BACKGROUND AND PURPOSE Total hip (THA) and knee (TKA) arthroplasty are effective pain treatment in osteoarthritis; however, there are patients with long-term pain and in need of analgesics. We studied purchases of paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and neuropathic pain medication before and after THA or TKA. PATIENTS AND METHODS We searched all THA (n = 149,158) and TKA (n = 180,585) cases in Finland between the years 1998 and 2018 and the drug purchases made by patients during 1997-2018 using linked Finnish register data. Drug purchases were studied in 3-month periods. RESULTS The purchases of all analgesics increased from 3 years before operation to 3 months before operation. Around the time of THA or TKA, the purchases of all analgesics spiked to 7-56%, depending on drug. The purchases of all analgesics decreased rapidly during the first 6 months postoperatively. Purchases of paracetamol, NSAIDs, and opioids at 6 months postoperatively (6-23%) were lower than they were at 3 months preoperatively. At 3 years postoperatively, only paracetamol purchases were lower (15-18%) postoperatively than they were 3 years before arthroplasty. NSAID, opioid, and neuropathic pain medication purchases remained higher (4-14%). INTERPRETATION THA and TKA stop and reduce the preoperative increases in purchases of paracetamol, NSAIDs, and opioids. The purchases of pain medications by THA and TKA patients 1 year after operation are close to those in the general population.

中文翻译：

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全髋关节和膝关节置换术前后止痛药的购买：对 329,743 例关节置换术的注册研究。

背景和目的 全髋关节置换术 (THA) 和全膝关节置换术 (TKA) 是治疗骨关节炎疼痛的有效方法；然而，有些患者长期疼痛，需要镇痛药。我们研究了 THA 或 TKA 前后对乙酰氨基酚、非甾体抗炎药 (NSAIDs)、阿片类药物和神经性止痛药的购买情况。患者和方法 我们使用链接的芬兰登记数据搜索了 1998 年至 2018 年间芬兰所有的 THA（n = 149,158）和 TKA（n = 180,585）病例，以及患者在 1997-2018 年间购买的药物。药物购买在 3 个月的时间内进行了研究。结果所有镇痛药的购买量从术前3年增加到术前3个月。在 THA 或 TKA 期间，所有镇痛药的购买量飙升至 7-56%，具体取决于药物。在术后的前 6 个月内，所有镇痛药的购买量都迅速减少。术后 6 个月购买的扑热息痛、非甾体抗炎药和阿片类药物 (6-23%) 低于术前 3 个月。术后 3 年，只有扑热息痛的购买量低于关节置换术前 3 年 (15-18%)。非甾体抗炎药、阿片类药物和神经性止痛药的购买量仍然较高 (4-14%)。解释 THA 和 TKA 停止并减少术前购买扑热息痛、NSAIDs 和阿片类药物的增加。THA和TKA患者术后1年止痛药的购买量与普通人群接近。和阿片类药物在术后 6 个月 (6-23%) 低于术前 3 个月。术后 3 年，只有扑热息痛的购买量低于关节置换术前 3 年 (15-18%)。非甾体抗炎药、阿片类药物和神经性止痛药的购买量仍然较高 (4-14%)。解释 THA 和 TKA 停止并减少术前购买扑热息痛、NSAIDs 和阿片类药物的增加。THA和TKA患者术后1年止痛药的购买量与普通人群接近。和阿片类药物在术后 6 个月 (6-23%) 低于术前 3 个月。术后 3 年，只有扑热息痛的购买量低于关节置换术前 3 年 (15-18%)。非甾体抗炎药、阿片类药物和神经性止痛药的购买量仍然较高 (4-14%)。解释 THA 和 TKA 停止并减少术前购买扑热息痛、NSAIDs 和阿片类药物的增加。THA和TKA患者术后1年止痛药的购买量与普通人群接近。解释 THA 和 TKA 停止并减少术前购买扑热息痛、NSAIDs 和阿片类药物的增加。THA和TKA患者术后1年止痛药的购买量与普通人群接近。解释 THA 和 TKA 停止并减少术前购买扑热息痛、NSAIDs 和阿片类药物的增加。THA和TKA患者术后1年止痛药的购买量与普通人群接近。