The Impact of Preoperative Opioid Use Disorder onComplications and Costs following Primary Total Hip andKnee Arthroplasty

Multiple studies have demonstrated that patients taking opioids in the preoperative period are at elevated risk forcomplications following total hip (THA) and knee (TKA) arthroplasty. However, the incidence and impact of opioid use disorder(OUD) among these patients—both clinically and fiscally—remain unknown. *e purpose of this study was to investigate thisrelationship.Methods. *e Nationwide Readmission Database (NRD) was used to identify patients undergoing THA and TKAfrom 2011 to 2015. Coarsened exact matching was used to statistically match the OUD and non-OUD cohorts. Further analysiswas then conducted on matched cohorts with multivariate analysis. *e incidence of OUD was also determined, and the costsassociated with this comorbidity were calculated.Results. *e incidence of OUD in arthroplasty patients increased 80% over thestudy period. OUD patients had higher odds of prosthetic joint infection (OR 1.55, 95% CI 1.23–1.94), wound complication (OR1.40, 95% CI 1.12–1.76), prosthetic complication (OR 1.37, 95% CI 1.10–1.70), and revision surgery (OR 1.47, 95% CI 1.19–1.81).OUD patients also had longer length of stays (TKA: +0.67 days; THA: +1.09 days), higher readmission (OR 1.60, 95% CI1.43–1.79), and increased 90-day costs (TKA: +$3,602 [95% CI $3,138–4,065]; THA: +4,527 [95% CI $3,593–4,920).Conclusion.OpioidusedisorderisbecomingamorecommoncomorbidityamongTHAandTKApatients.*isisconcerningasitrepresentsasignificant risk factor for postoperative complication. It additionally confers increased perioperative costs. Patients with OUDshould be counseled on their elevated risk, and future work will be needed to determine if this is a modifiable risk factor.