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Postoperative opioid use as an early indication of total hip arthroplasty failure.
- Source :
-
Acta orthopaedica [Acta Orthop] 2016 Jul; Vol. 87 Suppl 1, pp. 37-43. Date of Electronic Publication: 2016 May 11. - Publication Year :
- 2016
-
Abstract
- Background and purpose - A criticism of total hip arthroplasty (THA) survivorship analysis is that revisions are a late and rare outcome. We investigated whether prolonged opioid use is a possible indicator of early THA failure. Patients and methods - We conducted a cohort study of THAs registered in a total joint replacement registry from January 2008 to December 2011. 12,859 patients were evaluated. The median age was 67 years and 58% were women. Opioid use in the year after surgery was the exposure of interest, and the cumulative daily amounts of oral morphine equivalents (OMEs) were calculated. Post-THA OMEs per 90 day periods were categorized into quartiles. The endpoints were 1- and 5-year revisions. Results - After the first 90 days, 27% continued to use opioids. The revision rate was 0.9% within a year and 1.7% within 5 years. Use of medium-low (100-219 mg), medium-high (220-533 mg), and high (≥ 534 mg) amounts of OMEs in days 91-180 after surgery was associated with a 6 times (95% confidence interval (CI): 3-15), 5 times (CI: 2-13), and 11 times (CI: 2.9-44) higher adjusted risk of 1 year revision, respectively. The use of medium-low and medium-high amounts of OMEs in days 181-270 after surgery was associated with a 17 times (CI: 6-44) and 14 times (95% CI: 4-46) higher adjusted risk of 1-year revision. There was a similar higher risk of 5-year revision. Interpretation - Persistent postoperative use of opioids was associated with revision THA surgery in this cohort, and it may be an early indicator of potential surgical failures.
- Subjects :
- Aged
Cohort Studies
Confidence Intervals
Female
Humans
Male
Middle Aged
Osteoarthritis, Hip complications
Retrospective Studies
Analgesics, Opioid therapeutic use
Arthroplasty, Replacement, Hip
Osteoarthritis, Hip surgery
Pain, Postoperative drug therapy
Prosthesis Failure
Reoperation statistics & numerical data
Subjects
Details
- Language :
- English
- ISSN :
- 1745-3682
- Volume :
- 87 Suppl 1
- Database :
- MEDLINE
- Journal :
- Acta orthopaedica
- Publication Type :
- Academic Journal
- Accession number :
- 27168377
- Full Text :
- https://doi.org/10.1080/17453674.2016.1181820