Opioid Use and Total Joint Replacement

Cade Shadbolt, Chris Schilling, Maria C. Inacio, J. Haxby Abbott, Yana Pryymachenko, Ross Wilson, Peter F.M. Choong, Michelle M. Dowsey

Research output: Contribution to journalReview articlepeer-review

13 Citations (Scopus)

Abstract

Purpose of Review: We provide an overview of recent research into the relationship between preoperative opioid use and total joint replacement outcomes. Recent Findings: Recent findings indicate that total joint replacement patients with a history of preoperative opioid use experience higher rates of infection, revision, short-term complications, and prolonged postoperative opioid use, along with fewer improvements in pain and function following surgery. These risks are particularly pronounced among chronic opioid users. While the baseline risk profiles of these patients may contribute to higher rates of adverse outcomes, it is also plausible that certain outcomes are directly impacted by opioid use through mechanisms such as opioid-induced hyperalgesia and immunosuppression. There is little available data on the efficacy of interventions that aim to mitigate these risks. Summary: Well-designed clinical trials are needed to evaluate the efficacy of targeted perioperative interventions that aim to improve outcomes for this high-risk surgical population. Where such trials are not feasible, additional high-quality observational studies are necessary to further our understanding of the mechanisms underlying the relationships between opioid use and specific adverse outcomes.

Original languageEnglish
Article number58
JournalCurrent Rheumatology Reports
Volume22
Issue number10
DOIs
Publication statusPublished or Issued - 1 Oct 2020

Keywords

  • Complications
  • Narcotics
  • Opioids
  • Surgery
  • Surgical outcomes
  • Total joint replacement

ASJC Scopus subject areas

  • Rheumatology

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