Preoperative Pain Management Decisions Impact Outcome After Total Knee Arthroplasty-Implications for Opiate Use

Abstract

This Level-III retrospective comparative study, entitled “Chronic opioid use prior to total knee arthroplasty,” is a very timely and relevant analysis for primary-care physicians who refer patients in need of joint arthroplasty, surgeons caring for patients who are undergoing joint arthroplasty, and third parties seeking to better understand and predict variability in outcome. With the increased focus on outcomes and value in medicine, the hypothesis that the use of chronic pain medication prior to surgery is an independent risk factor for a less favorable outcome after an orthopaedic procedure is one that needs to be tested and understood. The major conclusion of this analysis is that preoperative narcotic usage may portend diminished success of total knee arthroplasty at a minimum of two years after surgery. While this paper certainly does not provide the final answers to questions about the appropriate role for opioid pain …