Prospective cohort study of opioid use after total knee arthroplasty in a single center

Fewer opioids prescribed for postoperative pain may help reduce the number of surplus opioids available in the community and decrease the risk of opioid dependence. Published data on patients' opioid use after total knee arthroplasty (TKA) are limited.

This was a prospective study designed to characterize opioid use after TKA. Patients who have undergone TKA and met inclusion criteria were recruited to complete a survey after orthopedic surgeon follow-up appointments approximately 2 and 6 weeks postoperatively. Questions included satisfaction with pain management strategies, type and quantity of medication prescribed, and quantity of leftover medication. Additional data on opioid use and baseline characteristics were determined through chart review.

A total of 60 patients completed surveys after TKA. All patients spent at least 1 night in the hospital or skilled nursing facility with an average length of stay of 1.2 days and an average consumption of 5.2 tablets of oxycodone 5 mg equivalents. After discharge, the mean number of oxycodone 5 mg tablet equivalents prescribed in the initial prescription was 38.6, with an average of 72.6 prescribed over 6 weeks. Patients reported an average of 15.7 unused oxycodone 5 mg tablet equivalents.

These results could help guide the development of TKA-specific opioid prescribing guidelines and confirm that patients are generally prescribed more opioids than they consume.