• Arch Orthop Trauma Surg · Dec 2022

    Total knee arthroplasty is associated with greater immediate post-surgical pain and opioid use than total hip arthroplasty.

    • David N Kugelman, Siddharth A Mahure, James E Feng, Joshua C Rozell, Ran Schwarzkopf, and William J Long.
    • New York University Langone Orthopaedic Hospital, 301 East 17 St, Manhattan, New York, NY, 10003, USA.
    • Arch Orthop Trauma Surg. 2022 Dec 1; 142 (12): 3575-3580.

    BackgroundAs greater emphasis is being placed on opioid reduction strategies and implementation of multimodal analgesia, we sought to determine whether immediate post-surgical opioid consumption was different between THA and TKA.MethodsA single-institution total joint arthroplasty database was used to identify patients who underwent elective THA and TKA from 2016 to July 2019. Baseline demographic data, operative time (defined by incision time), and American Society of Anesthesiologist (ASA) class were collected. Morphine milligram equivalents (MME) were calculated and derived from prospectively documented nursing opioid administration events, while visual analog scale (VAS) scores represented pain levels, both of which were collected as part of our institution's standard protocols. Activity Measure for Post-Acute Care (AMPAC) was used to determine physical therapy progress.ResultsA total of 11,693 cases were identified: 5,909 THA (50.53%) and 5784 (49.47%) TKA. THA patients tended to be slightly younger (63.38 years, SD 11.61 years, vs 65.72 years, SD 9.56 years; p < 0.01) and have lower BMIs (28.92 kg/m2 vs 32.52 kg/m2; p < 0.01). THA patients had lower ASA scores in comparison to TKA patients (p < 0.01). Aggregate opioid consumption (93.76 MME vs 147.55 MME; p < 0.01) along with first 24-h and 48-h usage was significantly less for THA as compared to TKA. Similarly, mean pain scores (4.15 vs 5.08; p < 0.01) were lower for THA, while AMPAC mobilization scores were higher (20.88 vs 19.29; p < 0.01) when compared to TKA.ConclusionTHA patients reported lower pain scores and were found to require less opioid medication in the immediate post-surgical period than TKA patients.© 2021. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.

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