Acta Scientific Pharmaceutical Sciences (ASPS)(ISSN: 2581-5423)

Research Article Volume 8 Issue 3

Knee Osteoarthritis, Falls, and Opioids: Interactions and Recommendations

Ray Marks*

OARC Clinical Research and Education Director, Ontario L3T 5H3, Canada

*Corresponding Author:Ray Marks, OARC Clinical Research and Education Director, Ontario L3T 5H3, Canada.

Received: January 19, 2024; Published: February 01, 2024

Abstract

Knee osteoarthritis, a widespread highly painful disabling joint disease is increasingly shown to affect and/or be impacted by an increased falls and injury risk. This brief highlights the current research being published as regards the use of narcotic agents to quell pain in this respect and their possible adverse falls associated implications. To this end, PUBMED and other data base indices were selected to identify information specifically pertaining to the topic using the key words: Falls, Fall Injuries, Knee Osteoarthritis, Opioids, and Pain. Results show a reasonable body of current science based evidence implying opioids should be advocated and used sparingly by older adults with knee osteoarthritis who have fallen or are at risk for falling. Conversely, a failure to identify this risk and a role for other methods of pain relief and mitigation may be expected to produce less than optimal clinical results at best.

Keywords: Falls; Falls Injuries; Knee Osteoarthritis; Opioid Analgesia; Pain; Treatment

