Nearly a third of patients scheduled to undergo surgery for hip, knee, or spine osteoarthritis (OA) were found to use prescription opioids, according to a study published in Arthritis Care & Research.
In this cross-sectional study, a total of 1126 patients (average age, 65.6) with end-stage knee (n=577), hip (n=459), and spine (n=168) OA were enrolled before undergoing surgery.
Data regarding current use of opioids and other pain medications were collected, in addition to sociodemographic data and information on health status, depression, and pain. The majority of participants were overweight (36%) or obese (41%). The average pain intensity score was 6.1 on a 0 to 10 scale and the average depression score was 5.3 on a 0 to 21 scale.
Rates of opioid use were calculated by sex, age, and surgical site. A total of 15% of the participants reported currently using opioids daily for pain related to OA and 15% reported using opioids sometimes. Opioid use was reported by 40% of patients with spine OA, 28% with knee OA, and 30% with hip OA.
Several factors were associated with a greater likelihood of opioid use: having spine vs knee OA; being obese, a woman, a current smoker, younger than 65; and having less than a high school education; more symptomatic joints and comorbidities; and higher mean depression and pain scores.
Study limitations include its retrospective design, which lacked data on specific types and dosages of medication used.
“As evidence continues to build that opioid use may negatively [affect] surgical outcomes, optimized pre-operative pain management and consideration of pre-surgical opioid use screening including potential dependency may be warranted for patients undergoing surgery for OA,” concluded the study authors.
Power JD, Perruccio AV, et al. Factors associated with opioid use in pre-surgical knee, hip and spine osteoarthritis patients [published online January 10, 2019]. Arthritis Care Res. doi:10.1002/acr.23831