Simon Kornvig, Henrik Kehlet, Christoffer C Jørgensen, Anders Fink-Jensen, Poul Videbech, Alma B Pedersen, Claus Varnum
{"title":"术前精神药理学治疗与髋关节和膝关节置换术后新的慢性阿片类药物使用风险的关联:一项丹麦基于登记的队列研究,涉及73033例手术。","authors":"Simon Kornvig, Henrik Kehlet, Christoffer C Jørgensen, Anders Fink-Jensen, Poul Videbech, Alma B Pedersen, Claus Varnum","doi":"10.2340/17453674.2025.44228","DOIUrl":null,"url":null,"abstract":"<p><strong>Background and purpose: </strong> Chronic opioid use is of great concern worldwide. Thus, identification of risk factors for new chronic opioid use (COU) after hip and knee arthroplasty is imperative to target preventive strategies. Depression/anxiety may be risk factors for new COU. However, no studies have investigated whether any or subgroups of preoperative psychopharmacological treatments (PPTs) are risk factors for new COU after hip and knee arthroplasty in a nationwide setting, which was the aim of the present study.</p><p><strong>Methods: </strong> This population-based cohort study included 40,476 primary hip and 32,557 primary knee arthroplasties from 2015 to 2022 using the Danish Hip/Knee Arthroplasty Registers. Preoperative opioid users were excluded. Dispensing records of psychotropics and opioids were obtained from the Danish National Prescription Registry. Relative risks of new COU were estimated with 95% confidence intervals (CI) using binary regression and adjusted for age, sex, and Charlson Comorbidity Index.</p><p><strong>Results: </strong> Among hip patients using psychopharmacological treatments (PPTs), 4.6% (202/4,439) had new COU compared with 2.2% (788/36,037) of patients not using PPTs, corresponding to an adjusted relative risk of 1.8 (CI 1.6-2.1). Among total and unicompartmental knee arthroplasties, 9.1% (298/3,261) and 6.4% (59/926) had new COU compared with 4.7 (1,011/21,529) and 2.9% (201/6,841) of patients not using PPTs, corresponding to adjusted relative risks of 1.8 (CI 1.6-2.1) and 2.0 (CI 1.5-2.7), respectively. Analyses of PPT subgroups showed similar results.</p><p><strong>Conclusion: </strong> Hip and knee arthroplasty patients using PPTs have almost a twofold increased risk of new COU. This emphasizes the need for prevention strategies in these patients.</p>","PeriodicalId":6916,"journal":{"name":"Acta Orthopaedica","volume":"96 ","pages":"492-498"},"PeriodicalIF":2.5000,"publicationDate":"2025-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207537/pdf/","citationCount":"0","resultStr":"{\"title\":\"Association of preoperative psychopharmacological treatment and the risk of new chronic opioid use after hip and knee arthroplasty: a Danish registry-based cohort study of 73,033 procedures.\",\"authors\":\"Simon Kornvig, Henrik Kehlet, Christoffer C Jørgensen, Anders Fink-Jensen, Poul Videbech, Alma B Pedersen, Claus Varnum\",\"doi\":\"10.2340/17453674.2025.44228\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background and purpose: </strong> Chronic opioid use is of great concern worldwide. Thus, identification of risk factors for new chronic opioid use (COU) after hip and knee arthroplasty is imperative to target preventive strategies. Depression/anxiety may be risk factors for new COU. However, no studies have investigated whether any or subgroups of preoperative psychopharmacological treatments (PPTs) are risk factors for new COU after hip and knee arthroplasty in a nationwide setting, which was the aim of the present study.</p><p><strong>Methods: </strong> This population-based cohort study included 40,476 primary hip and 32,557 primary knee arthroplasties from 2015 to 2022 using the Danish Hip/Knee Arthroplasty Registers. Preoperative opioid users were excluded. Dispensing records of psychotropics and opioids were obtained from the Danish National Prescription Registry. Relative risks of new COU were estimated with 95% confidence intervals (CI) using binary regression and adjusted for age, sex, and Charlson Comorbidity Index.</p><p><strong>Results: </strong> Among hip patients using psychopharmacological treatments (PPTs), 4.6% (202/4,439) had new COU compared with 2.2% (788/36,037) of patients not using PPTs, corresponding to an adjusted relative risk of 1.8 (CI 1.6-2.1). Among total and unicompartmental knee arthroplasties, 9.1% (298/3,261) and 6.4% (59/926) had new COU compared with 4.7 (1,011/21,529) and 2.9% (201/6,841) of patients not using PPTs, corresponding to adjusted relative risks of 1.8 (CI 1.6-2.1) and 2.0 (CI 1.5-2.7), respectively. Analyses of PPT subgroups showed similar results.</p><p><strong>Conclusion: </strong> Hip and knee arthroplasty patients using PPTs have almost a twofold increased risk of new COU. This emphasizes the need for prevention strategies in these patients.</p>\",\"PeriodicalId\":6916,\"journal\":{\"name\":\"Acta Orthopaedica\",\"volume\":\"96 \",\"pages\":\"492-498\"},\"PeriodicalIF\":2.5000,\"publicationDate\":\"2025-06-29\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12207537/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Acta Orthopaedica\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.2340/17453674.2025.44228\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"ORTHOPEDICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Acta Orthopaedica","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.2340/17453674.2025.44228","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"ORTHOPEDICS","Score":null,"Total":0}
Association of preoperative psychopharmacological treatment and the risk of new chronic opioid use after hip and knee arthroplasty: a Danish registry-based cohort study of 73,033 procedures.
Background and purpose: Chronic opioid use is of great concern worldwide. Thus, identification of risk factors for new chronic opioid use (COU) after hip and knee arthroplasty is imperative to target preventive strategies. Depression/anxiety may be risk factors for new COU. However, no studies have investigated whether any or subgroups of preoperative psychopharmacological treatments (PPTs) are risk factors for new COU after hip and knee arthroplasty in a nationwide setting, which was the aim of the present study.
Methods: This population-based cohort study included 40,476 primary hip and 32,557 primary knee arthroplasties from 2015 to 2022 using the Danish Hip/Knee Arthroplasty Registers. Preoperative opioid users were excluded. Dispensing records of psychotropics and opioids were obtained from the Danish National Prescription Registry. Relative risks of new COU were estimated with 95% confidence intervals (CI) using binary regression and adjusted for age, sex, and Charlson Comorbidity Index.
Results: Among hip patients using psychopharmacological treatments (PPTs), 4.6% (202/4,439) had new COU compared with 2.2% (788/36,037) of patients not using PPTs, corresponding to an adjusted relative risk of 1.8 (CI 1.6-2.1). Among total and unicompartmental knee arthroplasties, 9.1% (298/3,261) and 6.4% (59/926) had new COU compared with 4.7 (1,011/21,529) and 2.9% (201/6,841) of patients not using PPTs, corresponding to adjusted relative risks of 1.8 (CI 1.6-2.1) and 2.0 (CI 1.5-2.7), respectively. Analyses of PPT subgroups showed similar results.
Conclusion: Hip and knee arthroplasty patients using PPTs have almost a twofold increased risk of new COU. This emphasizes the need for prevention strategies in these patients.
期刊介绍:
Acta Orthopaedica (previously Acta Orthopaedica Scandinavica) presents original articles of basic research interest, as well as clinical studies in the field of orthopedics and related sub disciplines. Ever since the journal was founded in 1930, by a group of Scandinavian orthopedic surgeons, the journal has been published for an international audience. Acta Orthopaedica is owned by the Nordic Orthopaedic Federation and is the official publication of this federation.