Narcotic Use: A Modifiable Risk Factor for Hip and Knee Arthroplasty

The use of opioids in the United States has become an epidemic. Opioids have become frequently prescribed for arthritic pain in the hip and knee. The use of opioidsas first-round therapy for pain has been driven by several factors, including the health care providers’ lack of understanding that antiinflammatory medications are at least as effective as opioids, a patient’s expectation of complete pain relief on presentation to the emergency room or doctor’s office, and increasing importance placed on patient satisfaction. The harmful effects of opioids are observed after joint replacement with long-term use leading to worse results after joint replacement. Decreasing the amount of opioids used before surgery improves outcomes after surgery. The use of opioids may be modified before surgery to give better surgical results. The goal of this review is to determine how opioid medications should fit into the treatment of arthritis pain, learn the guidelines for their use in arthritis, and understand how to educate health care providers that opioid use is a modifiable risk factor. (Journal of Surgical Orthopaedic Advances 25(4):227–233, 2016) Key words: hip arthroplasty, knee arthroplasty, modifiable risk factor, opioid, pain