Physical therapy may help reduce the risk of long-term opioid use after TKR
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According to published results, preoperative and prompt postoperative physical therapy sustained for six or more sessions may reduce the risk of long-term opioid use in patients undergoing total knee replacement.
To determine an association between physical therapy (PT) and long-term opioid use after TKR, Kosaku Aoyagi, PT, PhD, and colleagues from Boston University performed a retrospective cohort study of data from 67,322 patients who underwent TKR from Jan. 1, 2001, to Dec. 31, 2016. According to the study, 38,408 patients were opioid-naïve, while 28,914 patients were opioid-experienced. Outcome measures included the receipt of any preoperative or postoperative PT, as well as quantity of PT sessions and timeframe of PT.
Aoyagi and colleagues found receipt of PT prior to TKR was associated with lower odds of long-term opioid use in both the opioid-naive and opioid-experienced cohorts, while receipt of PT after TKR was associated with lower odds of long-term opioid use in the opioid-experienced cohort.
Researchers also found that compared with patients who received five or less PT sessions after TKR, patients who received six sessions or more had lower odds of long-term opioid use in the opioid-experienced cohort. Additionally, the initiation of PT within 30 days after TKR was associated with lower odds of long-term opioid use in both cohorts.
“Opioids are the primary pain reliever typically used to manage postoperative TKR pain acutely. However, opioid prescriptions after TKR are a common starting point for conversion to long-term opioid use,” the researchers wrote in the study. “These findings suggest that PT may help reduce the risk of long-term opioid use after TKR,” they concluded.
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