Preoperative chronic opioid use prior to TJA associated with poor postoperative mobility
Click Here to Manage Email Alerts
Key takeaways:
- Preoperative chronic opioid use was associated with poor mobility after total joint arthroplasty.
- Opioid users had fewer average daily step counts at multiple postoperative timepoints vs. opioid-naïve patients.
Published results showed postoperative mobility was significantly reduced among chronic opioid users who underwent total hip or knee arthroplasty compared with opioid-naïve patients.
Charles L. Nelson, MD, and colleagues performed a secondary analysis of data from a multicenter, prospective cohort study which analyzed the impact of preoperative chronic opioid use on postoperative mobility for patients who underwent THA or TKA. The study included 153 patients (mean age, 61.9 years) who used opioids preoperatively and a matched control cohort of 306 patients (mean age, 62.1 years) who did not use opioids prior to surgery. According to the study, patients performed self-directed rehabilitation using a smartwatch while results were tracked on a smartphone-based platform (mymobility, Zimmer Biomet).
Chronic opioid use was defined as the use of hydrocodone, hydromorphone, fentanyl, codeine, morphine, oxycodone, oxymorphone or tramadol for 90 days or longer prior to enrollment.
Outcome measures were assessed at 1 month, 3 months, 6 months and 1 year and included postoperative mobility, measured by patient-reported ability to walk unassisted at 3 months; step counts; and EuroQol-5D responses.
The study found 87.8% of patients who used opioids and 90.7% of opioid-naïve patients returned to walking unassisted at 3 months, which the researchers called similar. Average daily step count was significantly lower in patients who used opioids vs. opioid- naïve patients at 3 months (4,710 vs. 5,579), 6 months (4,823 vs. 5,848) and 1 year (5,065 vs. 6,274).
After analyzing EQ-5D responses, researchers found 19.2% of patients who used opioids and 9.3% of opioid-naïve patients reported moderate to extreme problems with ambulation at 6 months postoperatively.
“While patient-reported outcome measures did not differ between the groups, return to preoperative step counts demonstrated delayed and incomplete recovery in chronic opioid users,” the researchers wrote.
Editor’s note: This article was updated on April 8, 2024, to more specifically define chronic opioid use according to the study.
Collapse
Click Here to Manage Email Alerts