Hospital and Surgeon Culture Drive Extended-Release Opioid Use After Arthroplasty

Total hip and knee arthroplasty are among the most successful interventions for end-stage osteoarthritis, yet managing acute postoperative pain remains a primary challenge for recovery and patient satisfaction [1]. Current clinical pathways emphasize multimodal analgesia, utilizing non-opioid adjuncts such as nonsteroidal anti-inflammatory drugs, gabapentinoids, and perioperative corticosteroids to minimize narcotic requirements [2, 3]. While regional anesthesia and specialized nerve blocks are recommended to facilitate early ambulation and reduce systemic adverse effects, the implementation of these techniques varies across clinical settings [4]. Despite clear guidelines discouraging the use of long-acting narcotics for acute surgical pain, prescribing patterns for potent analgesics often deviate from established evidence-based protocols. A comprehensive population-based analysis now examines the specific factors and institutional variations that influence the dispensing of extended-release opioids following major joint replacement surgery.