Evidence-Based Orthopaedic Post-Operative Opioid Prescribing Recommendations Following Hip and Knee Arthroplasty

Abstract

Total knee arthroplasty (TKA) and total hip arthroplasty (THA) are frequently performed surgeries to relieve joint pain, with TKA known for its high postoperative pain rates. However, the rise in opioid prescriptions for managing pain, including chronic pain, has led to concerns among healthcare professionals and researchers due to the significant number of opioid-related deaths and nonfatal overdoses, emphasizing the need for alternative pain management strategies. The current guidelines established by the American Association of Hip and Knee Surgeons (AAHKS) recommend non-opioid multimodal anesthesia strategies and cautious opioid use for primary total joint arthroplasty. A multimodal anesthesia approach is recommended for all hip and knee arthroplasty procedures, with a preference for surgeon-administered intraoperative intra-articular adductor canal blocks and pericapsular injections for TKAs. For THAs, a local soft tissue injection is administered, and a fascia iliac block is recommended if a block is necessary.