Trends From 2010 to 2019 in Opioid and Nonopioid Pain Management After Total Knee Arthroplasty

Authors

Tyler Bahoravitch, From the Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington, DC (Dr. Bahoravitch, Ms. Zhao, and Dr. Stake); the Department of Biochemistry, Georgetown University Medical Center, Washington, DC (Dr. Roberts); the Department of Orthopaedic Surgery, Virginia Commonwealth University School of Medicine, Richmond, VA (Dr. Ernst); and the Department of Orthopaedic Surgery, Johns Hopkins University School of Medicine, Baltimore, MD (Dr. Thakkar).
Max Roberts
Amy Zhao
Seth Stake
Brady Ernst
Savyasachi C. Thakkar

Document Type

Journal Article

Publication Date

6-1-2024

Journal

Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews

Volume

8

Issue

6

Abstract

INTRODUCTION: As the opioid epidemic enters its third decade, we reflect on how it has affected clinical practice within the orthopaedic community. Recent studies show prolonged opioid use after total knee arthroplasty (TKA) is associated with worse overall health outcomes. This study aims to elucidate trends in pain management after TKA over the past decade. METHODS: A retrospective analysis was performed using the PearlDiver database from 2010 to 2019. Patients who underwent primary TKA without a history of mental illness, complex pain syndromes, or opioids used 6 months before surgery were selected. Postoperative prescription filling rates of opioid and nonopioid at 30, 90 days, and 1 year from surgery were analyzed. Linear regression analysis and compound annual growth rates (CAGRs) were analyzed from 2010 to 2019, a P value <0.05 being considered significant. RESULTS: Between 2010 and 2019, 579,269 patients underwent primary TKA. At 30 days, filling of prescriptions for opioids (CAGR = 3.54%) and nonopioids (CAGR = 15.50%) markedly increased from 2010 to 2019. At 90 days, opioids decreased (CAGR = -4.42%). At 1 year, opioid (CAGR = -10.92%) and nonopioid (CAGR = -2.12%) prescriptions markedly decreased from 2010 to 2019. DISCUSSION: This study highlights patterns of decreased opioid prescription rates at 90 days and 1 year postoperatively from 2010 to 2019. Decreasing opioid rates may indicate effectiveness in targeted public health campaigns to curb opioid overuse.

APA Citation

Bahoravitch, Tyler; Roberts, Max; Zhao, Amy; Stake, Seth; Ernst, Brady; and Thakkar, Savyasachi C., "Trends From 2010 to 2019 in Opioid and Nonopioid Pain Management After Total Knee Arthroplasty" (2024). GW Authored Works. Paper 5110.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/5110

Department

School of Medicine and Health Sciences Student Works