Use of opioids before a total knee replacement can help predict increased opioid refills after the procedure, according to study results presented at the American Academy of Orthopaedic Surgeons 2017 Annual Meeting, March 14 to March 18 in San Diego.
Researchers reviewed the Humana database from 2007 to 2014 to identify TKR patients. They defined a preoperative opioid user as one who had used opioids within three months of the surgery. They measured postoperative opioid use by using monthly prescription refill rates. In total, 73,959 patients were included in the study. Of these, 31.2 percent were preoperative opioid users.
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Preoperative opioid use was the strongest predictor for prolonged opioid use following TKR. Opioid users were 1.6, 3 and 4.9 times more likely to be filling an opioid prescription at one, two and three months postoperatively, respectively.
Additionally, being younger, female and suffering from anxiety/depression also increased the likelihood of higher rates of opioid use after TKR surgery. Patients with anxiety/depression were 1.7 times more likely to fill an opioid prescription at two to three months, postoperatively.
The study also found that the percentage of TKR patients who used opioids within the three months prior to surgery increased by 9 percent over the study period.
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