Opioids are a vast group of analgesic drugs that act by interacting with opioid receptors in your body. Opioid drugs help control acute pain, such as surgical pain, pain caused by physical trauma, and so on.
However, the effectiveness of opioids has been questioned, as studies have demonstrated that the use of opioid medicines has not significantly improved pain-related function.
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Additionally, certain subtypes of opioids are suspected of causing chondrotoxicity. Nonetheless, they are still commonly prescribed for pain control in patients with osteoarthritis of the knee.
Osteoarthritis of the knee is a condition in which the cartilage of the knee degenerates, or decomposes, leading to chronic pain.
The impact of opioids on the development of osteoarthritis in vivo is unknown. In this context, scientists from the University of California, headed by Jannis Bodden, intended to describe associations between opioid use and structural knee changes and clinical outcomes over a four-year period.
The study involved a cross-sectional and longitudinal analysis of patients with osteoarthritis of the knee as part of the Osteoarthritis Initiative (OAI). For their cross-sectional cohort, researchers included 181 patients with basic opioids and available data on right knee magnetic resonance.
For the longitudinal cohort, this included 79 patients with initial use of opioids and available MRI data from the right knee that continued to use opioids for at least one year between the reference period and the four-year follow-up.
Whole organ magnetic resonance imaging (WORMS) scores were achieved, including a total summation score. Sub-cores were also taken into account for cartilage, meniscus and bone marrow abnormalities and sub-cystic lesions.
Findings related to Knee Injury Osteoarthritis Outcomes score (KOOS) symptoms, quality of life (QOL) and pain were also obtained at baseline and follow-up. Linear regression models were used to study associations between reference and longitudinal outcomes.
Because pain can change observations, a sensitivity analysis was conducted for longitudinal findings. All analyses were adjusted according to gender, BMI, age, race and Kellgren-Lawrence’s score.
The study yielded some interesting findings – opioid users showed greater structural degeneration initially and an increase beyond 4, compared to controls. Cartilage and meniscus scores have also risen further among opioid users.
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All baseline KOOS scores were lower for opioid users versus controls. There was a greater loss of quality of life as well.
Opioid users had worse knee structural degeneration and faster progression. Opioid use was also associated with worse symptoms, pain, and QOL, indicating that opioids may not be suited to prevent subjective disease progression in KOA patients
the research team concluded.
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