Pain medication purchases before and after total hip and knee arthroplasty: a register study of 329,743 arthroplasties

Authors

  • Ville Turppo Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio https://orcid.org/0000-0002-1101-2168
  • Reijo Sund Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio; Unit of Health Economics and Equity in Health Care, Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki https://orcid.org/0000-0002-6268-8117
  • Jukka Huopio Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
  • Heikki Kröger Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio; Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland
  • Joonas Sirola Kuopio Musculoskeletal Research Unit (KMRU), Institute of Clinical Medicine, University of Eastern Finland (UEF), Kuopio; Department of Orthopaedics, Traumatology and Hand Surgery, Kuopio University Hospital, Kuopio, Finland

DOI:

https://doi.org/10.2340/17453674.2022.2929

Keywords:

Arthroplasty, Hip, Knee, NSAID, Opioid, Pain Medication, Paracetamol

Abstract

Background and purpose: Total hip (THA) and knee (TKA) arthroplasty are effective pain treatment in osteoarthritis; however, there are patients with long-term pain and in need of analgesics. We studied purchases of paracetamol, non-steroidal anti-inflammatory drugs (NSAIDs), opioids, and neuropathic pain medication before and after THA or TKA.
Patients and methods: We searched all THA (n = 149,158) and TKA (n = 180,585) cases in Finland between the years 1998 and 2018 and the drug purchases made by patients during 1997–2018 using linked Finnish register data. Drug purchases were studied in 3-month periods.
Results: The purchases of all analgesics increased from 3 years before operation to 3 months before operation. Around the time of THA or TKA, the purchases of all analgesics spiked to 7–56%, depending on drug. The purchases of all analgesics decreased rapidly during the first 6 months postoperatively. Purchases of paracetamol, NSAIDs, and opioids at 6 months postoperatively (6–23%) were lower than they were at 3 months preoperatively. At 3 years postoperatively, only paracetamol purchases were lower (15–18%) postoperatively than they were 3 years before arthroplasty. NSAID, opioid, and neuropathic pain medication purchases remained higher (4–14%).
Interpretation: THA and TKA stop and reduce the preoperative increases in purchases of paracetamol, NSAIDs, and opioids. The purchases of pain medications by THA and TKA patients 1 year after operation are close to those in the general population.

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Published

2022-06-08

How to Cite

Turppo, V., Sund, R., Huopio, J., Kröger, H., & Sirola, J. (2022). Pain medication purchases before and after total hip and knee arthroplasty: a register study of 329,743 arthroplasties. Acta Orthopaedica, 93, 534–541. https://doi.org/10.2340/17453674.2022.2929

Issue

Section

National/international register study