We sought to clarify the relationship between chronic preoperative opioids and complications following rotator cuff repair. Specifically, we assessed revision, a definitive postoperative endpoint for surgical outcome.
This study used PearlDiver, a United States national insurance claims database. All RCR patients from 2008-2018 were identified and stratified based on a minimum of 2 opioid prescriptions within the 6 months prior to surgery, with one prescription occurring within 0-3 months prior to surgery, and a second prescription within 4-6 months prior to surgery. Univariate logistic regressions of risk factors were conducted followed by multivariate analysis of comorbidities including ongoing preoperative opioids, any preoperative NSAID prescriptions, age, gender, diabetes, tobacco, and obesity.
28,939 RCR patients were identified, of whom 10,695 had opioid prescriptions within both 0-3 months and 4-6 months prior to index RCR, while 18,244 had no opioid prescriptions within the 6-month preoperative period. 977 (3.4%) patients underwent revision within 6 months, which increased to 1,311 (4.5%) within 1 year of the index procedure. In the multivariate analysis controlling for age, preoperative NSAID prescriptions, tobacco, diabetes, obesity, and sex, we observed a significant association between chronic preoperative opioid prescriptions and RCR revision (6-months OR:1.12; p=0.021, 1-year OR:1.43; p<0.001) following index procedure.
We report increased rates of revision within both 6 months and 1 year in patients with prolonged preoperative opioid prescriptions. The opioid cohort had higher rates of preoperative NSAID use and tobacco use, which were also observed to be independent risk factors for revision at both timepoints.

Copyright © 2020. Published by Elsevier Inc.

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