Dose-dependent increased risk of periprosthetic infection and venous thromboembolic events was observed in patients in which opioid consumption was increased in the initial postoperative phase after total joint arthroplasty of hip and knee, as per the outcomes of a research published in The Journal of Bone and Joint Surgery.

Brian C Chung et al. studied the possible link between the dose of opioids used for pain relief and post-surgical complications after primary total hip arthroplasty (THA) and total knee arthroplasty (TKA). Adults patients (n = 1,525,985, mean age 65.7 ± 10.8 years, 39.2% males, and 77 % Caucasian) who underwent primary elective THA or TKA from the year 2004 to 2014 were recognized, and opioid intake (morphine milligram equivalents [MMEs]) in the first three postoperative days was recorded.

The patients were allocated into quintiles as per MME exposure: less than 54, 54 to 82, 83 to 116, 117 to 172, and more than 172 MMEs. Post-surgical periprosthetic infection, lung embolism, deep venous thrombosis, and pulmonary complications comprised primary outcomes. Univariate and multivariate analyses were done to explore the differences between groups and to account for confounders.

Increasing the MME exposure was linked with a dose-dependent higher chances of complications after the surgery. Patients exposed to more than 172 MMEs had greater odds of above mentioned primary outcomes than patients receiving less than 54 MMEs. In addition, more wound infections and dehiscence, and hospital readmission within 30 days and 90 days were observed in patients exposed to more than 172 MMEs.

Thus, dose-dependent early postoperative opioid usage is linked with periprosthetic joint infection and other complications in joint arthroplasty.