Association between sex and perioperative opioid prescribing for total joint arthroplasty: a retrospective population-based study

Ellen M. Soffin, Lauren A. Wilson, Jiabin Liu, Jashvant Poeran, Stavros G. Memtsoudis

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background: Scarce data exist on differential opioid prescribing between men and women in the pre-, peri-, and postoperative phases of care among patients undergoing total hip/knee arthroplasty (THA/TKA). Methods: In this retrospective population-based study, Truven Health MarketScan claims data were used to establish differences between men and women in (1) opioid prescribing in the year before THA/TKA surgery, (2) the amount of opioids prescribed at discharge, and (3) chronic opioid prescribing (3–12 months after surgery). Multivariable regression models measured odds ratios (OR) with 95% confidence intervals (95% CI). Results: Among 29 038 THAs (42% men) and 48 523 TKAs (52% men) men (compared with women) were less likely to receive an opioid prescription in the year before surgery (54% vs 60%, and 54% vs 60% for THA and TKA, respectively); P<0.001. However, in multivariable analyses male sex was associated with higher total opioid dosages prescribed at discharge after THA (OR=1.04; 95% CI 1.03, 1.06) and TKA (OR=1.05; 95% CI 1.04, 1.06); both P<0.001. Chronic opioid prescribing was found in 10% of the cohort (THA: n=2333; TKA: n=5365). Here, men demonstrated lower odds of persistent opioid prescribing specifically after THA (OR=0.90; 95% CI 0.82, 0.99) but not TKA (OR=0.96; 95% CI 0.90, 1.02); P=0.026 and P=0.207, respectively. Conclusions: We found sex-based differences in opioid prescribing across all phases of care for THA/TKA. The results highlight temporal opportunities for targeted interventions to improve outcomes after total joint arthroplasty, particularly for women, and to decrease chronic opioid prescribing.

Original languageEnglish
Pages (from-to)1217-1225
Number of pages9
JournalBritish Journal of Anaesthesia
Issue number6
StatePublished - Jun 2021


  • opioid prescribing
  • opioids
  • sex differences
  • total hip arthroplasty
  • total joint arthroplasty
  • total knee arthroplasty


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