(P 468) OPIATE USE AFTER TOTAL HIP ARTHROPLASTY FOR METASTATIC BONE DISEASE

Background: Metastatic bone disease (MBD) commonly affects the hip, and surgical intervention including total hip arthroplasty (THA) may be indicated for pain relief or functional improvement. Following THA, patients are often prescribed short courses of opioids for postoperative pain relief. This study investigated postoperative opioid use and ambulation functional status following THA in MBD patients.

Methods: This was a retrospective review of patients using opioids postoperatively who underwent THA for MBD at two institutions between 2009 and 2022. Preoperative and postoperative opioid usage and ambulation status at 6 weeks, 90 days, 6 months, and 1 year were collected. Opioid usage and ambulation status changes postoperatively were compared using the sign test. Factors associated with postoperative opioid use at 6 weeks and 90 days were compared using χ2 test or Fisher’s exact test.

Results: Twenty-seven primary THA and thirteen THA with complex acetabular reconstruction were included. Thirty patients used opiates preoperatively. Opioid use at 90 days was statistically significant for association with opioid use at 6 weeks. There was a statistically significant decrease between preoperative and 6 month median daily morphine milligram equivalent for preoperative opioid users. There was no statistically significant change in ambulation status.

Conclusion: o our knowledge, this is the first paper evaluating postoperative opioid use following primary THA in MBD patients. After THA in the setting of MBD, patients exhibited a significant decrease in postoperative opioid use at 6 months. Future studies with larger cohorts should characterize postoperative opioid use following joint arthroplasty in MBD patients.