Evidence map›Paper›PMID 35608692›Full record

ArticleEuropean journal of orthopaedic surgery & traumatology : orthopedie traumatologie2023

Impact of preoperative opioid use on patient-reported outcomes following primary total knee arthroplasty.

Vivek Singh, Benjamin Fiedler, Chelsea Sue Sicat, Andrew S Bi, James D Slover, William J Long, Ran Schwarzkopf

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Article in European journal of orthopaedic surgery & traumatology : orthopedie traumatologie, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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7 authors.

Vivek SinghDepartment of Orthopedic Surgery, NYU Langone Health, 301 East 17 th Street , New York, NY, 10003, USA.ORCID http://orcid.org/0000-0003-2450-1785
Benjamin FiedlerDepartment of Orthopedic Surgery, NYU Langone Health, 301 East 17 th Street , New York, NY, 10003, USA.
Chelsea Sue SicatDepartment of Orthopedic Surgery, NYU Langone Health, 301 East 17 th Street , New York, NY, 10003, USA.
Andrew S BiDepartment of Orthopedic Surgery, NYU Langone Health, 301 East 17 th Street , New York, NY, 10003, USA.
James D SloverDepartment of Orthopedic Surgery, NYU Langone Health, 301 East 17 th Street , New York, NY, 10003, USA.
William J LongDepartment of Orthopedic Surgery, NYU Langone Health, 301 East 17 th Street , New York, NY, 10003, USA.
Ran SchwarzkopfDepartment of Orthopedic Surgery, NYU Langone Health, 301 East 17 th Street , New York, NY, 10003, USA. Ran.Schwarzkopf@nyulangone.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe previous literature suggests that 25-30% of patients who undergo total knee arthroplasty (TKA) are using opioids prior to their surgery. This study aims to investigate the effect of preoperative opioid use on clinical outcomes and patient-reported outcome measures (PROMs) following TKA.

methodsWe retrospectively reviewed 329 patients who underwent primary TKA from 2019 to 2020, answered the preoperative opioid survey, and had available PROMs. Patients were stratified into two groups based on whether they were taking opioids preoperatively or not: 26 patients with preoperative opioid use (8%) and 303 patients without preoperative opioid use (92%) were identified. Demographics, clinical data, and PROMs [Forgotten Joint Score (FJS-12), Knee Injury and Osteoarthritis Outcome Score for Joint Replacement (KOOS, JR), and Veterans RAND-12 Physical and Mental components (VR-12 PCS and MCS)] were collected. Demographic differences were assessed with Chi-square and independent sample t-tests. Outcomes were compared using multilinear regression analysis, controlling for demographic differences.

resultsPreoperative opioid users had a significantly longer length-of-stay (2.74 vs. 2.10; p = 0.010), surgical time (124.65 vs. 105.69; p < 0.001), and were more likely to be African-American (38.5 vs. 14.2%; p = 0.010) compared to preoperative opioid-naive patients. Postoperative FJS-12 did not statistically differ between the two groups. While preoperative KOOS, JR scores were significantly lower for preoperative opioid users (41.10 vs. 46.63; p = 0.043), they did not significantly differ postoperatively. Preoperative VR-12 PCS did not statistically differ between the groups; however, both 3-month (33.87 vs. 38.41; p = 0.049) and 1-year (36.01 vs. 44.73; p = 0.043) scores were significantly lower for preoperative opioid users. Preoperative VR-12 MCS was significantly lower for preoperative opioid users (46.06 vs. 51.06; p = 0.049), though not statistically different postoperatively.

conclusionAt 8%, our study population had a lower percentage of opioid users than previously reported in the literature. Preoperative opioid users had longer operative times and length of stay compared to preoperatively opioid-naive patients. While both cohorts achieved similar clinical benefits following TKA, preoperative opioid users reported lower postoperative scores with respect to VR-12 PCS scores. LEVEL III EVIDENCE: Retrospective Cohort.

Indexed as

Arthroplasty, Replacement, KneeOpioid-Related DisordersOsteoarthritis, KneeAnalgesics, OpioidHumansKnee JointPatient Reported Outcome MeasuresRetrospective StudiesTreatment OutcomeAnalgesics, OpioidOpioidsOutcomesPatient-reported outcome measuresTotal knee arthroplasty

Identifiers

PMID35608692

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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.