ArticleActa orthopaedica2025
10-year trends in benzodiazepine, opioid, and concurrent use in hip and knee arthroplasty: a nationwide cohort study from the Netherlands.
Article in Acta orthopaedica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Factors Associated With Concurrent Benzodiazepine and Opioid Use Following Total Hip and Knee Arthroplasty: A Nationwide Cohort Study.Pharmacoepidemiology and drug safety · 2026Article
- Association of benzodiazepine and opioid use with hip fracture treated with arthroplasty: a nationwide case-control study.BMC geriatrics · 2026Article
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Authors and funding
7 authors.
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Abstract
background and purposeConcurrent benzodiazepine-opioid use is discouraged. We aimed to examine trajectories of benzodiazepine, opioid, and concurrent use following hip and knee arthroplasties for osteoarthritis (HA-OA, KA) and hip arthroplasty for fracture (HA-fracture).
methodsIn this nationwide cohort study, the Dutch Arthroplasty Register (LROI) was linked to the Dutch Foundation for Pharmaceutical Statistics (SFK). We evaluated the proportion of patients with ≥ 1 medication dispensation in the year pre- and post-procedure and the prescribing physicians. Concurrent use was defined as ≥ 7 days overlap of benzodiazepine and opioid exposure.
resultsWe included 109,238 HA-OA, 17,464 HA fracture, and 113,306 KA. Between 2013 and 2021, the risk difference of postoperative benzodiazepine use was -7.2% (95% confidence interval [CI] -8.1 to -6.2%), while postoperative opioid use increased by 29.7% (CI 28.5-30.8%). Among HA-OA, from 2013 (4,391 arthroplasties) to 2021 (12,905 arthroplasties), the percentage of preoperative benzodiazepine users went from 18% to 13%, and postoperative from 23% to 14%. In contrast, preoperative opioid use changed from 25% to 33% and postoperative from 36% to 69%, In 2021, 6% of HA-OA, 11% of HA fracture, and 9% of KA received a concurrent dispensation in the first post-procedure year, predominantly in the first quarter. Orthopedic surgeons prescribed 29% (~18,732 prescriptions) of initial concurrent dispensations; subsequent prescriptions were mainly from general practitioners.
conclusionFrom 2013-2022 in the Netherlands, benzodiazepine use decreased while opioid use increased among arthroplasty patients. Concurrent use remained frequent, despite safety recommendations against co-prescribing.
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