Opioid and analgesic use before and after revision knee arthroplasty for the indications "pain without loosening" versus "aseptic loosening" - a Danish nationwide study

Kristine Bollerup Arndt*, Henrik M Schrøder, Anders Troelsen, Martin Lindberg-Larsen

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskriftArtikelForskningpeer review

Abstract

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.

OriginalsprogEngelsk
Sider (fra-til)1618-1625.e3
TidsskriftJournal of Arthroplasty
Vol/bind37
Udgave nummer8
Tidlig onlinedato1 apr. 2022
DOI
StatusUdgivet - aug. 2022

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Copyright © 2022 The Authors. Published by Elsevier Inc. All rights reserved.

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