Opioid Prescription

The objective of the study is to assess the incidence of postoperative opioid prescription; refills in patients undergoing osteochondral autograft transplant (OAT) and osteochondral allograft transplant (OCA) procedures of the knee; (2) to evaluate the effect of filling preoperative opioid prescriptions on the incidence of postoperative filling; and (3) to assess the impact of age, sex, and diagnosis of low-back pain on postoperative opioid prescription filling.

Howver, osteochondral lesions of the knee have the potential; to cause considerable pain and resultant limitations in function. Osteochondral autograft transplant (OAT) and osteochondral allograft transplant (OCA) procedures may be considered; to address these focal cartilage defects, although development of chronic knee pain in these patients has reported.

But the Humana administrative claims database queried for patients undergoing knee OAT; and OCA procedures between 2007 and 2017 by use of Current Procedural Terminology codes. Patients were stratified by age; diagnosis of low-back pain, preoperative opioid use, autograft and allograft procedures, and open and arthroscopic procedures.

Filled an opioid prescription

However, preoperative opioid users defined as those having filled an opioid prescription; within 3 months before surgery. The relative risk (risk ratio) for opioid prescription refills calculated monthly for 12 months. Multivariate logistic regression analysis performed to determine odds ratios (ORs) at 3, 6, and 12 months.

Patients undergoing OAT or OCA procedures were identified by use of the following Current Procedural Terminology codes: 27415 (osteochondral allograft, knee, open), 27416 (osteochondral autograft, knee, open);29866 (arthroscopy, knee, osteochondral autograft), and 29867 (arthroscopy, knee, osteochondral allograft). Procedures were queried as being mutually exclusive, meaning patients included; only if they had the occurrence of 1 of the Current Procedural Terminology codes of interest; without having undergone any of the other 3 procedures.

They identified 300 patients: 133 (44%) underwent OAT and 167 (56%) underwent OCA procedures. But if the patients, 236 (79%) aged 49 years or younger, and 31% of patients filled opioid prescriptions preoperatively. Of those who filled preoperative opioid prescriptions; 28% were still filling prescriptions 12 months after surgery.

Low-back pain increased

However, multivariate analysis showed an increased risk of opioid prescription filling at 3 months (OR, 7.46 [95% confidence interval (CI), 3.26-17.38]), 6 months (OR, 15.41 [95% CI, 5.52-41.99]); and 12 months (OR, 13.45 [95% CI, 5.41-33.75]) postoperatively in preoperative opioid users. Filling opioid prescriptions preoperatively increased the risk of postoperative filling of opioid prescriptions; after cartilage restoration procedures of the knee.

Over 30% of patients were found to have filled an opioid prescription preoperatively. Univariate analysis showed that age of 50 years or older and low-back pain increased; the risk of postoperative prescription refilling, but only age of 50 years or older provided a significantly increased risk at 3 months postoperatively using a multivariate analysis.

However, results showed 31% of patients filled opioid prescriptions preoperatively. Twenty-eight percent of patients who filled opioid prescriptions preoperatively; still filled prescriptions 12 months postoperatively. There was an increased risk for opioid prescription filling; in preoperative opioid users at 3, 6 and 12 months postoperatively.