Predictors of use of pain medications for persistent knee pain after primary Total Knee Arthroplasty: a cohort study using an institutional joint registryReport as inadecuate




Predictors of use of pain medications for persistent knee pain after primary Total Knee Arthroplasty: a cohort study using an institutional joint registry - Download this document for free, or read online. Document in PDF available to download.

Arthritis Research and Therapy

, 14:R248

First Online: 16 November 2012Received: 04 May 2012Revised: 25 October 2012Accepted: 14 November 2012

Abstract

IntroductionTo study the use of pain medications for persistent index knee pain and their predictors after primary Total Knee Arthroplasty TKA.

MethodsThe Mayo Total Joint Registry collects patient-reported data including pain medication use on all patients who undergo TKA. We used data from patients who underwent primary TKA from 1993-2005. We examined whether gender, age reference, ≤60 yrs, body mass index BMI; reference, <25 kg-m, comorbidities measured by Deyo-Charlson index 5-point increase, anxiety and depression predicted use of pain medications non-steroidal anti-inflammatory drugs NSAIDs and opioids 2- and 5-years after primary TKA. Multivariable logistic regression additionally adjusted for operative diagnosis, American Society of Anesthesiologists ASA score, implant fixation and distance from the medical center.

Results7,139 of the 10,957 eligible 65% at 2-years and 4,234 of 7,404 eligible 57% completed questionnaires. Significant predictors of NSAIDs use were Odds ratio 95% confidence interval: male gender at 2- and 5-years, 0.5 0.4, 0.6 and 0.6 0.5, 0.8; age >70-80 years, 0.7 0.5, 0.9, 0.6 0.4, 0.8; and depression, 1.4 1.0, 1.8 and 1.7 1.1, 2.5. BMI ≥40 was associated with NSAIDs use only at 2-years, 1.6 1.1, 2.5. Significant predictors of opioid pain medication use at 2- and 5-years were: male gender, 0.5 0.3, 0.9 and 0.4 0.2, 0.8; age >70-80 years, 0.3 0.1, 0.6, 0.3 0.1, 0.8; and anxiety, 3.0 1.6, 5.7 and 4.0 1.7, 9.4.

ConclusionsFemale gender and younger age were associated with higher risk of use of NSAIDs and opioids after primary TKA. Depression was associated with higher NSAID use and anxiety with higher opioid pain medication use after primary TKA.

AbbreviationsASAAmerican Society of Anesthesiologists

BMIbody mass index

GEEgeneralized estimating equation

ICD-9International Classification of Diseases, ninth revision

NSAIDnon-steroidal anti-inflammatory drug

PROpatient-reported outcome

STROBEStrengthening of Reporting in Observational studies in Epidemiology

THAtotal hip arthroplasty

TKAtotal knee arthroplasty.

Electronic supplementary materialThe online version of this article doi:10.1186-ar4091 contains supplementary material, which is available to authorized users.

Download fulltext PDF



Author: Jasvinder A Singh - David G Lewallen

Source: https://link.springer.com/







Related documents