Decreased opioid use prior to joint replacement surgery has been linked with improved patient satisfaction and outcomes, fewer complications and a reduced need for post-surgical opioids, according to two new studies.
In the first study, researchers reviewed insurance data for 84,685 patients between 2007 and 2014. Patients undergoing total knee replacement (TKR), their comorbidities, prescriptions and 90-day outcomes were identified using condition/disease codes.
They found nearly 59 percent of the patients (49,617) did not use opioids prior to surgery, while 41.4 percent did. The top three prescribed opioids were hydrocodone/acetaminophen, oxycodone/acetaminophen, and oxycodone.
"This study found that within the three months prior to TKR, approximately one-third of patients are taking opioids," said Nicholas Bedard from the University of Iowa Hospitals and Clinics and lead study author.
"Pre-operative opioid users had continued and prolonged opioid use following TKR compared to non-opioid users. These patients also had more comorbidities and higher rates of post-operative complications compared to non-opioid users," Bedard added.
The second study, found similar results in a smaller number of patients undergoing TKR or total hip replacement surgery (THR).
"In opioid users, the study showed that a 50 percent or greater preoperative reduction of opioid use leads to better patient outcomes," said lead author Kevin Bozic from the University of Texas at Austin.
"We recommend that chronic opioid users who are considering hip or knee replacement work with their primary care physician or pain management team to reduce their use of opioids prior to considering elective surgery," Bozic said.
Both the studies were presented recently at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando, Florida.