The effect of preoperative
opioid use in orthopedic patients has been highlighted. Numerous studies have identified worse patient outcomes with pre-operative
opioid use; however, there is currently no information identifying risk factors for preoperative
opioid use in the total shoulder
arthroplasty (
TSA) population. The purpose of this study was to determine risk factors for preoperative
opioid use in patients undergoing primary anatomic
TSA for primary
osteoarthritis (OA) and to determine baseline preoperative patient-reported outcomes (PROs) in preoperative
opioid users compared with nonopioid users. The authors studied 982 TSAs performed for primary glenohumeral joint OA in a prospective
TSA registry. Patient demographic and clinical characteristics were prospectively assessed and included age; sex; socioeconomic status (SES); smoking status; body mass index (BMI); and history of chronic
back pain, depression,
diabetes mellitus, and
heart disease. Preoperative PROs, range of motion measurements, and preoperative
opioid use for
shoulder pain were assessed. Overall, 254 (25.9%) of 982 total patients were taking preoperative
opioids for
shoulder pain in the setting of primary OA. Female sex (P=.023), younger age (P=.019),
obesity (BMI >30 kg/m2) (P=.043), chronic
back pain (P<.001), and lower SES (P=.002) were associated with increased preoperative
opioid use following multivariate logistic regression. Patients with
opioid use had significantly worse preoperative
pain scores (P<.001), American Shoulder and Elbow Surgeons scores (P<.001), and total Constant scores (P<.002) compared with the non-
opioid group. [Orthopedics. 2020;43(6):356-360.].