Display options
Share it on

HSS J. 2015 Feb;11(1):71-5. doi: 10.1007/s11420-014-9418-4. Epub 2014 Nov 01.

Preoperative predictors of postoperative opioid usage, pain scores, and referral to a pain management service in total knee arthroplasty.

HSS journal : the musculoskeletal journal of Hospital for Special Surgery

Trevor R Banka, Allison Ruel, Kara Fields, Jacques YaDeau, Geoffrey Westrich

Affiliations

  1. Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA ; Weill Cornell Medical College, New York, NY USA.
  2. Hospital for Special Surgery, 535 E. 70th Street, New York, NY 10021 USA.

PMID: 25737672 PMCID: PMC4342398 DOI: 10.1007/s11420-014-9418-4

Abstract

BACKGROUND: Little is known about preoperative predictors of postoperative pain and referral to a recuperative pain management service after total knee arthroplasty (TKA).

QUESTIONS/PURPOSES: We sought to identify the preoperative predictors of postoperative pain scores, referral to a pain management service, and narcotic usage in patients undergoing primary total knee arthroplasty.

METHODS: We performed a prospective cohort study of 97 TKAs from a single surgeon. Pre and 6-week postoperative WOMAC, visual analog pain scale (VAS) scores, narcotic usage, and catastrophizing pain scores were collected.

RESULTS: After adjusting for all other variables, higher age and catastrophizing pain scores were associated with lower odds of postoperative opioid usage. Increasing age and BMI were associated with lower odds of being referred to pain management. There was no relationship between self-reported preoperative pain tolerance and postoperative change in WOMAC or VAS pain scores.

CONCLUSIONS: This information may help surgeons advise their patients preoperatively and set expectations during the recovery period.

Keywords: opioid usage; outcomes; pain management; preoperative predictors; total knee arthroplasty

References

  1. Bone Joint J. 2013 Jan;95-B(1):45-51 - PubMed
  2. Clin Orthop Relat Res. 2005 Nov;440:157-61 - PubMed
  3. Clin J Pain. 2001 Mar;17(1):52-64 - PubMed
  4. Rheumatology (Oxford). 1999 Jan;38(1):73-83 - PubMed
  5. Health Qual Life Outcomes. 2010 Aug 19;8:87 - PubMed
  6. Anesth Analg. 2011 Oct;113(4):784-90 - PubMed
  7. Pain. 2005 Feb;113(3):369-75 - PubMed
  8. J Behav Med. 2000 Aug;23(4):351-65 - PubMed
  9. Arthritis Rheum. 2006 Apr 15;55(2):325-32 - PubMed
  10. J Knee Surg. 2003 Oct;16(4):215-20 - PubMed
  11. J Bone Joint Surg Am. 2007 Jun;89(6):1161-9 - PubMed
  12. Knee. 2010 Jan;17(1):15-8 - PubMed
  13. Arthritis Rheum. 2011 Aug;63(8):2531-9 - PubMed
  14. J Bone Joint Surg Am. 2004 May;86-A(5):963-74 - PubMed
  15. J Bone Joint Surg Br. 1998 May;80(3):426-31 - PubMed
  16. Br J Gen Pract. 2007 Jan;57(534):15-22 - PubMed
  17. J Bone Joint Surg Am. 1998 Feb;80(2):163-73 - PubMed
  18. Clin Orthop Relat Res. 2003 Nov;(416):27-36 - PubMed
  19. Pain Med. 2008 Apr;9(3):299-314 - PubMed
  20. Curr Opin Rheumatol. 2006 Sep;18(5):526-30 - PubMed
  21. Anesthesiology. 2009 Dec;111(6):1206-16 - PubMed
  22. J Arthroplasty. 2009 Feb;24(2):210-6 - PubMed
  23. Clin Orthop Relat Res. 2010 Mar;468(3):798-806 - PubMed
  24. Ann Rheum Dis. 2005 Jan;64(1):29-33 - PubMed
  25. Arthritis Rheum. 2004 Feb 15;51(1):100-9 - PubMed
  26. Acta Anaesthesiol Scand. 2002 Nov;46(10):1265-71 - PubMed
  27. Pain. 2001 Feb 15;90(3):261-9 - PubMed
  28. J Arthroplasty. 2004 Oct;19(7 Suppl 2):125-30 - PubMed
  29. J Bone Joint Surg Am. 2007 Apr;89(4):780-5 - PubMed
  30. BMJ. 1999 May 15;318(7194):1299-300 - PubMed
  31. Pain. 2012 Nov;153(11):2192-203 - PubMed
  32. Knee. 2007 Dec;14(6):417-23 - PubMed
  33. Osteoarthritis Cartilage. 2007 Mar;15(3):273-80 - PubMed
  34. Clin Orthop Relat Res. 2007 Nov;464:21-6 - PubMed
  35. HSS J. 2006 Feb;2(1):78-82 - PubMed
  36. Pain Res Manag. 2008 Jul-Aug;13(4):335-41 - PubMed
  37. Clin J Pain. 2007 Oct;23(8):683-90 - PubMed
  38. Arthritis Rheum. 2001 Oct;45(5):453-61 - PubMed
  39. Clin Orthop Relat Res. 2008 Dec;466(12):3066-70 - PubMed

Publication Types