Patients who took opioids prior to undergoing total knee replacement surgery (TKR) experience 9% less pain relief at 6 months postsurgery, compared to those who did not, according to researchers from Brigham and Women’s Hospital.

Patients who had a higher degree of pain catastrophising—the degree of an exaggerated, negative response to pain—were more likely to take opioids for pain relief prior to TKR surgery, and they also had less pain relief after the surgery, per their study, published recently in the Journal of Bone and Joint Surgery.

The research team, led by Elena Losina, PhD, lead author, director of the Policy and Innovation Evaluation in Orthopedic Treatments Center and co-director of the Orthopedics and Arthritis Center for Outcomes Research at Brigham and Women’s Hospital reviewed data from 156 patients who had TKR at an average age of 66, notes a media release from Brigham and Women’s Hospital.

They collected patient-reported outcomes and demographic data both before and 6 months after surgery, and abstracted data regarding opioid use from the patients’ medical records. Researchers found that prior to surgery, 23% of patients had at least one opioid prescription.

Using standard pain scales (Pain Catastrophizing Scale, the Western Ontario and the McMaster Universities Osteoarthritis Index (WOMAC), the investigators quantified the pain experiences of patients undergoing TKR. They used sophisticated analytic methods to compare the change in the WOMAC pain score 6 months after knee surgery and establish the difference between patients who had and those who had not used opioids before TKR. Researchers found that the patients who used opioids prior to surgery had about 9% less pain reduction at 6 months following surgery, the release continues.

“With these study results, we’d encourage physicians to consider discussing long-term implications of opioid therapy with their patients,” Losina states in the release. “Although each patient case is different, patients and physicians should discuss the potential impact of using opioids in patients with knee osteoarthritis who are likely to consider total knee replacement within the next 2 years.”

[Source(s): Brigham and Women’s Hospital, Science Daily]