Research Establishes Link Between Pain Medication and Total Joint Replacement

Patients taking intra-articular corticosteroids were more likely to opt for total joint replacement (TJR) for osteoarthritis than the patients who took opioids for pain management, according to a large, retrospective, multicenter cohort study published in BMC Musculoskeletal Disorders.

“Currently available medications for chronic osteoarthritis pain are only moderately effective, and their use is limited in many patients because of serious adverse effects and contraindications,” the authors stated. “The objectives of this study were to describe the treatment history of patients with osteoarthritis receiving prescription pain medications and/or intra-articular corticosteroid injections, and to estimate the incidence of TJR in these patients.”

The multicenter cohort study included claims data of adult patients with osteoarthritis in the Innovation in Medical Evidence Development and Surveillance Distributed Database, dated between January 2013 and December 2019.

Among the final 1,992,670 patients, researchers noted that more than half the study population (58.3%) took opioids, 29.9% took NSAIDs, and 16.2% took intra-articular corticosteroids. Roughly 3.6% of the patients took both NSAIDs and opioids.

The TJR incidence rates per 100 person-years were highest in the intra-articular corticosteroids group (8.05) followed by the opioid cohort at 7.45, the NSAID cohort at 4.63, and ‘any pain medication’ cohort at the lowest being 3.21.

“Of the specific pain medication classes examined, the incidence rate of TJR was highest in patients receiving intra-articular corticosteroids and lowest in patients receiving NSAIDs,” the investigators concluded.

—Priyam Vora

Reference:
Shinde M, Rodriguez-Watson C, Zhang TC et al. Patient characteristics, pain treatment patterns, and incidence of total joint replacement in a US population with osteoarthritis. BMC Musculoskelet Disord. 2022; 23: 883. DOI: https://doi.org/10.1186/s12891-022-05823-7