Evidence map›Paper›PMID 40697893›Full record

ArticleArthroplasty today2025

Site of Service Changes Have Resulted in Increased Opioid Prescriptions for Primary Total Hip and Knee Patients in Michigan, a Michigan Arthroplasty Registry Collaborative Quality Initiative Quality Study.

Harjot Uppal, David Markel, Giresse Melone, Simarjeet Puri, Lisheng Chen, Tae Kim, Brian Hallstrom, Richard Hughes, Elizabeth Dailey

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Article in Arthroplasty today, 2025. 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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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

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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

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0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Harjot UppalSection of Orthopaedic Surgery, Henry Ford Providence Hospital, Southfield, MI, USA.
David MarkelSection of Orthopaedic Surgery, Henry Ford Providence Hospital, Southfield, MI, USA.
Giresse MeloneDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Simarjeet PuriSection of Orthopaedic Surgery, Henry Ford Providence Hospital, Southfield, MI, USA.
Lisheng ChenMichigan Arthroplasty Registry Collaborative Quality Initiative, Ann Arbor, MI, USA.
Tae KimDepartment of Surgery and Biomedical Engineering, University of Michigan, Ann Arbor, MI.
Brian HallstromDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Richard HughesDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.
Elizabeth DaileyDepartment of Orthopaedic Surgery, University of Michigan, Ann Arbor, MI, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: The Michigan Arthroplasty Registry Collaborative Quality Initiative (MARCQI) successfully changed opioid prescribing patterns by instituting guidelines for total hip (THAs) and knee arthroplasties (TKAs). Given Medicare changes, cases are moving to ambulatory surgery centers (ASCs) and hospital outpatient departments (HOPDs). We aimed to assess whether these sites adopted the well-proven opioid recommendations. Methods: Using data from the Michigan Arthroplasty Registry Collaborative Quality Initiative, all opioid-naïve (no prescription within 30 days) patients undergoing primary total joint arthroplasty between July 1, 2021, and June 30, 2022, were identified. Of the 12,962 THAs: 11.0% (1425) were in ASCs, 5.2% (674) in HOPDs, and 84% (10,863) in hospitals. Of the 20,092 primary TKAs: 10.3% (2064) were in ASCs, 4.5% (906) in HOPDs, and 85.2% (17,122) in hospitals. Results: The cohorts were statistically different, with unhealthier patients within the hospital population. For THAs and TKAs, ASCs had the highest mean oral morphine equivalents at discharge, 239 (±109.9) and 307.4 (±151.9), compared to hospitals and HOPDs ( Conclusions: ASC and HOPDs patients are selected for the ability to be discharged home. Yet opioid-naïve total joint arthroplasty patients at Michigan ASCs received more opioids at discharge compared to patients undergoing the same procedures at HOPDs and hospitals.

Indexed as

Ambulatory surgery centersOpioidsOutpatient surgeryPain managementPrimary total joint arthroplasty

Identifiers

PMID40697893
PMCPMC12280335

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