SynthesisArthritis care & research2021
Is There Any Role for Opioids in the Management of Knee and Hip Osteoarthritis? A Systematic Review and Meta-Analysis.
Synthesis in Arthritis care & research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled 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.
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.
Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 42 citations in OpenAlex.
- Impact of treatment duration on the effectiveness of opioid analgesia: a systematic review and meta-analysis.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026Pooled it
- Article
- Baseline pain medication is associated with longer duration of high adherence in a three-month digital treatment program for hip and knee osteoarthritis.Osteoarthritis and cartilage open · 2026Article
- The Link Between Depression, Analgesia Usage and Function in Osteoarthritis: A Propensity Score-Matched Analysis from the Osteoarthritis Initiative Cohort.Bioengineering (Basel, Switzerland) · 2026Article
- Red Algae Alters Expression of Inflammatory Pathways in an OsteoarthritisPharmaceuticals (Basel, Switzerland) · 2025Article
- Recent advances in the management of knee osteoarthritis: a narrative review.Frontiers in medicine · 2025Review
- Literature Review to Understand the Burden and Current Non-surgical Management of Moderate-Severe Pain Associated with Knee Osteoarthritis.Rheumatology and therapy · 2024Review
- Short-Term Opioid Treatment of Acute Locomotor Pain in Older Adults: Comparison of Effectiveness and Safety between Tramadol and Oxycodone: A Randomized Trial.Geriatrics (Basel, Switzerland) · 2024Article
- Model-Based Meta-Analysis Supporting the Combination of Acetaminophen and Topical Diclofenac in Acute Pain: A Therapy for Mild-to-Moderate Osteoarthritis Pain?Pain and therapy · 2024Article
- Effect of 4 weeks vs 8 weeks of acupuncture for knee osteoarthritis in China: protocol for a randomised controlled trial.BMJ open · 2024Article
- Opioids for Osteoarthritis: Cross-Sectional Survey of Patient Perspectives and Satisfaction.Journal of clinical medicine · 2023Article
- Opioid Prescribing for Osteoarthritis: Cross-Sectional Survey among Primary Care Physicians, Rheumatologists, and Orthopaedic Surgeons.Journal of clinical medicine · 2023Article
- Overview of Anti-Inflammatory and Anti-Nociceptive Effects of Polyphenols to Halt Osteoarthritis: From Preclinical Studies to New Clinical Insights.International journal of molecular sciences · 2022Review
- Does Pain Medication Use Influence the Outcome of 8 Weeks of Education and Exercise Therapy in Patients with Knee or Hip Osteoarthritis? An Observational Study.Pain medicine (Malden, Mass.) · 2022Observational
- Primary care consultations and pain medicine prescriptions: a comparison between patients with and without chronic pain after total knee replacement.BMC musculoskeletal disorders · 2022Article
- Conservative treatment of knee osteoarthritis: A review of the literature.World journal of orthopedics · 2022Review
- Consensus Guidelines on Interventional Therapies for Knee Pain (STEP Guidelines) from the American Society of Pain and Neuroscience.Journal of pain research · 2022Review
- The burden of hip and knee osteoarthritis in Finnish occupational healthcare.BMC musculoskeletal disorders · 2021Article
- Comprehensive Review of Knee Osteoarthritis Pharmacological Treatment and the Latest Professional Societies' Guidelines.Pharmaceuticals (Basel, Switzerland) · 2021Review
- Intra-articular Hyaluronic Acid for Osteoarthritis of the Knee in the United States: A Systematic Review of Economic Evaluations.Clinical medicine insights. Arthritis and musculoskeletal disorders · 2021Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 2 institutions in 2 countries.
Funding
Abstract
objectiveOpioids have long been prescribed for chronic pain conditions, including osteoarthritis (OA). However, there is little information about their temporal efficacy, or differences in efficacy and safety between opioids with strong versus weak/intermediate μ opioid receptor-binding affinity. To explore these research questions, we conducted a systematic review and meta-analyses of randomized controlled trials (RCTs) conducted in patients with knee and/or hip OA.
methodsWe searched Medline, Embase, PubMed Central, and the Cochrane Central Register of Controlled Trials from inception to December 2019 and sought unpublished data. Placebo-controlled RCTs of oral opioids in patients with knee and/or hip OA were included. Standardized mean differences (SMDs) were calculated for pain and function at 2, 4, 8, and 12 weeks. Subgroup analyses for strong and weak/intermediate opioids were conducted. Meta-regression was performed to assess the impact of dosage (morphine equivalency) on pain relief. Risk ratios were calculated for safety at the final follow-up.
resultsA total of 18 RCTs (9,283 participants) were included. Opioids demonstrated small benefits on pain at each time point, with SMDs ranging from -0.28 (95% confidence interval [95% CI] -0.38, -0.17) to -0.19 (95% CI -0.29, -0.08); similar effects were observed for function. Strong opioids demonstrated consistently inferior efficacy and overall worse safety than weak/intermediate opioids. Meta-regression revealed that incremental pain relief achieved beyond 20-50-mg doses was not substantial in the context of increased safety risks.
conclusionOpioids provide minimal relief of OA symptoms within a 12-week period, and they are known to cause discomfort in a majority of patients. Clinicians and policy makers should reconsider the utility of opioids in the management of OA.
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What OpenQuestion holds
Registered trials
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.