title: Reduction in narcotic use after primary total knee arthroplasty and association with patient pain relief and satisfaction.
abstract: We examined the prevalence of narcotic use before and after total knee arthroplasty (TKA) and its association with post-TKA pain relief and satisfaction. Data on 6364 primary, unilateral TKA patients in a national registry were analyzed. Before TKA, 24% of patients were prescribed one form of narcotic. Of these, 14% reported continued narcotic use at 12 months after TKA, whereas the majority discontinued use. Only 3% of patients who did not use narcotics before TKA had a narcotics prescription at 12 months. Patients who used narcotics before TKA were more likely to have a narcotic prescription at 12 months post-TKA, reported greater pain at 12 months, and were more likely to be dissatisfied with TKA outcome. These findings have implications for patient pre-TKA counseling.
authors.affiliation: Department of Orthopedics and Physical Rehabilitation, University of Massachusetts Medical School, Worcester, Massachusetts 01655, USA.
authors.forename: Patricia D
authors.initials: PD
authors.lastname: Franklin
authors.forename: John A
authors.initials: JA
authors.lastname: Karbassi
authors.forename: Wenjun
authors.initials: W
authors.lastname: Li
authors.forename: Wenyun
authors.initials: W
authors.lastname: Yang
authors.forename: David C
authors.initials: DC
authors.lastname: Ayers
mesh_terms: D000368:Aged; D018771:Arthralgia / Q000188:drug therapy*; D019645:Arthroplasty, Replacement, Knee; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use*; D020370:Osteoarthritis, Knee / Q000601:surgery*; D010147:Pain Measurement; D017060:Patient Satisfaction; D011182:Postoperative Care; D011300:Preoperative Care; D015995:Prevalence; D012042:Registries; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D009294:Narcotics