Department of Orthopaedics Surgery, West China Hospital, Sichuan University, 37# Wainan Guoxue Road, Chengdu, 610041, People's Republic of China.
Int Orthop. 2021 Aug;45(8):1923-1932. doi: 10.1007/s00264-021-04968-9. Epub 2021 Feb 16.
Opioid use is prevalent in the general population. This systematic review and meta-analysis sought to evaluate whether it affects patient-reported outcomes (PROs) following total hip or knee arthroplasty.
The following databases were systematically searched on February 5, 2020: Medline, Embase (Ovid), Cochrane Library, and Web of Science. Studies were included if they compared patients who received opioids or not before total hip or knee arthroplasty. Outcomes of interest were rates of post-operative revision, peri-prosthetic infection, and readmission.
Ten retrospective studies were included for review. Pre-operative opioid use was identified as a risk factor for post-operative revision [odds ratio (OR) 1.58, 95% confidence interval (CI) 1.15-1.73, p<0.01], peri-prosthetic infection (OR 1.36, 95% CI 1.08-1.71, p=0.01), and readmission (OR 1.41, 95% CI 1.20-1.75, p<0.01).
The available evidence indicates that pre-operative opioid use increases the risk of adverse outcomes following total hip or knee arthroplasty. Orthopedic physicians should consider these risks when treating their patients.
阿片类药物的使用在普通人群中很普遍。本系统评价和荟萃分析旨在评估其是否会影响全髋关节或全膝关节置换术后患者报告的结局（PROs）。
于 2020 年 2 月 5 日系统检索了以下数据库：医学文献在线数据库（Medline）、Embase（Ovid）、考科蓝图书馆（Cochrane Library）和 Web of Science。如果研究比较了全髋关节或全膝关节置换术前接受阿片类药物与未接受阿片类药物的患者，则纳入研究。感兴趣的结局包括术后翻修率、假体周围感染和再入院率。
共纳入 10 项回顾性研究进行综述。术前使用阿片类药物被确定为术后翻修的危险因素[比值比（OR）1.58，95%置信区间（CI）1.15-1.73，p<0.01]、假体周围感染（OR 1.36，95% CI 1.08-1.71，p=0.01）和再入院（OR 1.41，95% CI 1.20-1.75，p<0.01）。
现有证据表明，术前使用阿片类药物会增加全髋关节或全膝关节置换术后不良结局的风险。骨科医生在治疗患者时应考虑这些风险。
