Impact of Preoperative Opioid Use on Revision Total Knee Arthroplasty Outcomes

Preoperative opioid utilization is independently associated with a greater risk for an early revision total knee arthroplasty (rTKA). Chronic opioid utilization (defined as opioid use for ≥3 months preoperatively) is a significant predictor of rTKA. Continuous preoperative utilization before rTKA is associated with higher odds of adverse events. These include periprosthetic joint infection, venous thromboembolism, opioid overdose, revision surgery, extended hospital length of stay (LOS), nonhome discharge, 90-day readmission, and emergency room visits. The opioid holiday (6 months of opioid-naïve period after prior use) seems to confer risk reduction. Individuals who are actively taking opioids at the time of rTKA achieve lower postoperative outcome scores. These individuals are more likely to have longer LOSs.