{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:27:36Z","timestamp":1791822456136,"version":"4.3.4"},"reference-count":40,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,6,27]],"date-time":"2022-06-27T00:00:00Z","timestamp":1656288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["associationofanaesthetists-publications.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Anaesthesia"],"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:title>Summary<\/jats:title>\n                  <jats:p>Persistent pain following knee arthroplasty occurs in up to 20% of patients and may require ongoing analgesia, including extended opioid administration. A comprehensive secondary analysis was performed from results of a study that considered persistent postoperative pain in 242 patients who underwent unilateral knee arthroplasty using a standardised enhanced recovery programme. Opioid prescribing for 12\u2009months before and 12\u2009months after surgery was evaluated and converted to oral morphine equivalents. Demographic, functional, psychological and pain questionnaires were completed along with quantitative sensory testing and genetic analysis. Forty\u2010nine percent of patients had at least one opioid prescription in the 12\u2009months before surgery. Opioid prescriptions were filled in 93% of patients from discharge to 3\u2009months and in 27% of patients \u22656\u2009months after surgery. Persistent opioid use \u22656\u2009months after surgery was strongly associated with pre\u2010operative opioid use (RR 3.2, p\u2009&lt;\u20090.001 (95%CI 1.9\u20135.4)). The median (IQR [range]) oral morphine equivalent daily dose was 3.6 (0.9\u201310.5 [0\u2013100.0]) mg pre\u2010operatively, 35.0 (22.5\u201352.5 [4.6\u2013180.0]) mg in hospital, 12.8 (5.1\u201324.8 [0\u201357.9]) mg from discharge to 3\u2009months and 5.9 (4.5\u201312.0 [0\u201344.5]) mg at \u22656\u2009months following surgery. Predictors of increased daily oral morphine equivalent \u22656\u2009months after surgery included increased average daily oral morphine equivalent dose compared with previous values (lag), increased body mass index and three or more comorbid pain sites. Persistent opioid use was not associated with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain (RR 1.003, p\u2009=\u20090.655, 95%CI 0.65\u20131.002) or WOMAC function (RR 1.001, p\u2009=\u20090.99, 95%CI 0.99\u20131.03) outcomes 6\u2009months after surgery. There was no association between persistent opioid use and pre\u2010operative quantitative sensory testing results or psychological distress. Pre\u2010operatively, patients with a higher body mass index, more comorbid pain sites and those who had filled an opioid prescription in the last 12\u2009months, were at increased risk of persistent opioid use and a higher oral morphine equivalent daily dose \u2265\u20096\u2009months after surgery. Strategies need to be developed to limit dose and duration of persistent opioid use in patients following knee arthroplasty surgery.<\/jats:p>","DOI":"10.1111\/anae.15783","type":"journal-article","created":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T01:59:30Z","timestamp":1656381570000},"page":"882-891","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":20,"title":["Factors associated with persistent opioid use 6\u201312\u2009months after primary total knee arthroplasty"],"prefix":"10.1111","volume":"77","author":[{"given":"M. T.","family":"Kluger","sequence":"first","affiliation":[{"name":"Department of Anaesthesiology and Peri\u2010operative Medicine Waitemat\u0101 DHB  Auckland New Zealand"},{"name":"Faculty of Medicine and Health Sciences University of Auckland  New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. A.","family":"Rice","sequence":"additional","affiliation":[{"name":"Health and Rehabilitation Research Institute Auckland University of Technology  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Borotkanics","sequence":"additional","affiliation":[{"name":"Auckland University of Technology  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. N.","family":"Lewis","sequence":"additional","affiliation":[{"name":"Health and Rehabilitation Research Institute Auckland University of Technology  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. A.","family":"Somogyi","sequence":"additional","affiliation":[{"name":"Discipline of Pharmacology, Faculty of Medicine and Health Sciences University of Adelaide  South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. T.","family":"Barratt","sequence":"additional","affiliation":[{"name":"Discipline of Pharmacology, Faculty of Medicine and Health Sciences University of Adelaide  South Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery Waitemat\u0101 DHB  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P. J.","family":"McNair","sequence":"additional","affiliation":[{"name":"Health and Rehabilitation Research Institute Auckland University of Technology  Auckland New Zealand"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,6,27]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"53","article-title":"The projected burden of knee osteoarthritis in New Zealand: healthcare expenditure and total joint provision","volume":"132","author":"Wilson R","year":"2019","journal-title":"New Zealand Medical Journal"},{"key":"e_1_2_6_3_1","volume-title":"Acute Pain Management: Scientific Evidence","author":"Schug SA","year":"2020"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.joca.2017.04.002"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/EJA.0000000000000319"},{"key":"e_1_2_6_6_1","unstructured":"HarrisonA GraingerR.Symptomatic management of osteoarthritis.https:\/\/bpac.org.nz\/BPJ\/2008\/October\/docs\/bpj17_osteoarthritis_pages_14-20.pdf(accessed 03\/12 \/2021)."},{"key":"e_1_2_6_7_1","unstructured":"National Institute for Health and Care Excellence.Osteoarthritis: care and management. 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