Patients who use opioids before an elective joint replacement surgery may have an increased risk of repeat surgery or hospitalization, according to a new published in The Journal of Bone and Joint Surgery.
Hue Luu, MD, associate professor of orthopaedic surgery and associate director of the molecular oncology lab at the University of Chicago, and colleagues analyzed 233,000 patients who underwent a total knee replacement and 91,000 patients who had a total hip replacement in the U.S. between 2003 and 2014. They also looked at one year of follow-up data for all of the patients and three years follow-up data for 160,000 patients from the study.
Researches found more than half of the hip and knee replacement patients had one or more opioid prescriptions filled in the six months prior to their respective surgeries. They also found rates of prolonged preoperative opioid use, used for more than 60 days, was 16 percent for knee replacement patients and 19 percent for hip replacement patients.
Hospital readmissions rates in knee replacement patients were 4.8 percent among patients who did not take opioids prior to surgery and 6.2 percent among patients who did take painkillers in the 60 days leading up to their surgery. Among the hip replacement patients, hospital readmission rates were 3.7 percent for those who did not take opioids before surgery and 5.8 percent for those who did.
After one year, repeat knee surgery rates doubled in the long-term opioid group, where about 1 percent did not take painkillers before surgery and 2.1 percent took oxycodone more than 60 days prior. Within the hip replacement group, repeat surgery rates were 0.39 percent and 1.1 percent, respectively.
After three years, hospital readmission and repeat surgery risk was higher among patients who used opioids for greater than a month before their respective surgeries.
"[B]oth readmissions and additional revision surgeries add to the cost of healthcare and are often physically and emotionally challenging for our patients," Dr. Luu said in a journal press release. "As physicians, we can help our patients and the healthcare system by reducing or eliminating preoperative opioid use in hip and knee replacement patients."
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