Opioid Use After Robotic-Assisted Versus Conventional Total Hip Arthroplasty: A National Database Analysis.

IF 1.1 4区 医学 Q3 ORTHOPEDICS Orthopedics Pub Date : 2024-09-01 Epub Date: 2024-07-08 DOI:10.3928/01477447-20240702-03
Thompson Zhuang, Bill Young, Jessica Hooper, Derek F Amanatullah, Lauren Shapiro, Robin N Kamal
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Abstract

Background: In this study, we tested the null hypothesis that robotic-assisted total hip arthroplasty (THA) vs conventional THA was not associated with (1) the amount of postoperative opioid use and (2) the incidence of new, persistent opioid use.

Materials and methods: We used a large, national administrative database to identify patients 50 years and older undergoing primary robotic or conventional THA. Patients with hip fractures or a history of malignancy, hip infection, or opioid use disorder were excluded. Patients who filled an opioid prescription within 1 year to 30 days preoperatively or who underwent a subsequent procedure within 1 year after THA were excluded. Outcomes included the morphine milligram equivalents (MMEs) filled within the THA perioperative period and the incidence of new, persistent opioid use. Multivariable logistic regression models were used to evaluate associations between robotic-assisted THA and new, persistent opioid use, adjusting for age, sex, insurance plan, region, location of surgery, and comorbidities.

Results: In the postoperative period, robotic-assisted THA, compared with conventional THA, was associated with a lower mean total MMEs filled per patient (452.2 vs 517.1; P<.001) and a lower mean MMEs per patient per day (71.53 vs 74.64; P<.001). Patients undergoing robotic-assisted THA had decreased odds of developing new, persistent opioid use compared with patients undergoing conventional THA (adjusted odds ratio, 0.82 [95% CI, 0.74-0.90]).

Conclusion: Robotic-assisted THA is associated with lower postoperative opioid use and a decreased odds of developing new, persistent opioid use compared with conventional THA. For the purposes of reducing opioid use, our results support the adoption of robotic-assisted THA. [Orthopedics. 2024;47(5):289-294.].

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机器人辅助与传统全髋关节置换术后阿片类药物的使用:全国数据库分析。
背景:在这项研究中,我们检验了以下零假设:机器人辅助全髋关节置换术(THA)与传统 THA 相比,与(1)术后阿片类药物的使用量和(2)新的、持续使用阿片类药物的发生率无关:我们使用一个大型的全国性行政数据库来识别 50 岁及以上接受初级机器人或传统 THA 手术的患者。排除了髋部骨折或有恶性肿瘤、髋部感染或阿片类药物使用障碍病史的患者。术前1年至30天内开过阿片类药物处方或在THA术后1年内接受过后续手术的患者不包括在内。研究结果包括在 THA 围手术期使用的吗啡毫克当量 (MME) 以及新的、持续使用阿片类药物的发生率。多变量逻辑回归模型用于评估机器人辅助THA与新的、持续使用阿片类药物之间的关系,并对年龄、性别、保险计划、地区、手术地点和合并症进行了调整:结果:在术后期间,机器人辅助 THA 与传统 THA 相比,每位患者使用的阿片类药物的平均总量较低(452.2 对 517.1;PPC 结论:机器人辅助 THA 与阿片类药物的持续使用有关:与传统的 THA 相比,机器人辅助 THA 术后阿片类药物使用量更低,新的、持续使用阿片类药物的几率也更低。为了减少阿片类药物的使用,我们的研究结果支持采用机器人辅助 THA。[骨科。202x;4x(x):xx-xx]。
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来源期刊
Orthopedics
Orthopedics 医学-整形外科
CiteScore
2.20
自引率
0.00%
发文量
160
审稿时长
3 months
期刊介绍: For over 40 years, Orthopedics, a bimonthly peer-reviewed journal, has been the preferred choice of orthopedic surgeons for clinically relevant information on all aspects of adult and pediatric orthopedic surgery and treatment. Edited by Robert D''Ambrosia, MD, Chairman of the Department of Orthopedics at the University of Colorado, Denver, and former President of the American Academy of Orthopaedic Surgeons, as well as an Editorial Board of over 100 international orthopedists, Orthopedics is the source to turn to for guidance in your practice. The journal offers access to current articles, as well as several years of archived content. Highlights also include Blue Ribbon articles published full text in print and online, as well as Tips & Techniques posted with every issue.
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