Evidence map›Paper›PMID 36806032›Full record

ArticleJournal of experimental orthopaedics2023

A modern multimodal pain protocol eliminates the need for opioids for most patients following total knee arthroplasty: results from a retrospective comparative cohort study.

Leland van Deventer, Amy Bronstone, Claudia Leonardi, Matthew Bennett, Peter Yager, Vinod Dasa

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Journal of experimental orthopaedics, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
2.9field-weighted citation impact, top 10% of its field
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

6 citing papers in PubMed, 9 citations in OpenAlex.

  1. Impact of an Opioid Avoidance Protocol for ACL Reconstruction: A Pilot Sequential Cohort Study.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2026
    Article
  2. Article
  3. Article
  4. Article
  5. Review
  6. Persistent Opioid Use Following Major Orthopedic Surgery.Current pain and headache reports · 2025
    Review
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

6 authors at 2 institutions in 1 country.

Leland van DeventerSchool of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Amy BronstoneDepartment of Orthopaedic Surgery, Louisiana State University Health Sciences Center, 1542 Tulane Avenue, Box T6-7, New Orleans, LA, 70112, USA.
Claudia LeonardiSchool of Public Health, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Matthew BennettSchool of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Peter YagerSchool of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA.
Vinod DasaSchool of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA. vdasa@lsuhsc.edu.ORCID http://orcid.org/0000-0001-5282-4026
Louisiana State University · USLouisiana State University Health Sciences Center New Orleans · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeModern multimodal analgesia has been shown to significantly reduce opioid use following total knee arthroplasty (TKA). This study was conducted to determine if changing TKA discharge opioid prescriptions from automatic to upon request resulted in more opioid free recoveries without compromising pain control.

methodsBetween December 2019 and August 2021, an orthopedic surgeon performed 144 primary unilateral TKAs; patients received the same multimodal analgesia protocol except for postoperative opioid prescribing. The first consecutively-treated cohort automatically received an opioid prescription following discharge (automatic group) and the second cohort received opioid prescriptions only upon request (upon request group). Opioid prescription data were derived from a prescription monitoring program and patient-reported outcomes (PROs) were collected preoperatively and at 2 and 12 weeks postoperatively.

resultsA higher percentage of the upon request group was opioid free 3 months after TKA compared with the automatic group (55.6% vs 4.3%, p < 0.0001) without compromising pain or function. Among opioid-naïve patients, 72% in the upon request group were opioid free after TKA compared with 5.4% in the automatic group. Opioid prescribing was not significantly reduced among opioid-experienced patients regardless of the pain protocol.

conclusionRequiring patients to request opioid prescriptions following TKA resulted in a higher rate of opioid free TKA, especially among opioid-naïve patients, without increasing pain compared with offering all patients an initial opioid prescription. LEVEL OF EVIDENCE: Level III.

Indexed as

Multimodal analgesiaOpioidsPainRetrospective cohort studyTotal knee arthroplasty

Identifiers

PMID36806032
PMCPMC9940069
OpenAlexW4321374697

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.