Characterization of Patients Undergoing Total Knee Arthroplasty in a Real-World Setting and Pain-Related Medication Prescriptions for Management of Postoperative Pain

Carmen S. KirknessCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedic, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.Correspondence[email protected]

Carrie McAdam-MarxCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedic, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.

Sudhir UnniCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedic, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.

Jason YoungCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedic, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.

Xiangyang YeCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedic, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.

Arthi ChandranCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedic, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.

Christopher L. PetersCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedic, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.

Carl V. AscheCarmen S. Kirkness, PhD, is Assistant Director, Center for Outcomes Research and Assistant Professor, Department of Medicine, University of Illinois College of Medicine, Peoria, Illinois, USA. Carrie McAdam-Marx, PhD, is Research Assistant Professor of Pharmacotherapy, Pharmacotherapy Outcomes Research Center, University of Utah, Salt Lake City, Utah, USA. Sudhir Unni, PhD, is Research Associate, Pharmacotherapy Outcomes Research Center, University of Utah. Jason Young, MD, is Health Economist and Outcomes Research Fellow, Pharmacotherapy Outcomes Research Center, University of Utah. Xiangyang Ye, MS, is Senior Research Analyst, Pharmacotherapy Outcomes Research Center, University of Utah. Arthi Chandran, MPH, is Associate Director, Global Health Economics and Outcomes Research, Pfizer Inc., New York, New York, USA. Christopher L. Peters, MD, is Professor of Orthopaedic, School of Medicine, University of Utah. Carl V. Asche, PhD, is Director, Center for Outcomes Research and Visiting Research Professor, Department of Medicine, University of Illinois College of Medicine.

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ABSTRACT

Presently, no “gold-standard” exists for the management of pain after total knee arthroplasty (TKA) surgery. Understanding pain management methods used in clinical practice and the associated patient outcomes are necessary to fill gaps in pain management strategies. This study characterizes medication use in the immediate postoperative period among patients undergoing TKA at an academic medical center. Additionally, pre- and postoperative measures of pain (numeric pain rating scale), physical function (Knee Society Scale and Lower Extremity Function [LEFS]), and quality of life (Medical Outcomes Study Short-Form [SF]-36) were evaluated. The patient data were extracted from a clinical database at the University of Utah Orthopedic Clinic between September 1, 2008, and November 30, 2010. A total of 168 patients (mean age 64.0 ± 10.1 years, 63.1% were female, mean body mass index [BMI] 31.7 ± 7.1 kg/m²) were included. The most common comorbidities in these patients were osteoarthritis, hypertension, and major depressive disorders. Bupivacaine and fentanyl were commonly given on the day of surgery with oxycodone, hydrocodone/acetaminophen, and celecoxib prescribed at hospital discharge. Preoperative pain levels were reduced by half at 6 weeks. Physical function and quality of life were similar to established benchmarks and previously reported levels, respectively. Confirmation of results over a longer follow-up period is warranted.

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Characterization of Patients Undergoing Total Knee Arthroplasty in a Real-World Setting and Pain-Related Medication Prescriptions for Management of Postoperative Pain

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Characterization of Patients Undergoing Total Knee Arthroplasty in a Real-World Setting and Pain-Related Medication Prescriptions for Management of Postoperative Pain

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