Racial/Ethnic Disparities in Physical Function Before and After Total Knee Arthroplasty Among Women in the United States

Abstract Background The use of total knee arthroplasty (TKA) in treatment of chronic degenerative pathologies of the knee has boasted of an experience of 50 years. The aim of this bibliometric and visualized study is to comprehensively examine the current status and global trends of TKA research. Methods Publications related to TKA research from 2010 to 2019 were retrieved from Web of Science database, and then analyzed through bibliometric methodology. As for the visualized study, the software VOS viewer was utilized for bibliographic coupling, coauthorship, cociation, and co-occurrence analysis, along with further simulation of publication trends in this field. Results A total of 8631 publications were eventually included. The number of publications tends to increased annually over the worldwide. The United States was the pioneer which has made tremendous contribution, with the most publications and citations, as well as the highest H-index. The JOURNAL OF ARTHROPLASTY has published most papers, while CLINICAL ORTHOPAEDICS AND RELATED RESEARCH has the highest citation frequency. Hospital for Special Surgery have made the greatest contribution when total publication number and coauthorship were taken together. Studies could be divided into five clusters: “alignment study”, “revision TKA study”, “complication study”, “rehabilitation study”, and “perioperative management study”, which have a trend of balanced development in this field. Conclusions There will be an increasing number of publications on TKA research according to the current global trends, and the United States maintained the leadership in this area. Additionally, a trend of balanced development may exist in the field of TKA research, accompanied with inherent changes of hotspots in each cluster.

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Effect of preoperative long-term opioid therapy on patient outcomes after total knee arthroplasty: an analysis of multicentre population-based administrative data

Canadian Journal of Surgery ◽

10.1503/cjs.007319 ◽

2021 ◽

Vol 64 (2) ◽

Author(s):

C. Michael Goplen ◽

Sung Hyun Kang ◽

Jason R. Randell ◽

Allyson Jones ◽

Donald C. Voaklander ◽

...

Keyword(s):

Total Knee Arthroplasty ◽

Physical Function ◽

Knee Arthroplasty ◽

Population Based ◽

Womac Pain ◽

Opioid Use ◽

Before And After ◽

Total Knee ◽

Opioid Users

Background: Up to 40% of patients are receiving opioids at the time of total knee arthroplasty (TKA) in the United States despite evidence suggesting opioids are ineffective for pain associated with arthritis and have substantial risks. Our primary objective was to determine whether preoperative opioid users had worse knee pain and physical function outcomes 12 months after TKA than patients who were opioidnaive preoperatively; our secondary objective was to determine the prevalence of opioid use before and after TKA in Alberta, Canada. Methods: In this retrospective analysis of population-based data, we identified adult patients who underwent TKA between 2013 and 2015 in Alberta. We used multivariable linear regression to examine the association between preoperative opioid use and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain and physical function scores 12 months after TKA, adjusting for potentially confounding variables. Results: Of the 1907 patients, 592 (31.0%) had at least 1 opioid dispensed before TKA, and 124 (6.5%) were classified as long-term opioid users. Long-term opioid users had worse adjusted WOMAC pain and physical function scores 12 months after TKA than patients who were opioid-naive preoperatively (pain score β = 7.7, 95% confidence interval [CI] 4.0 to 11.6; physical function score β = 7.8, 95% CI 4.0 to 11.6; p < 0.001 for both). The majority (89 ([71.8%]) of patients who were long-term opioid users preoperatively were dispensed opioids 180–360 days after TKA, compared to 158 (12.0%) patients who were opioid-naive preoperatively. Conclusion: A substantial number of patients were dispensed opioids before and after TKA, and patients who received opioids preoperatively had worse adjusted pain and functional outcome scores 12 months after TKA than patients who were opioidnaive preoperatively. These results suggest that patients prescribed opioids preoperatively should be counselled judiciously regarding expected outcomes after TKA.

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