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Trends and risk factors for prolonged opioid use after unicompartmental knee arthroplasty.

Abstract The purpose of this study was to evaluate trends in opioid use after unicompartmental knee arthroplasty (UKA), to identify predictors of prolonged use and to compare the rates of opioid use after UKA, total knee arthroplasty (TKA) and total hip arthroplasty (THA).
PMID
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Trends and predictors of opioid use after total knee and total hip arthroplasty.

Authors

Mayor MeshTerms

Arthroplasty, Replacement, Knee

Hemiarthroplasty

Keywords

Arthroplasty

Opioid

Journal Title the bone & joint journal
Publication Year Start




PMID- 29292342
OWN - NLM
STAT- MEDLINE
DCOM- 20180104
LR  - 20180104
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 1 Supple A
DP  - 2018 Jan
TI  - Trends and risk factors for prolonged opioid use after unicompartmental knee
      arthroplasty.
PG  - 62-67
LID - 10.1302/0301-620X.100B1.BJJ-2017-0547.R1 [doi]
AB  - AIMS: The purpose of this study was to evaluate trends in opioid use after
      unicompartmental knee arthroplasty (UKA), to identify predictors of prolonged use
      and to compare the rates of opioid use after UKA, total knee arthroplasty (TKA)
      and total hip arthroplasty (THA). MATERIALS AND METHODS: We identified 4205
      patients who had undergone UKA between 2007 and 2015 from the Humana Inc.
      administrative claims database. Post-operative opioid use for one year
      post-operatively was assessed using the rates of monthly repeat prescription.
      These were then compared between patients with and without a specific variable of
      interest and with those of patients who had undergone TKA and THA. RESULTS: A
      total of 4205 UKA patients were analysed. Of these, 1362 patients (32.4%) were
      users of opioids. Pre-operative opioid use was the strongest predictor of
      prolonged opioid use after UKA. Opioid users were 1.4 (81.6% versus 57.7%), 3.7
      (49.5% versus 13.3%) and 5.5 (35.8% versus 6.5%) times more likely to be taking
      opioids at one, two and three months post-operatively, respectively (p < 0.05 for
      all). Younger age and specific comorbidities such as anxiety/depression, smoking,
      back pain and substance abuse were found to significantly increase the rate of
      repeat prescription for opioids after UKA. Overall, UKA patients required
      significantly less opioid prescriptions than patients who had undergone THA and
      TKA. CONCLUSION: One-third of patients who undergo UKA are given opioids in the
      three months pre-operatively. Pre-operative opioid use is the best predictor of
      increased repeat prescriptions after UKA. However, other intrinsic patient
      characteristics are also predictive. Cite this article: Bone Joint J 2018;100-B(1
      Supple A):62-7.
CI  - (c)2018 The British Editorial Society of Bone & Joint Surgery.
FAU - Bedard, N A
AU  - Bedard NA
AD  - University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
FAU - DeMik, D E
AU  - DeMik DE
AD  - University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
FAU - Dowdle, S B
AU  - Dowdle SB
AD  - University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
FAU - Callaghan, J J
AU  - Callaghan JJ
AD  - University of Iowa, 200 Hawkins Drive, Iowa City, IA 52242, USA.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
RN  - 0 (Analgesics, Opioid)
SB  - AIM
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Analgesics, Opioid/*therapeutic use
MH  - Arthroplasty, Replacement, Hip
MH  - *Arthroplasty, Replacement, Knee
MH  - Databases, Factual
MH  - Drug Utilization/statistics & numerical data/*trends
MH  - Female
MH  - *Hemiarthroplasty
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pain, Postoperative/*drug therapy
MH  - Risk Factors
MH  - Time Factors
OTO - NOTNLM
OT  - Arthroplasty
OT  - Opioid
EDAT- 2018/01/03 06:00
MHDA- 2018/01/05 06:00
CRDT- 2018/01/03 06:00
PHST- 2017/05/05 00:00 [received]
PHST- 2017/06/20 00:00 [accepted]
PHST- 2018/01/03 06:00 [entrez]
PHST- 2018/01/03 06:00 [pubmed]
PHST- 2018/01/05 06:00 [medline]
AID - 100-B/1_Supple_A/62 [pii]
AID - 10.1302/0301-620X.100B1.BJJ-2017-0547.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Jan;100-B(1 Supple A):62-67. doi:
      10.1302/0301-620X.100B1.BJJ-2017-0547.R1.