Opioid use and its impact on long term functional outcomes in total knee arthroplasties

Abstract

Background: With the current opioid epidemic, it is important for surgeons to be aware of how long-term opioid use affects post-operative outcomes and pain. This study aims to follow the long-term functional outcomes in a cohort of patients undergoing elective total knee arthroplasty (TKA) who were recipients of an established multimodal analgesia (MMA) pathway. Methods: Patients who had undergone unilateral TKA with a standardized MMA at our health system were identified. A total of 150 patients were contacted via telephone for formal consent prior to acquisition to the following outcomes: Knee Injury and Osteoarthritis Outcome Scores (KOOS), analog pain scores, and opioid consumption. Outcomes were collected at three time points postoperatively: 3, 6, and 12 months. Results: There was an improvement in KOOS scores and a decrease in persistent opioid use over time. There was not a significant difference in pain scores between opioid and non-opioid users at each of the three time points. There was a statistically significant difference with respect to KOOS scores at 3 and 6 months between opioid and non-opioid users. Conclusion: Our study demonstrates that patients who underwent TKA with a standardized MMA who also had continued opioid use post-operatively were more likely to have lower functional outcomes compared to non-opioid users.