title: Characterization of patients undergoing total knee arthroplasty in a real-world setting and pain-related medication prescriptions for management of postoperative pain.
abstract: Presently, no "gold-standard" exists for the management of pain after total knee arthroplasty (TKA) surgery. Understanding pain management methods used in clinical practice and the associated patient outcomes are necessary to fill gaps in pain management strategies. This study characterizes medication use in the immediate postoperative period among patients undergoing TKA at an academic medical center. Additionally, pre- and postoperative measures of pain (numeric pain rating scale), physical function (Knee Society Scale and Lower Extremity Function [LEFS]), and quality of life (Medical Outcomes Study Short-Form [SF]-36) were evaluated. The patient data were extracted from a clinical database at the University of Utah Orthopedic Clinic between September 1, 2008, and November 30, 2010. A total of 168 patients (mean age 64.0 ± 10.1 years, 63.1% were female, mean body mass index [BMI] 31.7 ± 7.1 kg/m(2)) were included. The most common comorbidities in these patients were osteoarthritis, hypertension, and major depressive disorders. Bupivacaine and fentanyl were commonly given on the day of surgery with oxycodone, hydrocodone/acetaminophen, and celecoxib prescribed at hospital discharge. Preoperative pain levels were reduced by half at 6 weeks. Physical function and quality of life were similar to established benchmarks and previously reported levels, respectively. Confirmation of results over a longer follow-up period is warranted.
authors.affiliation: Center for Outcomes Research, University of Illinois College of Medicine, Peoria, Illinois 61656, USA. csk@uicomp.uic.edu
authors.forename: Carmen S
authors.initials: CS
authors.lastname: Kirkness
authors.forename: Carrie
authors.initials: C
authors.lastname: McAdam-Marx
authors.forename: Sudhir
authors.initials: S
authors.lastname: Unni
authors.forename: Jason
authors.initials: J
authors.lastname: Young
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Ye
authors.forename: Arthi
authors.initials: A
authors.lastname: Chandran
authors.forename: Christopher L
authors.initials: CL
authors.lastname: Peters
authors.forename: Carl V
authors.initials: CV
authors.lastname: Asche
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000700:Analgesics / Q000627:therapeutic use*; D019645:Arthroplasty, Replacement, Knee; D016208:Databases, Factual; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D011788:Quality of Life; D020127:Recovery of Function; D013997:Time Factors
chemical_list: D000700:Analgesics