Opioid Prescription Patterns Following Zone II Flexor Tendon Repairs: A National Database Study

The opioid epidemic continues to be a major public health concern, with postoperative-opioid prescriptions contributing to side effects and long-term use/dependency. Given the evolving landscape of opioid prescription and use, the current study sought to investigate opioid prescribing patterns following zone II flexor tendon repairs (FTRs), and to identify factors correlating with opioid use over the 90-day postoperative period.

Using the 2010-2020 M165Ortho PearlDiver Mariner Patient Claims Database, patients undergoing primary zone II FTRs were identified. Exclusion criteria were patients with prior opioid use or concurrent injuries. Demographic, clinical, and opioid prescription data were analyzed using multivariate linear analysis to assess trends in opioid use and factors correlating with prescribing patterns over the 90-day postoperative period.

Of 19,574 patients, opioids were prescribed for 72.1% (14,117). Over the years of the study, the precent receiving opioids remained similar, but of those receiving opioids, the number of prescriptions declined and morphine milligram equivalents (MMEs) declined. Factors associated with MMEs prescribed included older age, male sex, higher comorbidity, and geographic region.

Despite a decline in opioid quantity per patient, most patients still receive opioids after zone II FTR. Demographic factors associated with MMEs prescribed may suggest different needs for different cohorts, but regional factors suggest room for more consistent pain management strategies.

This study highlights persistent opioid prescribing after zone II FTR, despite a decline in prescriptions and dosage per patient over time, and identifies factors that may guide more consistent, targeted pain management.

Retrospective cohort study (administrative claims database study).

Level 2b.