Evidence map›Paper›PMID 42839279›Full record

ArticleBMC musculoskeletal disorders2026

Risk factors for long-term analgesic prescription after hip or knee arthroplasty for osteoarthritis: results of a multivariable regression analysis based on health insurance claims data from 137,875 patients with postoperative inpatient rehabilitation.

Caroline Schmuker, Kristin Kieselbach, Vanessa Kaiser, Urs A Fichtner, Christian Günster

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Article in BMC musculoskeletal disorders, 2026. 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

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Caroline SchmukerInstitute of General Practice and Family Medicine, Jena University Hospital, Friedrich Schiller University Jena, Bachstraße 18, Jena, 07743, Germany. caroline.schmuker@wido.bv.aok.de.
Kristin KieselbachInterdisciplinary Pain Center, Medical Center University Freiburg, Lehener Str. 86, Freiburg, 79106, Germany.
Vanessa KaiserInstitute of Medical Biometry and Statistics, Medical Faculty and Medical Center, Section of Health Care Research and Rehabilitation Research, University of Freiburg, Hugstetter Str. 49, Freiburg, 79106, Germany.
Urs A FichtnerInstitute of Medical Biometry and Statistics, Medical Faculty and Medical Center, Section of Health Care Research and Rehabilitation Research, University of Freiburg, Hugstetter Str. 49, Freiburg, 79106, Germany.
Christian GünsterAOK Research Institute, Rosenthaler Str. 31, Berlin, 10178, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundContinued analgesic prescription after elective total hip arthroplasty (THA) or total knee arthroplasty (TKA) indicates persistent pain and increases the risk of adverse drug reactions, particularly in older patients or those with chronic conditions. The aim of this study was to identify independent risk factors for long-term analgesic prescription in patients who have undergone arthroplasty followed by inpatient orthopaedic rehabilitation.

methodsThe study is based on nationwide claims data from Germany's largest statutory health insurance provider (AOK) for the period from 2020 to 2024. Potential risk factors included demographic characteristics as well as factors related to the hospital stay/surgery and outpatient treatment in the 12 months prior to surgery. Adjusted odds ratios (OR) were calculated using a multivariable logistic regression model. In addition, we examined the extent to which model performance, measured by the area under the curve (AUC), improved when an additional variable category was included.

resultsThe strongest association with long-term analgesic prescription after arthroplasty was observed for intensive use of analgesics in the year prior to surgery, which showed a more than sixfold increase in the odds (THA: OR 6.7; TKA: OR 7.5). A higher care dependency level, substance use disorders, a high BMI (≥ 40 kg/m

conclusionThe results of this observational study based on a large nationwide database may provide valuable clinical insights and establish a robust framework for future confirmatory trials.

trial registrationNot applicable. This study is a retrospective analysis of routinely collected billing data and does not involve health interventions.

Indexed as

AnalgesicsArthroplasty, Replacement, HipArthroplasty, Replacement, KneeOsteoarthritis, HipOsteoarthritis, KneePostoperative PainAgedAged, 80 and overDrug PrescriptionsFemaleGermanyHumansInpatientsMaleMiddle AgedMultivariate AnalysisAnalgesicsArthroplastyBilling dataJoint replacementPain medicationPredictorsReal-world evidenceRehabilitation

Identifiers

PMID42839279
PMCPMC13640226

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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.