Preoperative chronic opioid use and outcomes after primary hip and knee arthroplasty: Age, sex and BMI matter

Approval date: December 2018
Starting date: September 1st 2019

RGHH Nelissen, MGJ Gademan, TPM Vliet Vlieland, A Dahan, W Lijferink, D Broekhuis  

Research proposal abstract 

Inappropriate opioid use may lead to poor outcome after surgery and addiction of these drugs. In the Netherlands, opioid use is still increasing, the prescription of opioids by general practitioners increased 6-fold between 2005-2015. The main indication (>50%) for opioid prescription here was musculoskeletal pain. As musculoskeletal pain is the main indication for arthroplasty and more and more opioids are prescribed after surgery, arthroplasty patients have a substantial risk to become chronic opioid users. In the Netherlands annually >65.000 patients undergo arthroplasty surgery, hence (chronic) opioid use may be substantial, with a major impact on patients’ lives and society.

Therefore our aim is to evaluate opioid use in patients with a joint replacement. For that matter, the LROI, (Dutch Arthroplasty Register) will be linked with the registry of community pharmacies (SFK). The LROI is a nationwide population-based register with information on >630.000 prosthesis (95% of all primary total hip and knee replacements). The SFK contains information >95% of community pharmacies on medication use of individual patients. Combing data from these two registers will lead to extensive and unique data regarding out of hospital pain medication use and its consequences in Dutch patients with a total joint replacement. As such, this study provides important information for both orthopaedic surgeons and patients eligible for joint replacement surgery. Moreover other patient groups (patients with chronic pain 
and patients undergoing surgery) and their caregivers may benefit from these results as part of the results are applicable to them as well.