Phase I recovery opioid consumption following unilateral total knee arthroplasty stratified by race: a single center study
Roxana Farokhnia, Emily H Garmon, Bryce C Allen, Michael R Fettiplace, Chandni Raiyani, Michael P Hofkamp

Introduction
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Total knee arthroplasty (TKA) is a common orthopedic procedure that is associated with higher levels of pain and opioid use in the immediate postoperative period than other joint arthroplasties.
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Worse pain and symptoms for racial minorities compared to White patients have been reported postoperatively for TKA.
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We hypothesize that racial disparities exist in the morphine milligram equivalent (MME) consumption during Phase I recovery following unilateral TKA.
Methods
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Included patients who underwent unilateral TKA from January 1, 2018 to December 31, 2022 who identified as White or Caucasian (N=177), Black or African American (N=184), or Hispanic (N=193) at Baylor Scott and White - Temple.
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Phase I recovery time was defined as the time from when Phase I recovery started until the time the patients met discharge criteria
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Morphine milligram equivalent (MME) was calculated using the criteria described by Nielsen et al.
Results
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No statistically significant racial disparities in MME consumption during Phase I recovery between White or Caucasian, Hispanic, and Black or African American patients (median 8.8 mg vs 8.8 mg vs 11.9 mg; p=0.818 between White or Caucasian and Hispanic and p=0.667 between White or Caucasian and Black or African American)
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Hispanic patients were significantly more likely than White or Caucasian patients to have had celecoxib administered preoperatively (71.0% vs 58.2% p=0.01)
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Black or African American patients were more likely than White or Caucasian patients to have a longer time from skin incision to would closure (85 + 22 minutes, p<0.001) and longer time from start of Phase I recovery until patient met discharge criteria (85 + 43 minutes, p=0.037).
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African American patients were more likely than White or Caucasian patients to be female (67.4% p=0.014), younger (64 + 9 years p=0.001), and have had previous arthroplasty on the contralateral knee (17.9% p=0.008).
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Hispanic patients were more likely than White or Caucasian patients to be younger (64 + 8 years p=0.001), shorter (median 162.6 cm p<0.001), and weigh less (88.8 + 17.9 kg).