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Table 1 Studies reporting outcomes following preoperative opioid use

From: Rationale for and approach to preoperative opioid weaning: a preoperative optimization protocol

Authors Year Discipline Findings
Lawrence et al. 2008 Spine 47 chronic opioid-using patients experienced significantly worsened outcomes of pain and disability postoperatively compared to 44 non-opioid-using patients
Anderson et al. 2009 Spine Logistical regression model of 488 ACDF patients revealed “weak” preoperative opioid use as an independently significant negative predictive variable for postoperative neck disability
Roullet et al. 2009 Orthopedics 12 chronic preoperative opioid-using patients had greater postoperative opioid consumption and phantom limb pain than 10 non-opioid-using controls
Zywiel et al. 2011 Orthopedics 45 TKA patients using opioids preoperatively had significantly greater postoperative dysfunction and complications including need for revision compared to non-opioid-using controls
Raebel et al. 2013 Bariatric surgery 77% of 933 chronic opioid-using bariatric surgery patients continued to use opioids at 12-month postoperative follow-up and generally at higher doses
Pivec et al. 2014 Orthopedics 54 THA patients using opioids preoperatively had significantly greater postoperative pain and opioid consumption, increased hospital LOS, worsened postoperative function and increased arthroplasty failure compared to non-opioid-using controls
Armaghani et al. 2014 Spine Logistic regression model of 583 patients demonstrated that of 321 patients using chronic preoperative opioids, “increasing preoperative use” correlated with ongoing opioid dependence 12 months postoperatively
Kelly et al. 2015   762 “weak opioid” (codeine, propoxyphene, hydrocodone), 226 “strong opioid” (meperidine, morphine, oxycodone) and 16 non-opioid-using patients showed no significant differences in pain and disability at 2-year follow-up
Menendez et al. 2015 Orthopedics 15,901 THA, TKA, TSA, and spine fusion patients with a diagnosis of opioid dependence or abuse had statistically significantly worsened morbidity and mortality outcomes than over 9 million controls
Hina et al. 2015 Orthopedics 28 opioid-using orthopedic patients displayed significantly greater hyperalgesia preoperatively, reported greater pain and consumed significantly more opioids postoperatively than 40 non-opioid-using controls
Morris et al. 2015 Orthopedics 32 Reverse TSA patients using chronic preoperative opioids had significantly worse outcomes of postoperative shoulder function including ROM compared to 36 controls
Morris et al. 2016 Orthopedics 60 TSA patients using chronic preoperative opioids had significantly worse outcomes of postoperative shoulder function including ROM and decreased satisfaction compared to 164 controls
Sing et al. 2016 Orthopedics 116 TKA and THA patients using preoperative opioids had significantly worse postoperative pain and increased opioid consumption, increased hospital LOS, admission to rehabilitation facilities, worsened surgical outcomes (including arthrofibrosis and periprosthetic fractures) compared to 58 non-opioid-using controls
Aasvang et al. 2016 Orthopedics 58 TKA patients using chronic preoperative opioids had significantly increased pain and opioid requirements within the first week of surgery compared to 57 non-opioid-using controls
Zarling et al. 2016 Orthopedics 106 TKA and THA using chronic preoperative opioids had greater likelihood of postoperative rehabilitation facility admission and significantly increased continued use of opioids 12 months postoperatively than 209 non-opioid-using controls
Nguyen et al. 2016 Orthopedics  
Faour et al. 2017 Spine 77 ACDF patients using chronic preoperative opioids had significantly lower incidence of return to work than 204 non-opioid-using controls
Tye et al. 2017 Spine 80 lumbar decompression patients from the worker’s compensation population using chronic preoperative opioids greater than 3 months were significantly less likely to return to work than those (n = 60) using opioids less than 3 months preoperatively
Ben-Ari et al. 2017 Orthopedics 12,772 TKA patients using chronic preoperative opioids had significantly higher incidence of revision than 19,864 non-opioid-using controls
Smith et al. 2017 Orthopedics 36 TKA patients using chronic preoperative opioids had significantly worse pain 6 months postoperatively compared to 120 non-opioid-using controls
Waljee et al. 2017 General surgery 17,577 patients using chronic preoperative opioids had significantly longer hospital LOS, increased incidence of discharge to rehabilitation facilities and hospital readmission, and generated significantly higher financial expenditures than 182,428 controls
Villavicencio et al. 2017 Spine 60 TLIF patients using chronic preoperative opioids had significantly greater 12-month postoperative pain and disability compared to 33 non-opioid-using controls
Rozell et al. 2017 Orthopedics 275 TKA and THA patients using chronic preoperative opioids (compared to 527 controls) were shown in a regression model to be more likely to require increase perioperative opioids and increased hospital LOS as well as suffer higher incidence of complications
Chan et al. 2017 Orthopedics 36 TKA patients maintained on methadone preoperatively required greater postoperative opioids and inpatient pain management consultation, and had increased hospital LOS compared to 36 matched controls
Cheah et al. 2017 Orthopedics 138 TSA patients using chronic preoperative opioids had significantly greater postoperative pain and opioid use compared to 124 non-opioid-using controls