Opioid and Analgesic Use Before and After Revision Knee Arthroplasty for the Indications "Pain Without Loosening" Versus "Aseptic Loosening" - A Danish Nationwide Study.

Autor: Arndt KB; Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark., Schrøder HM; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Orthopaedic Surgery, Naestved Hospital, Naestved, Denmark., Troelsen A; Department of Orthopaedic Surgery, Copenhagen University Hospital, Hvidovre, Denmark., Lindberg-Larsen M; Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, Odense, Denmark; Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
Jazyk: angličtina
Zdroj: The Journal of arthroplasty [J Arthroplasty] 2022 Aug; Vol. 37 (8), pp. 1618-1625.e3. Date of Electronic Publication: 2022 Apr 01.
DOI: 10.1016/j.arth.2022.03.077
Abstrakt: 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.
(Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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