Predictors of pain medication use for arthroplasty pain after revision total knee arthroplasty.

Abstract

OBJECTIVE:

Our objective was to study the use of pain medications for persistent knee pain and their predictors after revision total knee arthroplasty (TKA).

METHODS:

We examined whether demographic (gender, age) and clinical characteristics [BMI, co-morbidity measured by the Deyo-Charlson index (a 5-point increase), anxiety and depression] predict the use of NSAIDs and narcotic pain medications 2 and 5 years after revision TKA. Multivariable logistic regression adjusted for these predictors as well as operative diagnosis, American Society of Anesthesiologists class and distance from the medical centre.

RESULTS:

A total of 1533 patients responded to the 2-year questionnaire and 881 responded to the 5-year questionnaire. NSAID use was reported by 13.4% (206/1533) of patients at 2 years and 16.7% (147/881) at 5 years. Narcotic medication use was reported by 5.4% (83/1533) of patients at 2 years and 5.9% (52/881) at 5 years. Significant predictors of the use of NSAIDs for index TKA pain at 2 and 5 years were age >60-70 years [odds ratio (OR) 0.62 (95% CI 0.39, 0.98) and 0.46 (0.25, 0.85)] compared with age ≤60 years and a higher Deyo-Charlson index [OR 0.51 (95% CI 0.28, 0.93)] per 5-point increase at 5-year after revision TKA. Significant predictors of narcotic pain medication use for index TKA pain were age >60-70 years [OR 0.41 (0.21, 0.78)] and >70-80 years [0.40 (95% CI 0.22, 0.73)] at 2 years and depression [OR 4.58 (95% CI 1.58, 13.18)] at 5 years.

CONCLUSION:

Younger age and depression were risk factors for the use of NSAIDs and narcotic pain medications for index TKA pain at 2- and 5-years after revision TKA.

• Authors: Jasvinder A Singh, David G Lewallen
• Journal: Rheumatology (Oxford, England) (Rheumatology (Oxford)) Vol. 53 Issue 10 Pg. 1752-8 (Oct 2014) ISSN: 1462-0332 [Electronic] England
• PMID: 24459220 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)
• Copyright: © The Author 2014. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: [email protected].

Chemical References

• Analgesics

Topics

• Adult
• Age Factors
• Aged
• Aged, 80 and over
• Analgesics (therapeutic use)
• Arthroplasty, Replacement, Knee (adverse effects)
• Depression
• Female
• Follow-Up Studies
• Humans
• Knee Joint (surgery)
• Male
• Middle Aged
• Pain, Postoperative (drug therapy)
• Registries
• Risk Factors
• Severity of Illness Index
• Sex Factors
• Surveys and Questionnaires
• Treatment Outcome