Grant: Catalyst Grant: Musculoskeletal Health and Arthritis

Prolonged inappropriate use of opioids by senior citizens is growing in prevalence in Canada. One of the drivers of this process is the use of opioids for management of pain resulting from end-stage osteoarthritis (OA). The surgical management for OA is total joint arthroplasty (TJA), which generally results in improved function and reduced pain. However, it is unclear if TJA results in a reduction in the use of opioids in chronic users, or if prolonged pre-operative opioid use affects the success rate of a TJA. We will utilize population level data in Ontario to identify patients that have had a TJA for OA in Ontario, between 2002-2015, and will determine the extent of opioid use pre- and post-operative in this population, as well as the trend of use over time. Furthermore, we will determine if prolonged opioid use has an impact on the rates of complications as well as health care utilization following TJA. We will also determine if TJA has an effect on long-term opioid use, as well as identify patients that are at increased risk for continued opioid use post-operatively. As awareness of this issue grows, physicians are under increased pressure and scrutiny to modulate their prescribing habits. In order to develop efficacious policies and enact change, we first need to be able to identify patient and provider factors that significantly influence pre- and post-operative opioid use.