Opioid use prior to arthroscopic rotator cuff repair may lead to worse outcomes
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SAN DIEGO — Opioid use prior to arthroscopic rotator cuff repair may lead to worse outcomes, according to results presented at the American Academy of Orthopaedic Surgeons Annual Meeting.
Fabien Meta, MD, Eric C. Makhni, MD, MBA, and colleagues classified patients undergoing arthroscopic rotator cuff repair from 2017 to 2020 as acute, chronic or non-opioid users based on the number of opioid prescriptions filled within 3 months prior to surgery. Researchers collected Patient-Reported Outcome Measurement Information System (PROMIS) scores, including PROMIS pain interference score, PROMIS upper extremity physical function score and PROMIS depression mood score.
“We looked at these scores in our patients preoperatively and then postoperatively up to 1 year out from surgery,” Meta, lead author of the study and an orthopedic surgery resident in the department of orthopedic surgery at Henry Ford Health System, told Healio Orthopedics.
Meta noted acute and chronic opioid users had lower functional scores and higher pain scores preoperatively compared with non-users. However, acute and chronic opioid users had similar preoperative mood scores vs. non-users, according to Meta.
“When you look at the 6-month postoperative results, we still had the acute and chronic users having significantly lower function and higher pain scores. Additionally, they had inferior mood scores based on the depression surveys,” Meta said.
Similarly, Meta noted chronic opioid users had significantly lower functional scores compared with non-users at 1-year follow-up. He added pain and mood scores continued to be inferior among acute and chronic opioid users. Although non-opioid users showed significantly greater improvement in functional scores at 6-month follow-up compared with acute opioid users, Meta noted that ultimately there was no significant difference at 1 year in terms of the magnitude of improvement in functional scores.
Makhni noted it is important for future research to identify whether modifying opioid use prior to arthroscopic rotator cuff repair may improve patient-reported outcomes.
“We have to get a handle on why these patients are on opioids. Is it something we can modify or not? And, if we can modify it, what happens when we do?” Makhni, senior and corresponding author to the study and clinical associate professor of the division of sports medicine in the department of orthopedic surgery at Henry Ford Health System, told Healio Orthopedics.
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Meta F, et al. Paper 065. Presented at: American Academy of Orthopaedic Surgeons Annual Meeting. Aug. 31-Sept. 3, 2021; San Diego.
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