TY - JOUR
T1 - Opioid and analgesic use before and after revision knee arthroplasty for the indications "pain without loosening" versus "aseptic loosening" - a Danish nationwide study
AU - Arndt, Kristine Bollerup
AU - Schrøder, Henrik M
AU - Troelsen, Anders
AU - Lindberg-Larsen, Martin
N1 - Copyright © 2022 Elsevier Inc. All rights reserved.
PY - 2022/8
Y1 - 2022/8
N2 - BACKGROUND: It is uncertain if patients undergoing revision knee arthroplasty for "pain without loosening" are relieved of pain. This study aimed to compare pre- and postoperative analgesic consumption by patients undergoing revision for "pain without loosening" versus "aseptic loosening" and to determine predictors for postoperative long-term opioid use.METHODS: A retrospective nationwide study of 1,037 revisions for "pain without loosening" and 2,317 revisions for "aseptic loosening" during 1997-2018 from the Danish Knee Arthroplasty Register was carried out. Analgesic use was defined by prescription reimbursement, and long-term opioid use by prescription reimbursement in 4 consecutive quarters.RESULTS: In the preoperative year, 37% and 29% of patients revised for "pain without loosening" and "aseptic loosening" were opioid users compared to 32% and 30% in the postoperative year. Non-steroidal anti-inflammatory drug (NSAID) use was significantly lower postoperatively for both indications (35% versus 28% for "pain without loosening" and 33% versus 25% for "aseptic loosening"). Use of other analgesics was unchanged. Long-term opioid use increased postoperatively by 4% for patients with "pain without loosening" (P = .029) and by 3% for "aseptic loosening" (P = .003). New long-term opioid users (without preoperative long-term use) were 9% for "pain without loosening" and 8% for "aseptic loosening". Predictors of new long-term opioid use were other opioid-requiring diagnoses or procedures within the first postoperative year, Charlson Comorbidity Index (CCI) ≥3, and preoperative long-term NSAID use.CONCLUSION: The consumption of opioids decreased slightly after knee arthroplasty revision for the indication "pain without loosening", but not for "aseptic loosening". The amount of new long-term opioid users increased for both indications.
AB - BACKGROUND: It is uncertain if patients undergoing revision knee arthroplasty for "pain without loosening" are relieved of pain. This study aimed to compare pre- and postoperative analgesic consumption by patients undergoing revision for "pain without loosening" versus "aseptic loosening" and to determine predictors for postoperative long-term opioid use.METHODS: A retrospective nationwide study of 1,037 revisions for "pain without loosening" and 2,317 revisions for "aseptic loosening" during 1997-2018 from the Danish Knee Arthroplasty Register was carried out. Analgesic use was defined by prescription reimbursement, and long-term opioid use by prescription reimbursement in 4 consecutive quarters.RESULTS: In the preoperative year, 37% and 29% of patients revised for "pain without loosening" and "aseptic loosening" were opioid users compared to 32% and 30% in the postoperative year. Non-steroidal anti-inflammatory drug (NSAID) use was significantly lower postoperatively for both indications (35% versus 28% for "pain without loosening" and 33% versus 25% for "aseptic loosening"). Use of other analgesics was unchanged. Long-term opioid use increased postoperatively by 4% for patients with "pain without loosening" (P = .029) and by 3% for "aseptic loosening" (P = .003). New long-term opioid users (without preoperative long-term use) were 9% for "pain without loosening" and 8% for "aseptic loosening". Predictors of new long-term opioid use were other opioid-requiring diagnoses or procedures within the first postoperative year, Charlson Comorbidity Index (CCI) ≥3, and preoperative long-term NSAID use.CONCLUSION: The consumption of opioids decreased slightly after knee arthroplasty revision for the indication "pain without loosening", but not for "aseptic loosening". The amount of new long-term opioid users increased for both indications.
KW - analgesic
KW - opioid
KW - pain
KW - revision
KW - revision knee arthroplasty
KW - total knee arthroplasty
UR - http://www.scopus.com/inward/record.url?scp=85129019748&partnerID=8YFLogxK
U2 - 10.1016/j.arth.2022.03.077
DO - 10.1016/j.arth.2022.03.077
M3 - Journal article
C2 - 35378235
SN - 0883-5403
VL - 37
SP - 1618-1625.e3
JO - The Journal of arthroplasty
JF - The Journal of arthroplasty
IS - 8
ER -