PTSD Is Associated with Increased Rates of Opioid Prescriptions Following Primary Total Shoulder Arthroplasty

Hackensack University Medical Center research underscores the importance of preoperative counseling and tailored pain management

Mental health disorders affect roughly 50% of the U.S. population, yet data on post-traumatic stress disorder (PTSD) in patients undergoing total shoulder arthroplasty (TSA) are limited. This study, published in the Journal of Shoulder and Elbow Surgery, assessed postoperative complications, adverse outcomes and health care utilization in TSA patients with preexisting PTSD compared to those without.

Using the TriNetX database, TSA patients from October 1, 2002, to May 1, 2022, with PTSD were identified and 1:1 propensity score–matched to patients without PTSD. Postoperative prescriptions and health care utilization were analyzed at 5, 14, and 30 days. Complications were evaluated at 30 and 90 days, and arthroplasty-related complications at 90 days, 1 year, and 2 years postoperatively.

After matching, 929 patients per cohort were analyzed. Postoperative emergency department visits and hospitalizations were similar between groups. Patients with PTSD received more opioid prescriptions: 2.4 versus 2.1 at 14 days (P less than .001) and 3.1 versus 2.7 at 30 days (P = .002). No differences were observed in medical or orthopedic complications at any follow-up.

TSA patients with preexisting PTSD demonstrate increased short-term opioid use despite comparable complication rates. These findings underscore the importance of preoperative counseling and tailored postoperative pain management to optimize outcomes in patients with PTSD.

Featured Researchers

Dr. Eitan M. Kohan

Eitan M. Kohan, M.D., is a fellowship-trained orthopedic surgeon specializing in shoulder and elbow conditions, currently practicing at Orthopedic Specialists of New Jersey, affiliated with Hackensack University Medical Center. He is an active member of the American Shoulder and Elbow Surgeons and the American Academy of Orthopaedic Surgeons, with expertise in advanced arthroscopic, minimally invasive, and open surgical techniques for complex shoulder and elbow pathology.

Dr. Francis Alberta

Frank Alberta, M.D., is a board-certified, fellowship-trained orthopedic surgeon with over 20 years of experience specializing in complex shoulder and elbow surgery, and is a member of both the American Shoulder and Elbow Surgeons and the American Academy of Orthopaedic Surgeons. He has published extensively in peer-reviewed literature, delivered national presentations, and has been recognized with over 30 Top Doctor awards for his clinical excellence and commitment to advancing patient outcomes.

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