{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T16:06:25Z","timestamp":1784045185018,"version":"3.55.0"},"reference-count":23,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"\n Importance<\/jats:title>\n Oxycodone and hydrocodone are the most frequently prescribed opioids for postoperative joint arthroplasty pain, yet comparative effectiveness data remain limited.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n To compare postoperative pain outcomes and opioid consumption for hydrocodone vs oxycodone among patients undergoing elective joint arthroplasty.<\/jats:p>\n <\/jats:sec>\n \n Design, Setting, and Participants<\/jats:title>\n This cohort study was a preplanned secondary analysis of a randomized clinical trial conducted among cytochrome P450 2D6 (CYP2D6) normal metabolizers (NMs) who underwent elective joint arthroplasty in 5 US surgery clinical sites from March 2021 to September 2023 and received hydrocodone or oxycodone postoperatively. Follow-up concluded in March 2024. Data analysis was conducted from October 2024 to December 2025.<\/jats:p>\n <\/jats:sec>\n \n Exposure<\/jats:title>\n Postoperative analgesia with hydrocodone or oxycodone within a multimodal pain management approach (opioids and nonopioids).<\/jats:p>\n <\/jats:sec>\n \n Main Outcomes and Measures<\/jats:title>\n Coprimary outcomes were composite pain score at postoperative day 10 (sum of current, worst, and mean pain over 7 days; range 3-15) and cumulative morphine milligram equivalents (MMEs) over 10 days. Secondary outcomes included mobility scores at day 10 and Patient-Reported Outcomes Measurement Information System anxiety and depression scores at day 30. Multivariable regressions were adjusted for demographic and clinical covariates.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 663 participants (mean [SD] age, 66 [10.6] years; 384 [57.9%] female), 217 received oxycodone and 446 received hydrocodone. Hydrocodone was associated with significantly lower composite pain scores compared with oxycodone (mean [SD], 9.0 [2.0] vs 9.3 [2.2]; adjusted\n P<\/jats:italic>\n \u2009=\u2009.001) and significantly lower cumulative MME (mean [SD], 93.5 [159.3] vs 154.5 [121.6]; adjusted\n P<\/jats:italic>\n \u2009&amp;lt;\u2009.001). Secondary outcomes did not differ between groups (mobility score: mean [SD], 26.3 [10.4] vs 30.9 [14.7];\n P<\/jats:italic>\n \u2009=\u2009.29; anxiety score: mean [SD], 45.4 [8.3] vs 45.5 [8.7];\n P<\/jats:italic>\n \u2009=\u2009.31; depression score: mean [SD], 43.8 [7.8] vs 44.0 [7.9];\n P<\/jats:italic>\n \u2009=\u2009.97). Findings were consistent in sensitivity analyses, restricting to opioid and acetaminophen combinations, restricting to sites prescribing both opioids, and in subgroups of knee arthroplasty, but not consistent in hip arthroplasty.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions and Relevance<\/jats:title>\n In this cohort study of CYP2D6 NMs undergoing joint arthroplasty, within multimodal analgesia, hydrocodone provided comparable pain control to oxycodone with significantly lower opioid exposure, supporting its use as a viable and possibly preferable analgesic option.<\/jats:p>\n <\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2026.23079","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T15:30:20Z","timestamp":1784043020000},"page":"e2623079","source":"Crossref","is-referenced-by-count":0,"title":["Hydrocodone vs Oxycodone and Postoperative Pain and Opioid Use in Joint Arthroplasty"],"prefix":"10.1001","volume":"9","author":[{"given":"Noor 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