Opioid Use – Bad Idea Before Replacement Surgery

Hold the opioids. Two new studies have revealed that decreased opioid use prior to joint replacement surgery has been linked with improved patient satisfaction and outcomes. Patients who followed the reduced protocol experienced fewer complications and reduced their need for post-surgical opioids.

As reported in the publication CanIndia News, in the first study, researchers reviewed insurance data for 84, 685 patients between 2007 and 2014. Using condition and disease codes, researchers identified patients undergoing total knee replacement (TKR), their comorbidities, the prescriptions they filled and their 90-day outcomes. They found that 49, 617 patients, nearly 59%, did not use opioids prior to their surgery. The remaining 41.4% did. The top three prescribed opioids were hydrocodone/acetaminophen, oxycodone/acetaminophen, and oxycodone.

Nicholas Bedard, M.D. from the University of Iowa Hospitals and Clinics and lead study author said, “This study found that within the three months prior to TKR, approximately one-third of patients were taking opioids.”

And the result? “Pre-operative opioid users had continued and prolonged opioid use following TKR compared to non-opioid users. These patients also had more comorbidities and higher rates of post-operative complications compared to non-opioid users, ” Bedard said.

The second study produced similar results. Kevin Bozic, M.D., MBA from the University of Texas at Austin told the CanIndia writer, “In opioid users, the study showed that a 50% or greater preoperative reduction of opioid use leads to better patient outcomes. We recommend that chronic opioid users who are considering hip or knee replacement reduce their use of opioids prior to considering elective surgery.”

Both the studies were presented at the 2016 Annual Meeting of the American Academy of Orthopaedic Surgeons in Orlando, Florida.