Preoperative opioid users more likely to abuse opioids after TKA — 3 study insights

A study, published in The Journal of Arthroplasty, examined how preoperative opioid use affects recovery from total knee arthroplasty.

Nicholas Hernandez, MD, of Rochester, Minn.-based Mayo Clinic, and colleagues conducted a retrospective review of 53 patients on preoperative opioids who were matched 1 to 2 against a control group with no opioid use. They examined opioid refills, Knee Society Score, morphine equivalent dose prescribed and persistent opioid use postoperatively.

Here's what they found:

1. Physicians prescribed an average medication dose of 1,248 mg at discharge. Doses ranged from zero mg to 5,600 mg.

2. Average postoperative daily opioid use was higher for the preoperative opioid group.

3. The preoperative opioid group as well as preoperative tramadol users filled more opioid refills, had higher persistent postoperative opioid use, had lower Knee Society Scores and required more manipulations under anesthesia than the control group.

Researchers concluded, "Preoperative opioid users were discharged with less opioids, required more refills, were more likely to remain on opioids, and required more manipulations under anesthesia than opioid naïve patients. These risks extended to preoperative tramadol users."

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