title: Long-Acting Opioid Use Independently Predicts Perioperative Complication in Total Joint Arthroplasty.
abstract: Opioid therapy is an increasingly used modality for treatment of musculoskeletal pain despite multiple associated risks. The purpose of this study was to evaluate how preoperative opioid use affects early outcomes after total joint arthroplasty.
  
  
  
  A total of 174 patients undergoing total joint arthroplasty were matched by age, gender, and procedure into 3 groups stratified by preoperative opioid use (nonuser, short acting [eg, Vicodin], long acting [eg, Oxycontin]).
  
  
  
  Compared to nonusers, preoperative long-acting use was associated with increased postoperative mean opioid consumption (46 mg vs 366 mg mean morphine equivalents, P < .001) and independently predicted complications within 90 days (odds ratio: 6.15, confidence interval: [1.46, 25.95], P = .013).
  
  
  
  Preoperative opioid use should be disclosed as a risk factor for complication to patients and taken into consideration by physicians before initiating opioid management.
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: David C
authors.initials: DC
authors.lastname: Sing
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Barry
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Jonathan W
authors.initials: JW
authors.lastname: Cheah
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Thomas P
authors.initials: TP
authors.lastname: Vail
authors.affiliation: Department of Orthopaedic Surgery, University of California, San Francisco, San Francisco, California.
authors.forename: Erik N
authors.initials: EN
authors.lastname: Hansen
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000009:adverse effects*; D019644:Arthroplasty, Replacement, Hip; D019645:Arthroplasty, Replacement, Knee; D005260:Female; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009020:Morphine; D010098:Oxycodone / Q000009:adverse effects; D010351:Patient Discharge / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000209:etiology*; D011184:Postoperative Period; D057234:Preoperative Period; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000701:Analgesics, Opioid; D009020:Morphine; D010098:Oxycodone
keywords: chronic pain; complications; hip arthroplasty; knee arthroplasty; opioid dependence