References

  1. GBD 2021 Osteoarthritis Collaborators. “Global, regional, and national burden of osteoarthritis, 1990-2020 and projections to 2050: a systematic analysis for the Global Burden of Disease Study 2021”. The Lancet Rheumatology9 (2023): e508-e522.
  2. di Laura Frattura Giorgio., et al. “Risk of falls in patients with knee osteoarthritis undergoing total knee arthroplasty: a systematic review and best evidence synthesis”. Journal of Orthopaedics3 (2018): 903-908.
  3. Amann Markus., et al. "Opioid‐mediated muscle afferents inhibit central motor drive and limit peripheral muscle fatigue development in humans”. The Journal of Physiology1 (209): 271-283.
  4. Tsonga Theano., et al. “Analyzing the history of falls in patients with severe knee osteoarthritis”. Clinics in Orthopedic Surgery4 (2015): 449-456.
  5. Boudreau Robert M., et al. “Central nervous system medication use and incident mobility limitation in community elders: the Health, Aging, and Body Composition study”. Pharmacoepidemiology and Drug Safety10 (2009): 916-922.
  6. Iijima Hirotaka and Tomoki Aoyama. “Increased recurrent falls experience in older adults with coexisting of sarcopenia and knee osteoarthritis: a cross-sectional study”. BMC Geriatrics1 (3032): 698.
  7. Krebs Erin E., et al. “Association of opioids with falls, fractures, and physical performance among older men with persistent musculoskeletal pain”. Journal of General Internal Medicine5 (2016): 463-469.
  8. Lo-Ciganic W-H., et al. “Analgesic use and risk of recurrent falls in participants with or at risk of knee osteoarthritis: data from the Osteoarthritis Initiative”. Osteoarthritis and Cartilage9 (2017): 1390-1398.
  9. van Schoor N M., et al. “Clinical osteoarthritis of the hip and knee and fall risk: The role of low physical functioning and pain medication”. Seminars in Arthritis and Rheumatism3 (2020): 380-386.
  10. Manlapaz Donald G., et al. "Risk factors for falls in adults with knee osteoarthritis: a systematic review”. PM&R7 (2019): 745-757.
  11. No Authors listed. “Use of opioids to control arthritis pain under scrutiny. Increase in falls, fractures in older adults attributed to narcotic painkillers, such as oxycodone, Vicodin or Percocet”. DukeMedicine Healthnews5 (2013): 7.
  12. Gerlach Lauren B., et al. "Opioids and other central nervous system–active polypharmacy in older adults in the United States”. Journal of the American Geriatrics Society9 (2017): 2052-2056.
  13. Aparasu Rajender R and Satabdi Chatterjee. “Use of narcotic analgesics associated with increased falls and fractures in elderly patients with osteoarthritis”. Evidence-based Medicine1 (2014).
  14. Fuggle Nicholas., et al. "Safety of opioids in osteoarthritis: outcomes of a systematic review and meta-analysis”. Drugs and Aging36 (2019): 129-143.
  15. Dufort Alexander and Zainab Samaan. "Problematic opioid use among older adults: epidemiology, adverse outcomes and treatment considerations”. Drugs and Aging(2021): 1-11.
  16. Söderberg Karin C., et al. "Newly initiated opioid treatment and the risk of fall-related injuries: a nationwide, register-based, case-crossover study in Sweden”. CNS Drugs27 (2013): 155-161.
  17. Ofori-Asenso Richard., et al. “Prevalence and correlates of falls in a middle-aged population with osteoarthritis: Data from the Osteoarthritis Initiative”. Health and Social Care In The Community2 (2021): 436-444.
  18. Rolita Lydia., et al. “Greater number of narcotic analgesic prescriptions for osteoarthritis is associated with falls and fractures in elderly adults”. Journal of the American Geriatrics Society3 (2013): 335-340.
  19. Kim Janis and Kharma Foucher. “Fall experiences from the perspectives of people with osteoarthritis: in their own words”. Disability and Rehabilitation1 (2024): 77-85.
  20. Deyo, Richard A., et al. “Opioids for low back pain”. BMJ (Clinical Research Ed.J350 (2015): g6380.
  21. Guan Qi., et al. "Opioid initiation and the hazard of falls or fractures among older adults with varying levels of central nervous system depressant burden”. Drugs and Aging9 (2022): 729-738.
  22. Gray Shelly L., et al. "Association between medications acting on the central nervous system and fall-related injuries in community-dwelling older adults: a new user cohort study”. The Journals of Gerontology: Series A5 (2020): 1003-1009.
  23. Santosa Katherine B., et al. "Higher amounts of opioids filled after surgery increase risk of serious falls and fall-related injuries among older adults”. Journal of General Internal Medicine35 (2020): 2917-2924.
  24. Delbari Ahmad., et al. “Prevalence, complications, and risk factors of falls and fear of falling among older adults; based on Ardakan Cohort Study on Aging (ACSA)”. Archives of Academic Emergency Medicine1 (2023): e9. 13.
  25. Abrams Geoffrey D., et al. "In vitro chondrotoxicity of nonsteroidal anti-inflammatory drugs and opioid medications”. The American Journal of Sports Medicine14 (2017): 3345-3350.
  26. Thorlund J B., et al. "Opioid use in knee or hip osteoarthritis: a region-wide population-based cohort study”. Osteoarthritis and Cartilage6 (2019): 871-877.
  27. Avouac, J., et al. “Efficacy and safety of opioids for osteoarthritis: a meta-analysis of randomized controlled trials”. Osteoarthritis and Cartilage8 (2007): 957-965.
  28. D’Arcy Yvonne., et al. "Treating osteoarthritis pain: mechanisms of action of acetaminophen, nonsteroidal anti-inflammatory drugs, opioids, and nerve growth factor antibodies”. Postgraduate Medicine8 (2021): 879-894.
  29. Gammel Lauren B., et al. "Controlled substance use and clinical outcomes of elderly patients after a fall”. Cureus2 (2022).
  30. Gaskell Helen., et al. “Oxycodone for neuropathic pain in adults”. The Cochrane Database of Systematic Reviews7 (2016): CD010692.
  31. Lee Marion., et al. "A comprehensive review of opioid-induced hyperalgesia”. Pain Physician2 (2011): 145.
