Limited preoperative opioid use lowers pain scores post-TKA

A study, published in The Journal of Bone and Joint Surgery, examined how opioid use impacted total knee arthroplasty outcomes.

Savannah Smith, a MD candidate at Boston-based Brigham and Women's Hospital, and colleagues examined pain relief in total knee arthroplasty patients who did not use opioids preoperatively.

Researchers augmented data from a study of TKA outcomes with opioid-use data taken from medical records. Researchers collected patient-reported outcomes before and six months after a TKA procedure. In total, researchers analyzed data from 156 patients with a mean age of 65.7 and a mean body mass index of 31.1 kg/m2. Female patients made up 62.2 percent of the cohort.

Preoperatively, 36 patients had at least one opioid prescription. Mean baseline Western Ontario and McMaster Universities Osteoarthritis Index scores were 43 point s for the group who had not used opioids and 46.9 for the group that had. Mean Preoperative Pain Catastrophizing Scale scores were also greater in the opioid group.

In the six months following, the opioid group reduced their WOMAC scores by 27 points, while the nonopioid group reduced their pain scores by 33.6 points.

Researchers concluded, "Patients who used opioids prior to TKA obtained less pain relief from the operation. Clinicians should consider limiting pre-TKA opioid prescriptions to optimize the benefits of TKA."

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