Opioid Concerns, Work Interference Cited as Top Reasons to Delay Knee Replacement Surgery

Patients in need of a total knee replacement (TKR) often delay surgery by two or more years because of concerns about the duration of postoperative pain, work interference, and the side effects opioids might have on their recovery and rehabilitation according to a new healthcare survey. 
 
The survey explores patient perspectives and factors related to the decision to delay knee-replacement surgery, which is an increasingly common procedure. In 2013 there were 727,000 primary and revision knee arthroplasty procedures in the United States and that number is projected to grow to 889,000 procedures by 2019, according to a Medtech Insight research report on U.S. surgical volumes.
 
“Regardless of pain level, gender, education or income, the majority of respondents delayed knee replacement surgery,” said Angeline Carlson, Ph.D., adjunct professor, Department of Pharmaceutical Care & Health Systems at the University of Minnesota. “Results from this survey show that patients worry about the impact of surgery on their lives, have a very real concern about the ability to control pain during recovery, and possess an overwhelming desire to avoid using opioids to manage pain after surgery.” 
 
More than 650 surgical candidates suffering from knee osteoarthritis in the United States participated in the online survey, supported by SPR Therapeutics. Highlights from the survey include:
 

• More than half (54 percent) of respondents delayed a TKR for two or more years; 24 percent specifically cited concerns that postoperative pain and/or the side effects of opioids might extend their recovery and rehabilitation as reasons for delaying the procedure;
• Ninety-two percent of respondents said a new pain management approach that reduced or eliminated the use of opioid-containing pain medications would be an important factor in their choice of the surgeon they would select to perform their surgery;
• Sixty-six percent said they would likely switch surgeons to obtain access to a non-opioid pain management approach;
• Seventy-four percent of respondents were more concerned about the pain they were likely to experience within the first several weeks following surgery compared to the pain they were likely to experience within the first three days following surgery.

“These results raise significant concerns because postponing surgery can often lead to deconditioning, weakening or lost function in muscles and ligaments and greater difficulty doing everyday activities,” said survey co-author Keith Berend, M.D., clinical assistant professor in the Department of Orthopaedics at The Ohio State University. “Particularly here in Ohio, we face an epidemic of narcotic-related deaths, and we need access to innovative drug-free pain relief options that can carry patients through the rehabilitation period without opiates and help expedite their decision to have a surgery they should not postpone. As one of the investigators currently using the SPRINT PNS System in clinical trials, I’m eager to offer it to my patients undergoing knee replacement surgery.” 
 
The SPRINT PNS System includes a proprietary threadlike lead and a small, wearable stimulator patch. The lead is placed percutaneously, or through the skin, and connects to the wearable stimulator, which activates peripheral nerves to achieve pain relief. 
 
SPRINT was specifically designed to preferentially activate target nerve fibers, delivering sustained, significant pain relief without opioids, permanent implants or tissue destruction. The U.S. Food and Drug Administration (FDA)-cleared therapy was developed to address a wide spectrum of chronic and acute post-surgical pain conditions affecting millions worldwide.
 
“Opioids are routinely provided for several weeks to manage postoperative pain with approximately 20 percent of patients using them for 90 days or longer after surgery,” said Maria Bennett, SPR Therapeutics founder, president and CEO. “The results of this survey reinforce the need for alternative, non-narcotic pain relief therapies such as SPRINT, that could significantly reduce or even eliminate the use of opiates providing a much-needed medical advance for patients during the post-operative recovery period.”
 
Detailed results from the survey are published in a peer-reviewed article of Reconstructive Review, the official journal of the Joint Implant Surgery and Research Foundation.
 
SPR Therapeutics LLC is a private company headquartered in Cleveland, Ohio. The company is commercializing its SPRINT technology which provides opioid-free, peripheral nerve stimulation for the relief of chronic and acute pain, and is advancing additional clinical trials to treat low back pain, neuropathic pain and pain following total knee replacement. The SPR-patented SPRINT technology received FDA clearance for commercial use in the United States.