Key result
Postoperative opioid usage during hospital stay following primary THA decreased significantly from 34.5 MME/d in 2016 to 13.3 MME/d in 2021, an average decrease of 2.81 MME/d each year (p<0.001).
Why the study?
Although protocols have been proposed to limit opioid use after orthopedic surgery, changing trends in opioid use over time have not been described.
Do improved postoperative opioid protocols decrease opioid usage following primary total hip arthroplasty?
Cohort (n=7,897)
No
Do improved postoperative opioid protocols decrease opioid usage following primary total hip arthroplasty?
Postoperative opioid usage during hospital stay following primary total hip arthroplasty significantly decreased from 2016 to 2021, reflecting the successful impact of opioid-reducing protocols.
Answers are grounded in this paper and cite their sources.
Opioid reduction trends post-THA support protocol monitoring; leaves open outcome benefits and broader applicability.
Several 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.
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Scanlon et al. (2023) conducted a cohort in Primary total hip arthroplasty (n=7,897). Year of surgery (2016-2021) vs. 2016 was evaluated on Average daily postoperative opioid usage (MME/d) (decrease of 2.81 MME/d each year, p=< 0.001). Postoperative opioid usage during hospital stay following primary THA decreased significantly from 34.5 MME/d in 2016 to 13.3 MME/d in 2021, an average decrease of 2.81 MME/d each year (p<0.001).
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