Persistent opioid use after hip and knee arthroplasty

While opioids have well-established benefits in managing postoperative pain, the adverse effects of persistent opioid use are a subject of increasing concern. The prevalence of persistent opioid use in opioid naive patients undergoing Orthopaedic surgery has been reported as 13.7%. In this study, we aimed to quantify the prevalence of opioid use in our arthroplasty patients. Methods: This single centre observational cohort study evaluated the duration of postoperative opioid use in consecutive patients undergoing unilateral primary knee or hip arthroplasty. A survey designed by a panel of experienced clinicians, consisted of 10 multiple-choice questions and 1 free text response, was sent via email or post 3 months post-surgery. The data was collated on Excel and analysed. Results: Eighty-eight (88) patients responded to our survey. The overall prevalence of persistent opioid use at 3 months following total joint arthroplasty was 7%. Almost 80% of patients had ceased opioids by 6-weeks after surgery. Preoperative opioid users, patients having total knee arthroplasty, females and patient with low back pain were more likely to be members of the persistent opioid group. 87% of patients rated their understanding regarding opioids usage as adequate or excellent. Conclusion: The incidence of persistent opioid use in our population was low, especially in the opioid naive group. We believe the key to the low rate of persistent opioid use lies in patient education, tapering opioids before surgery and use of evidence-based care pain management pathways.