Acute Pain Management
Chronic Opioid Use Prior to Total Knee Arthroplasty
Zywiel MG, Stroh DA, Lee SY, et al (Univ of Toronto, Ontario, Canada; Sinai Hosp of Baltimore, MD; Hallym Univ Med Ctr, Kangdonggu, Seoul, South Korea; et al) J Bone Joint Surg Am 93:1988-1993, 2011§
Chronic use of opioid medications may lead to dependence or hyperalgesia, both of which might adversely affect perioperative and postoperative pain management, rehabilitation, and clinical outcomes after total knee arthroplasty. The purpose of this study was to evaluate patients who underwent total knee arthroplasty following six or more weeks of chronic opioid use for pain control and to compare them with a matched group who did not use opioids preoperatively.
Forty-nine knees in patients who had a mean age of fifty-six years (range, thirty-seven to seventy-eight years) and who had regularly used opioid medications for pain control prior to total knee arthroplasty were compared with a group of patients who had not used them. Length of hospitalization, aseptic complications requiring reoperation, requirement for specialized pain management, and clinical outcomes were assessed for both groups.