title: Preoperative opioid use and outcomes after reverse shoulder arthroplasty.
abstract: BACKGROUND
  The potential adverse effect of preoperative opioid use on outcomes after reverse shoulder arthroplasty (RSA) has not been investigated. The purpose of this study was to evaluate outcomes after RSA in patients with a history of preoperative opioid use and compare them with a control group without a history of preoperative opioid use.
  
  
  METHODS
  Sixty-eight RSAs performed for rotator cuff tear arthropathy (CTA) with a minimum of 2 years of follow-up were identified in a prospective shoulder arthroplasty registry. Thirty-two patients with a history of preoperative opioid use for shoulder pain were compared with a control group of 36 patients who did not use opioids preoperatively. Shoulder function scores and range of motion measurements were assessed preoperatively and at the final follow-up.
  
  
  RESULTS
  No differences were noted between the 2 groups in age, gender, duration of follow-up, depression, smoking, chronic back pain, diabetes, heart disease, or body mass index. Preoperative opioid use was associated with significantly lower preoperative shoulder function scores. Both groups significantly improved on all shoulder function scores and for range of motion measurements from the preoperative to the final follow-up assessment; however, the nonopioid group had significantly better outcomes. The magnitude of change between the groups from preoperatively to the final follow-up was nearly identical.
  
  
  CONCLUSIONS
  Improvements can be expected in patients with a history of preoperative opioid use; however, patients with preoperative opioid use have a lower preoperative baseline and should not expect to reach the same peak outcome scores after RSA as patients without a history of preoperative opioid use.
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA. Electronic address: brent.joseph.morris@gmail.com.
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Morris
authors.affiliation: Health and Human Performance, University of Houston, Houston, TX, USA.
authors.forename: Mitzi S
authors.initials: MS
authors.lastname: Laughlin
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
authors.forename: Hussein A
authors.initials: HA
authors.lastname: Elkousy
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Gartsman
authors.affiliation: Fondren Orthopedic Group, Texas Orthopedic Hospital, Houston, TX, USA.
authors.forename: T Bradley
authors.initials: TB
authors.lastname: Edwards
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D019643:Arthroplasty, Replacement; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D017006:Rotator Cuff / Q000601:surgery*; D000070636:Rotator Cuff Injuries; D012785:Shoulder Joint / Q000601:surgery*; D020069:Shoulder Pain / Q000188:drug therapy* / Q000209:etiology / Q000601:surgery; D013708:Tendon Injuries / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid
keywords: Reverse shoulder arthroplasty; opioid use; rotator cuff tear arthropathy