Purpose
To determine the influence of preoperative opioid use on Patient-Reported Outcomes
Measurement Information System (PROMIS) scores pre- and postoperatively in patients
undergoing arthroscopic rotator cuff repair (RCR).
Methods
A retrospective review of all RCR patients aged >18 years old was performed. PROMIS
pain interference (“PROMIS PI”), upper extremity function (“PROMIS UE”), and depression
(“PROMIS D”) scores, were reviewed. These measures were collected at preoperative,
6-month, and 1-year postoperative time points. A prescription drug–monitoring program
was queried to track opioid prescriptions. Patients were categorized as chronic users,
acute users, and nonusers based on prescriptions filled. Comparison of means were
carried out using analysis of variance and least squares means. Effect sizes and 95%
confidence intervals were calculated.
Results
In total, 184 patients who underwent RCR were included. Preoperatively, nonusers (n =
92) had superior PROMIS UE (30.6 vs 28.9 vs 26.1; P < .05) and PI scores (61.5 vs 64.9 vs 65.3; P < .001) compared with acute users (n = 65) and chronic users (n = 27), respectively.
At 6 months postoperatively; nonusers demonstrated significantly greater PROMIS UE
(41.7 vs 35.6 vs. 33.5; P < .001), lower PROMIS D (41.6 vs 45.8 vs 51.1; P < .001), and lower PROMIS PI scores (50.7 vs 56.3 vs 58.1; P < .01) when compared with acute and chronic users, respectively. Nonusers had lower
PROMIS PI (47.9 vs 54.3 vs 57.4; P < .0001) and PROMIS D (41.6 vs 48.3 vs 49.2; P = .0002) scores compared with acute and chronic users at 1-year postoperatively.
Nonusers experienced a significantly greater magnitude of improvement in PROMIS D
6 months postoperatively compared with chronic opioid users (–5.9 vs 0.0; P < .01).
Conclusions
Patients undergoing RCR demonstrated superior PROMIS scores pre- and postoperatively
if they did not use opioids within 3 months before surgery.
Level of Evidence
III, retrospective comparative trial.
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Article info
Publication history
Published online: April 07, 2022
Accepted:
March 22,
2022
Received:
June 6,
2021
Footnotes
The authors report the following potential conflicts of interest or sources of funding: S.J.M. reports other from DePuy, A Johnson & Johnson company, Exactech, and FX Shoulder, outside the submitted work. V.M. reports other from Stryker, Arthrex, and Pinnacle, outside the submitted work. E.C.M. reports other from Smith & Nephew and Springer, outside the submitted work. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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