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The Journal of arthroplasty v.33 no.1, 2018년, pp.113 - 118   SCIE
본 등재정보는 저널의 등재정보를 참고하여 보여주는 베타서비스로 정확한 논문의 등재여부는 등재기관에 확인하시기 바랍니다.

Narcotic Use and Total Knee Arthroplasty

Cancienne, Jourdan M. (Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia ) ; Patel, Kishan J. (Department of Orthopaedic Surgery, Larkin Community Hospital, South Miami, Florida ) ; Browne, James A. (Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia ) ; Werner, Brian C. (Department of Orthopaedic Surgery, University of Virginia Health System, Charlottesville, Virginia ) ;
  • 초록  

    Abstract Background Although the United States is in the midst of a narcotic epidemic, risk factors for use and the impact of perioperative narcotic use on total knee arthroplasty (TKA) outcomes is ill-defined. Methods A national database was queried for patients who underwent primary TKA from 2007 to 2015. Patients taking narcotics in the preoperative, and for a prolonged period of time postoperatively, were identified. The risk factors for prolonged narcotic use were analyzed with a regression analysis, in addition to evaluating preoperative and prolonged postoperative use as independent risk factors for short-term and long-term complications. Results In total, 113,337 patients met inclusion criteria, of which 31,733 patients were prescribed narcotics preoperatively and 35,770 patients were prescribed narcotics more than 3 months postoperatively. There are several independent risk factors for prolonged narcotic use postoperatively, the most significant being the number of narcotic prescriptions prescribed preoperatively. Preoperative narcotic use was independently associated with an increased risk of emergency room visits, readmission, infection, stiffness, and aseptic revision. Prolonged postoperative use was also associated with significantly increased rates of infection, stiffness, and aseptic revision. Conclusion Preoperative and prolonged narcotic use following TKA was associated with an increased risk of short-term and long-term complications following TKA. The liberal use of narcotics in the perioperative period should be considered a modifiable risk factor when considering elective TKA.


  • 주제어

    narcotics .   total knee arthroplasty .   complications .   revision .   opioid prescription.  

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