 2022
    Pooled it

47 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

C Michael GoplenDepartment of Surgery, University of Alberta, Edmonton, AB, T6G 2B7, Canada. cgoplen@ualberta.ca.
Wesley VerbeekFaculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, T6G 2R7, Canada.
Sung Hyun KangAlberta Bone and Joint Institute, Calgary, Alberta, T2N 4Z6, Canada.
C Allyson JonesDepartment of Physical Therapy, University of Alberta, Edmonton, AB, T6G 2G4, Canada.
Donald C VoaklanderSchool of Public Health, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada.
Thomas A ChurchillDepartment of Surgery, University of Alberta, Edmonton, AB, T6G 2B7, Canada.
Lauren A BeaupreDepartment of Surgery, University of Alberta, Edmonton, AB, T6G 2B7, Canada.

Funding

University of Alberta RES0039945
6 · The paper itself

Abstract

backgroundA significant number of patients use opioids prior to total joint arthroplasty (TJA) in North America and there is growing concern that preoperative opioid use negatively impacts postoperative patient outcomes after surgery. This systematic review and meta-analysis evaluated the current evidence investigating the influence of preoperative opioid use on postoperative patient-reported outcomes (PRO) after total joint arthroplasty.

methodsA systematic search was performed using Ovid, Embase, Cochrane Library, Scopus, Web of Science Core Collection, CINAHL on February 15th, 2018. Studies reporting baseline and postoperative PRO among those prescribed preoperative opioids and those who were not prior to total knee and hip arthroplasty were included. Standardized mean differences (SMD) in absolute difference and relative change in PRO measures between the two groups was calculated using random effect models.

resultsSix studies were included (n = 7356 patients); overall 24% of patients were prescribed preoperative opioids. Patients with preoperative opioid use had worse absolute postoperative PRO scores when compared to those with no preoperative opioid use (standardized mean difference (SMD) -0.53, 95% Confidence interval (CI) -0.75, - 0.32, p < 0.0001). When relative change in PRO score was analyzed, as measured by difference between postoperative and preoperative PRO scores, there was no group differences (SMD -0.26, 95% CI -0.56, 0.05, p = 0.10).

conclusionPatients prescribed preoperative opioids may attain worse overall pain and function benefits after TJA when compared to opioid-naïve patients, but do still benefit from undergoing TJA. These results suggest preoperative opioid users should be judiciously counselled regarding potential postoperative pain and function improvements after TJA.

Indexed as

Patient Reported Outcome MeasuresAnalgesics, OpioidArthroplasty, Replacement, HipArthroplasty, Replacement, KneeHumansKnee JointNorth AmericaPain MeasurementPostoperative PainPreoperative CareRecovery of FunctionTreatment OutcomeAnalgesics, OpioidOpioidsPatient-reported outcomesTotal hip arthroplastyTotal knee arthroplasty

Identifiers

PMID31103029
PMCPMC6525974

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.