Opioid use before THA linked to longer stay and higher rate of all-cause ED visits
According to published results, opioid use before elective total hip arthroplasty resulted in poor intraoperative and postoperative outcomes, such as increased time in surgery, longer length of stay and a higher rate of all-cause ED visits.
Researchers from the department of orthopedic surgery at NYU Langone Health retrospectively analyzed the results of 793 patients who underwent elective primary THA from November 2018 to March 2020. Patient-reported outcome measures (PROMs) included the forgotten joint score-12, hip disability and osteoarthritis outcome score for joint replacement and the Veterans RAND 12 physical and mental component scores, according to the study.
Investigators found 10% of patients preoperatively used opioids. This cohort reported longer length of stay (1.37 vs. 1.07 days), longer surgical times (102.44 vs. 90.20 minutes) and a higher percentage of all-cause postoperative ED visits (6.7% vs. 2.1%) compared with the patients who did not use opioids preoperatively.
Despite “significantly lower” preoperative PROMs in the preoperative opioid cohort, researchers found no statistically significant differences in postoperative PROMs, indicating a similar benefit from THA for both groups, according to the study.
“The current opioid epidemic is an increasing concern for orthopedic surgeons. Opioid users not only are subject to the inherent harmful side effects of the medications, but also demonstrate poorer postoperative outcomes,” researchers wrote in the study. “Given that opioid use is rising annually and is a modifiable risk factor, all stakeholders need to be sensitive to preoperative opioid consumption and must engage patients in discussions regarding the priority of minimizing or eliminating opioid use both preoperatively and postoperatively to optimize outcomes following THA.”