Opiate use after total hip arthroplasty for metastatic bone disease.

person Gayathri Vijayakumar Rush University Medical Center, Chicago, IL info_outline Gayathri Vijayakumar, Dylan Vance, Matthew W. Colman, Steven Gitelis, Kyle Sweeney, Alan T. Blank

Authors person Gayathri Vijayakumar Rush University Medical Center, Chicago, IL info_outline Gayathri Vijayakumar, Dylan Vance, Matthew W. Colman, Steven Gitelis, Kyle Sweeney, Alan T. Blank Organizations Rush University Medical Center, Chicago, IL, University of Kansas Medical Center, Kansas City, KS Abstract Disclosures Research Funding No funding received None. Background: Metastatic bone disease (MBD) commonly affects the hip and surgical intervention including total hip arthroplasty (THA) may be indicated for pain relief or to improve function. Following THA, patients are often prescribed short courses of opioids for postoperative pain relief. This study investigated postoperative opioid use following THA in MBD patients. Methods: This was a retrospective review of patients using opioids preoperatively who underwent THA for MBD at two institutions between 2009 and 2022. Preoperative and postoperative opioid usage at 6 weeks and 90 days were quantified through calculating daily morphine milligram equivalents (MME) and compared using the sign test. Results: Nineteen primary THA and 11 THA with complex acetabular reconstruction were included. At six weeks, 26 (86.7%) patients were utilizing opiates and at ninety days 23 (76.7%) patients were utilizing opiates. There was a statistically significant difference between median daily preoperative MME compared to daily MME at ninety days (p < 0.001). The only statistically significant association with opioid use at 90 days was opioid use at 6 weeks. Conclusions: To our knowledge, this is the first paper evaluating postoperative opioid use following primary THA in MBD patients. After THA in the setting of MBD, patients exhibit decreased postoperative opioid use. Postoperative opioid use. Opiate Use at 6 weeks 26 (86.7%) p value Daily MME at 6 weeks, median (IQR) 45 (18.75-101.25) Delta MME preop and 6 weeks, median (IQR) 0 (*-12.75-41.25) p = 0.186 Opiate Use at 90 days 23 (76.7%) Daily MME at 90 days, median (IQR) 30 (8.75-122.50) Delta MME preop and 90 days, median (IQR) 10 (*-12.75 – 63.75) p < 0.001 MME, morphine milligram equivalent; IQR, interquartile range; *negative value in IQR denotes greater opioid use compared to preoperative opioid use; statistically significant p value is bolded.