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Preoperative Predictors of Postoperative Opioid Usage, Pain Scores, and Referral to a Pain Management Service in Total Knee Arthroplasty

  • Original Article
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HSS Journal ®

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.

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Disclosures

Conflict of Interest:

Trevor R. Banka, MD, Allison Ruel, BA, Kara Fields, MS and Jacques YaDeau, MD, PhD have declared that they have no conflict of interest. Geoffrey Westrich, MD is a board member of Eastern Orthopaedic Association and Knee Society and employee at Exactech, Stryker, and DJO and receives payments for development of educational presentations from Exactech, Stryker, and DJ and research support from Exactech and Stryker, outside the work.

Human/Animal Rights

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2008 (5).

Informed Consent

Informed consent was obtained from all patients for being included in the study.

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Disclosure forms provided by the authors are available with the online version of this article.

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Authors and Affiliations

  1. Hospital for Special Surgery, 535 E. 70th Street, New York, NY, 10021, USA

    Trevor R. Banka MD, Allison Ruel BA, Kara Fields MS, Jacques YaDeau MD, PhD & Geoffrey Westrich MD

  2. Weill Cornell Medical College, New York, NY, USA

    Trevor R. Banka MD, Jacques YaDeau MD, PhD & Geoffrey Westrich MD

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  1. Trevor R. Banka MD
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  2. Allison Ruel BA
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  3. Kara Fields MS
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Correspondence to Geoffrey Westrich MD.

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Level of Evidence: Level I: Prognostic study.

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Banka, T.R., Ruel, A., Fields, K. et al. Preoperative Predictors of Postoperative Opioid Usage, Pain Scores, and Referral to a Pain Management Service in Total Knee Arthroplasty. HSS Jrnl 11, 71–75 (2015). https://doi.org/10.1007/s11420-014-9418-4

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  • DOI: https://doi.org/10.1007/s11420-014-9418-4

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