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Preoperative Opioid Use in Knee Surgery Patients
Sean J Meredith1, Vidushan Nadarajah1,2, Julio J Jauregui1
1Department of Orthopaedics, University of Maryland School of Medicine, Baltimore, Maryland.
The Journal of Knee Surgery
|July 11, 2018
Summary
Preoperative opioid use in knee surgery patients is linked to poorer outcomes and psychological factors. Identifying these predictors can improve patient care and surgical expectations.
Area of Science:
- Orthopedic Surgery
- Pain Management
- Psychological Medicine
Background:
- Opioid use is prevalent in patients undergoing knee surgery.
- Factors influencing preoperative opioid use and their impact on outcomes require further investigation.
Purpose of the Study:
- To identify demographic, diagnostic, and psychological factors associated with opioid use in knee surgery patients.
- To determine the clinical correlates and patient-reported outcome (PRO) measures associated with preoperative opioid use.
Main Methods:
- Cross-sectional analysis of 383 knee surgery patients.
- Classification of patients into opioid and non-opioid users based on medical records.
- Assessment using Patient-Reported Outcomes Measurement Information System (PROMIS) in six domains.
Main Results:
- Opioid use was associated with female gender, unemployment, smoking, higher American Society of Anesthesiologists (ASA) scores, prior surgeries, and psychological distress (anxiety, depression).
- Preoperative opioid use independently predicted worse PRO measures, including physical function, pain interference, fatigue, and social satisfaction.
- Worse expectations of surgical outcomes were also linked to preoperative opioid use.
Conclusions:
- Preoperative opioid use in knee surgery patients is associated with a distinct set of demographic, psychological, and clinical factors.
- Opioid use is a significant predictor of poorer patient-reported outcomes following knee surgery.
- Understanding these associations can inform targeted interventions and improve preoperative patient counseling to manage expectations.
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