Patients using less opioids after hip, knee replacement surgery

By Amy Wallace  |  Oct. 23, 2017 at 11:22 AM
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Oct. 23 (UPI) -- It seems that there is at one area where the opioid abuse trend is on the decline -- patients having hip and knee replacement surgery.

The study, conducted by University of Massachusetts Medical School, is being presented this week at the ANESTHESIOLOGY 2017 conference in Boston.

"Opioids are powerful pain medications but have many unwanted side effects, including the risk of addiction," Philipp Gerner, a medical student at the University of Massachusetts Medical School, said in a press release. "This has prompted more interest in offering patients multimodal therapies to manage pain while also reducing the amount of opioids prescribed. Our research reflects that there has been steady progress over time toward achieving that goal."

Researchers analyzed medical records for more than 1 million patients who had knee or hip replacement surgery between 2006 to 2014 from the Premiere Perspective nationwide database of joint replacement surgeries. There were 377,657 hip replacement and 779,338 knee replacement surgeries between 2006 and 2014 listed in the database, which collects information from 546 hospitals.

A November 2016 revealed that older surgical patients -- age 66 and up -- are at significantly lower risk of developing an addiction to opioids after surgery compared to younger patients.

The current study found fewer patients having hip and knee replacement surgery received prescription opioids as the sole treatment for pain during recovery. More of these patients successfully used a variety of pain management methods, including acetaminophen, non-steroidal anti-inflammatory drugs, peripheral nerve block, gabapentin/pregabalin, COX-2 inhibitors or ketamine to control pain instead of prescription opioids.

Roughly 27 percent of patients who received opioids alone to manage pain for hip replacement surgery in 2006 solely used opioids. In 2014, that number dropped to 10 percent. For knee replacement patients, 23 percent used opioids alone in 2006, and just 7 percent in 2014.

"While we tend to think of large, academic hospitals as implementing changes more effectively, smaller hospitals -- especially specialty institutions performing a lot of orthopedic surgeries -- may be more open to evidence-based changes in practice to stay competitive," said Dr. Stavros G. Memtsoudis, director of critical care services in the Department of Anesthesiology at the Hospital for Special Surgery in New York.

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