Preoperative opioid use associated with chronic opioid use after THA
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Key takeaways:
- Preoperative opioid use was associated with chronic opioid use after total hip arthroplasty.
- Surgical approach did not impact chronic opioid use at 180 days postoperatively.
Results published in the Journal of Arthroplasty showed preoperative opioid use was associated with chronic opioid use after total hip arthroplasty, while surgical approach did not affect long-term opioid use.
In a retrospective cohort study, researchers analyzed data on opioid use and surgical approach among 508 patients (mean age, 64 years) who underwent primary THA from Jan. 1, 2016, to March 1, 2019. According to the study, 192 patients underwent direct anterior THA; 207 patients underwent antero-lateral THA; and 109 patients underwent posterior THA.
Opioid use was assessed 90 days preoperatively and 1 year postoperatively. Long-term opioid use was defined as patients who continued to fill opioid prescriptions more than 180 days after surgery, according to the study.
In terms of in-hospital opioid use, the direct anterior group received 138 morphine milligram equivalents (MME); the antero-lateral group received 148.4 MME; and the posterior approach group received 159.9 MME. However, no significant differences were observed in the percentage of long-term opioid users between the direct anterior group (20.3%), the antero-lateral group (22.7%) and the posterior group (25%).
“Not taking opioids 90 days prior to surgery, regardless of approach, was associated with a 78% decrease in the odds of becoming a chronic opioid user,” the researchers wrote in the study.
“This illustrates the importance of educating patients on preoperative opioid cessation prior to elective THA and that opioid usage should be considered a modifiable risk factor as part of patient optimization protocols,” they wrote.
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