  32. Xie Junqing., et al. “Association of Tramadol vs Codeine prescription dispensation with mortality and other adverse clinical outcomes”. JAMA15 (2021): 1504-1515.
  33. Dragos Dorin., et al. "Phytomedicine in joint disorders”. Nutrients1 (2017): 70.
  34. Doré Adam L., et al. “Lower-extremity osteoarthritis and the risk of falls in a community-based longitudinal study of adults with and without osteoarthritis”. Arthritis Care and Research5 (2015): 633-639.
  35. Bloomer Ainsley., et al. "Balancing safety, comfort, and fall risk: an intervention to limit opioid and benzodiazepine prescriptions for geriatric patients”. Geriatric Orthopaedic Surgery and Rehabilitation13 (2022): 21514593221125616.
  36. Virnes Roosa-Emilia., et al. “Opioids and falls risk in older adults: a narrative review”. Drugs and Aging3 (2022): 199-207.
  37. Seppala Lotta J., et al. “Fall-risk-increasing drugs: a systematic review and meta-analysis: III. Others”. Journal of the American Medical Directors Association 19,4 (2018): 372.e1-372.e8.
  38. Silverman Stuart., et al. “Clinical and economic burden of prescribing tramadol and other opioids for patients with osteoarthritis in a commercially insured population in the United States”. Pain1 (2022).
  39. Henriksen, Marius., et al. “Opioid-induced reductions in gait variability in healthy volunteers and individuals with knee osteoarthritis”. Pain Medicine (Malden, Mass.)11 (2019): 2106-2114.
  40. Cordovilla-Guardia, Sergio., et al. “Association of benzodiazepines, opioids and tricyclic antidepressants use and falls in trauma patients: conditional effect of age”. PloS One1 e0227696.
  41. Taqi, Aqila., et al. “Current use of analgesics and the risk of falls in people with knee osteoarthritis: a population-based cohort study using primary care and hospital records”. Osteoarthritis and Cartilage Open2 100165.
  42. Wilfong, Jessica M., Anthony V. Perruccio, and Elizabeth M. Badley. "Examination of the increased risk for falls among individuals with knee osteoarthritis: a Canadian longitudinal study on aging population based study”. Arthritis Care and Research11 (2023): 2336-2344.
  43. Bieganowski, Thomas., et al. “Opioid consumption and mobilization in staged bilateral total joint arthroplasty: did we learn our lesson the first time?”. The Journal of Arthroplasty1 (2024): 49-53.
  44. Bodden, Jannis., et al. "Opioid users show worse baseline knee osteoarthritis and faster progression of degenerative changes: a retrospective case-control study based on data from the Osteoarthritis Initiative (OAI)”. Arthritis Research and Therapy1 (2021): 146.
  45. Aspinall, Sherrie L., et al. "Central nervous system medication burden and risk of recurrent serious falls and hip fractures in veterans affairs nursing home residents”. Journal of the American Geriatrics Society1 (2019): 74-80.
  46. Rat, Anne-Christine., et al. "Antihypertensive, anticholinergic, and opioid drugs impact fall events differently in patients with knee and/or hip osteoarthritis: a five-year follow-up of the khoala cohort”. Or Hip Osteoarthritis: A Five-Year Follow-Up of the Khoala Cohort(2023).
  47. Losina, Elena., et al. "Opioid use among medicare beneficiaries with knee osteoarthritis: prevalence and correlates of chronic use”. Arthritis Care and Research4 (2023): 876-884.
  48. Yoshikawa, Aya., et al. "Opioid use and the risk of falls, fall injuries and fractures among older adults: a systematic review and meta-analysis”. The Journals of Gerontology: Series A10 (2020): 1989-1995.
  49. Ebata Nozomi., et al. “Use of analgesics before and after total joint replacement in working-age Japanese patients with knee and hip osteoarthritis: a retrospective database study”. Asia-Pacific Journal of Sports Medicine, Arthroscopy, Rehabilitation and Technology35 (2023): 1-8.
  50. van den Driest Jacoline J., et al. "Opioid prescriptions in patients with osteoarthritis: a population-based cohort study”. Rheumatology9 (2020): 2462-2470.
  51. Gress, Kyle., et al. "Treatment recommendations for chronic knee osteoarthritis”. Best Practice and Research Clinical Anaesthesiology3 (2020): 369-382.
  52. Busse Jason W., et al. "Guideline for opioid therapy and chronic noncancer pain”. CMAJ18 (2017): E659-E666.
  53. Gérard Baptiste., et al. “How to treat chronic pain in rheumatic and musculoskeletal diseases (RMDs) - A pharmacological review”. Joint Bone Spine1 (2024): 105624.
  54. Sethi Vidhu., et al. “Model-based meta-analysis supporting the combination of acetaminophen and topical diclofenac in acute pain: a therapy for mild-to-moderate osteoarthritis pain?”. Pain and Therapy, 10 (2024).
  55. Wang Zhuo., et al. "Medicinal plants and their secondary metabolites in alleviating knee osteoarthritis: a systematic review”. Phytomedicine(2022): 154347.

 

Citation

Citation: Ray Marks. “Knee Osteoarthritis, Falls, and Opioids: Interactions and Recommendations".Acta Scientific Pharmaceutical Sciences 8.3 (2024): 03-11.

Copyright

Copyright: © 2024 Ray Marks. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.




Metrics

Acceptance rate32%
Acceptance to publication20-30 days

Indexed In




News and Events


  • Certification for Review
    Acta Scientific certifies the Editors/reviewers for their review done towards the assigned articles of the respective journals.
  • Submission Timeline for Upcoming Issue
    The last date for submission of articles for regular Issues is July 10, 2024.
  • Publication Certificate
    Authors will be issued a "Publication Certificate" as a mark of appreciation for publishing their work.
  • Best Article of the Issue
    The Editors will elect one Best Article after each issue release. The authors of this article will be provided with a certificate of "Best Article of the Issue"
  • Welcoming Article Submission
    Acta Scientific delightfully welcomes active researchers for submission of articles towards the upcoming issue of respective journals.

Contact US