ArticleBone & joint open2020
Inpatient and outpatient opioid requirements after total joint replacement are strongly influenced by patient and surgical factors.
Article in Bone & joint open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 20 citations in OpenAlex.
- Trial
- Factors driving higher opioid use after total hip arthroplasty: Insights from a large-scale, tertiary centre analysis.SICOT-J · 2026Article
- Do Medical and Recreational Marijuana State Laws Impact Trends in Postoperative Opioid Prescriptions Among Patients Who Have Undergone TJA?Clinical orthopaedics and related research · 2025Article
- Association of patient and clinical characteristics with postoperative opioid consumption following total knee arthroplasty: a single center retrospective study.Proceedings (Baylor University. Medical Center) · 2025Article
- Expectations about pain management after discharge from total hip and knee replacement surgery: a qualitative study with patients and prescribers.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
- Is a Rapid Recovery Protocol for THA and TKA Associated With Decreased 90-day Complications, Opioid Use, and Readmissions in a Health Safety-net Hospital?Clinical orthopaedics and related research · 2024Observational
- How is postoperative pain after hip and knee replacement managed? An analysis of two large hospitals in Australia.Perioperative medicine (London, England) · 2024Article
- Role of the NeuroCuple™ Device for the Postoperative Pain Management of Patients Undergoing Unilateral Primary Total Knee and Hip Arthroplasty: A Pilot Prospective, Randomized, Open-Label Study.Journal of clinical medicine · 2023Article
- Post-total joint arthroplasty opioid prescribing practices vary widely and are not associated with opioid refill: an observational cohort study.Archives of orthopaedic and trauma surgery · 2023Observational
- Reduced Narcotic Utilization in Total Joint Arthroplasty Patients in an Urban Tertiary Care Center.Arthroplasty today · 2022Article
- The Ramifications of Opioid Utilization and Outcomes of Alternative Pain Control Strategies for Total Knee Arthroplasties.Orthopedic reviews · 2022Article
- Opioid Use Consequences, Governmental Strategies, and Alternative Pain Control Techniques Following Total Hip Arthroplasties.Orthopedic reviews · 2022Review
Corrections and comments
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Authors and funding
7 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
aimsCurrently, there is no single, comprehensive national guideline for analgesic strategies for total joint replacement. We compared inpatient and outpatient opioid requirements following total hip arthroplasty (THA) versus total knee arthroplasty (TKA) in order to determine risk factors for increased inpatient and outpatient opioid requirements following total hip or knee arthroplasty.
methodsOutcomes after 92 primary total knee (n = 49) and hip (n = 43) arthroplasties were analyzed. Patients with repeat surgery within 90 days were excluded. Opioid use was recorded while inpatient and 90 days postoperatively. Outcomes included total opioid use, refills, use beyond 90 days, and unplanned clinical encounters for uncontrolled pain. Multivariate modelling determined the effect of surgery, regional nerve block (RNB) or neuraxial anesthesia (NA), and non-opioid medications after adjusting for demographics, ength of stay, and baseline opioid use.
resultsTKAs had higher daily inpatient opioid use than THAs (in 5 mg oxycodone pill equivalents: median 12.0 vs 7.0; p < 0.001), and greater 90 day use (median 224.0 vs 100.5; p < 0.001). Opioid refills were more likely in TKA (84% vs 33%; p < 0.001). Patient who underwent TKA had higher independent risk of opioid use beyond 90 days than THA (adjusted OR 7.64; 95% SE 1.23 to 47.5; p = 0.01). Inpatient opioid use 24 hours before discharge was the strongest independent predictor of 90-day opioid use (p < 0.001). Surgical procedure, demographics, and baseline opioid use have greater influence on in/outpatient opioid demand than RNB, NA, or non-opioid analgesics.
conclusionOpioid use following TKA and THA is most strongly predicted by surgical and patient factors. TKA was associated with higher postoperative opioid requirements than THA. RNB and NA did not diminish total inpatient or 90-day postoperative opioid consumption. The use of acetaminophen, gabapentin, or NSAIDs did not significantly alter inpatient opioid requirements.Cite this article:
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