Trends in Opioid Use Following Primary Total Hip Arthroplasty from 2016 to 2021: Have Improved Postoperative Opioid Protocols Decreased Usage?

Abstract

AbstractSeveral studies have proposed protocols aimed at limiting the use of opioids following orthopedic surgery. However, current literature has not described the changing trends in opioid use over time. Therefore, the purpose of the present analysis was to determine how opioid use has changed following primary total hip arthroplasty (THA) within the last 5 years.We retrospectively reviewed all patients who underwent primary THA at our institution between January 2016 and April 2021 with a minimum length of stay of one midnight. Demographic data including age, gender, race, body mass index, American Society of Anesthesiologist classification as well as dosage and type of opioid medication prescribed on each postoperative day while in the hospital were collected. These data were converted to milligram morphine equivalents (MME) per day of hospitalization to facilitate comparison. Linear regression analysis was used to detect the significance of yearly trends in MME per day.We identified 7,897 patients who met inclusion and exclusion criteria. The greatest daily average opioid usage per patient was in 2016 (34.5 ± 77.5 MME/d) and the least was in 2021 (13.3 ± 16.5 MME/d). Our analysis demonstrated a significant linear downward trend in average daily postoperative opioid usage over time with an average decrease of 2.81 MME/d each year (R 2: 0.004; p< 0.001). Concerns regarding the negative effects of opioid pain medication following orthopedic surgery have encouraged the development of opioid-reducing protocols. The results of this analysis demonstrate the successful impact of these efforts on limiting opioid consumption during the hospital stay following primary THA. This is a level III evidence retrospective cohort study.