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Opioid Prescriptions After Total Joint Arthroplasty.

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Area of Science:

  • Orthopedic Surgery
  • Pain Management
  • Pharmacology

Background:

  • Opioid analgesics are frequently prescribed for pain management following total joint arthroplasty (TJA).
  • Limited data exists regarding the specific quantities of opioids prescribed post-TJA.

Purpose of the Study:

  • To quantify and analyze the volume of opioid prescriptions issued after total knee arthroplasty (TKA) and total hip arthroplasty (THA).
  • To compare opioid prescription patterns between TKA and THA patients.
  • To investigate the impact of pre-operative opioid exposure on post-operative prescribing.

Main Methods:

  • Retrospective review of 1000 TJA cases (TKA and THA) between April 2014 and September 2015.
  • Quantification of opioid prescriptions using standardized morphine milligram equivalents (MME).
  • Categorization of patients into opioid-naïve and non-opioid-naïve groups.

Main Results:

  • A significant proportion of patients were opioid-naïve: 84% for TKA and 77% for THA.
  • Median initial opioid prescription volume was higher for TKA (600 MME) than THA (450 MME).
  • Patients not opioid-naïve received substantially higher opioid volumes post-surgery for both TKA and THA (p < .001).

Conclusions:

  • Opioid prescription volumes vary significantly after TJA, with TKA generally requiring higher initial and total amounts.
  • Pre-operative opioid use is a critical factor influencing post-operative opioid prescription quantities.
  • Strategies to decrease pre-operative opioid utilization may reduce overall post-TJA opioid prescribing.