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J Arthroplasty. 2018 Jan;33(1):119-123. doi: 10.1016/j.arth.2017.08.022. Epub 2017 Aug 24.

Risk for Prolonged Opioid Use Following Total Knee Arthroplasty in Veterans.

Author information

1
Department of Anesthesia, University of Iowa, Carver College of Medicine, Iowa City, Iowa; Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa.
2
Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa; Department of Internal Medicine, University of Iowa, Carver College of Medicine, Iowa City, Iowa.
3
Center for Comprehensive Access and Delivery Research and Evaluation (CADRE), Iowa City VA Health Care System, Iowa City, Iowa.

Abstract

BACKGROUND:

Patients undergoing total knee arthroplasty (TKA) may be at risk for prolonged postsurgical opioid use due to a high prevalence of persistent postsurgical pain (20%) and high rates of presurgical opioid use.

METHODS:

The current study uses a Veterans Health Administration sample of 6653 Veterans who underwent TKA in the fiscal year 2014 that did not require surgical revision during the subsequent year.

RESULTS:

Sixty percent of the sample had used an opioid in the year prior to surgery, including 20% who were on long-term opioid use at the time of surgery (defined as 90+ days of continuous use) and 40% with any other opioid use in the year prior to surgery. In patients on long-term opioids at the time of surgery, 69% received opioids for at least 6 months and 57% for at least 12 months after TKA. In patients not on long-term opioids at the time of TKA, only 4% received opioids for at least 6 months and 2% for at least 12 months after TKA. Differing risk factors for prolonged opioid use 12 months after TKA were identified in these 2 cohorts (ie, those who were and were not receiving long-term opioids at TKA).

CONCLUSION:

These findings suggest that the greatest risk for prolonged opioid use after TKA is preoperative opioid use.

KEYWORDS:

Veteran; long-term opioid; opioid risk; post-surgical; total knee arthroplasty

PMID:
28927564
DOI:
10.1016/j.arth.2017.08.022
[Indexed for MEDLINE]

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