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Opioid Use Patterns After Total Joint Arthroplasty.

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Most patients stop opioid use within 3 months after total joint arthroplasty (TJA). However, some patients, especially those with prior opioid use, may continue needing prescriptions 6 months post-surgery.

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Area of Science:

  • Orthopaedic Surgery
  • Pain Management
  • Pharmacology

Background:

  • Persistent opioid use after elective total joint arthroplasty (TJA) is not well-documented.
  • Understanding long-term opioid use patterns is crucial for patient care and managing the opioid crisis.

Purpose of the Study:

  • To characterize new persistent opioid use following TJA.
  • To identify factors associated with continued opioid prescriptions 6 months postoperatively.

Main Methods:

  • Retrospective review of 977 primary TJA procedures.
  • Opioid prescription data verified using the Surescripts database.
  • Analysis of opioid use patterns in opioid-naïve and opioid-non-naïve patients.

Main Results:

  • 3.7% of opioid-naïve and 18.0% of opioid-non-naïve patients filled opioid prescriptions at 6 months post-TJA.
  • Opioid-non-naïve patients with continued fills had significantly more preoperative fills (5.49 vs. 2.52).
  • Preoperative fills and continued fills beyond 2-3 months were associated with persistent opioid use.

Conclusions:

  • The majority of patients cease opioid use by 3 months post-TJA.
  • Prior opioid use and higher preoperative fill counts are predictors of persistent opioid use.
  • Further research into risk stratification and non-opioid pain management strategies is warranted.