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J Knee Surg 2023; 36(13): 1374-1379
DOI: 10.1055/a-1946-6217
Original Article

Does Preoperative Opioid Consumption Influence Patient Satisfaction following Total Knee Arthroplasty?

Austin F. Smith
1   Department of Orthopaedic Surgery, University of Louisville, Louisville, Kentucky
,
Nolan S. Smith
2   School of Medicine, University of Louisville, Louisville, Kentucky
,
Langan S. Smith
3   UofL Physicians – Orthopaedic Group, Louisville, Kentucky
,
Madhusudhan R. Yakkanti
4   Louisville Orthopaedic Clinic, Louisville, Kentucky
,
Arthur L. Malkani
5   Department of Orthopaedic Surgery, Adult Reconstruction Program, University of Louisville, Louisville, Kentucky
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Abstract

Chronic opioid use prior to total knee arthroplasty (TKA) has been implicated in adverse outcomes. The purpose of this study was to evaluate clinical outcome measures and patient satisfaction in patients with a history of preoperative chronic opioid use undergoing primary TKA. A retrospective cohort study was performed on 296 consecutive patients undergoing primary TKA. Seventy-four (25%) patients were identified with chronic preoperative opioid use (study group; 22 males, 52 females). A 3:1 matched cohort ratio of control versus study group was utilized resulting in a control group consisting of 222 patients (97 males, 125 females) without chronic opioid use prior to surgery. There was no statistically significant difference in age, BMI, or follow-up. Average follow-up was 23.4 months in the control group and 23.6 months in the study group (p = 0.87). Clinical data including patient satisfaction (Likert score), Knee Society (KS) Knee scores, KS Function scores, Forgotten Joint Score (FJS), length of stay (LOS), and complications were evaluated. Patient satisfaction at the most recent visit was 92.8% in the control group versus 83.8% in the chronic opioid group (p = 0.0016). Differences in patient-reported outcomes measures comparing the control and study cohorts included KS Function Score of 83.23 versus 75.31 (p = 0.0034). The FJS of 63.7 versus 58 (p = 0.1883) and the KS Knee Score of 89.5 versus 88.1 (p = 0.4075) were not significant. Postoperative opioid usage for the control versus the study group was 62/222 (27.9%) versus 56/74 (75.7%) at 4 to 8 weeks (p <0.0001), and 4/222 (1.80%) versus 27/74 (36.5%) at 12 months (p <0.0001). Overall complication occurrence was 18.9% in the study group versus 11.3% in the control group (p = 0.11). Patients with history of chronic preoperative opioid use had significantly lower patient satisfaction and KS Function scores and increased postoperative opioid usage at 12 months compared with patients without a history of opioid use prior to TKA.

Keywords

primary TKA - opioid use - TKA - patient satisfaction

Note

The COI was subsequently added on 28 February 2024.




Publication History

Received: 12 January 2022

Accepted: 15 September 2022

Accepted Manuscript online:
18 September 2022

Article published online:
23 December 2022

© 2022. Thieme. All rights reserved.

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