Mood Disorders Are Associated with Increased Perioperative Opioid Usage and Health Care Costs in Patients Undergoing Knee Cartilage Restoration Procedure

Austin V. Stone, Meredith L. Murphy, Cale A. Jacobs, Christian Lattermann, Gregory S. Hawk, Katherine L. Thompson, Caitlin E.W. Conley

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: To identify the prevalence of mood disorder diagnoses in patients undergoing cartilage transplantation procedures and determine the relationship between mood disorders, opioid usage, and postoperative health care costs. Design: Patients with current procedural terminology (CPT) codes for osteochondral autograft transplantation (OAT), osteochondral allograft transplantation (OCA), and autologous chondrocyte implantation (ACI) were identified in the Truven Health Marketscan database (January 2009-September 2014). Patients were grouped based on having a preoperative mood disorder diagnosis (preMDD). Preoperative opioids, postoperative opioids ≥90 days, and health care costs within the year postoperative were compared for those with and without mood disorders. Costs were analyzed, adjusting for preoperative cost, sex, age, and opioid usage, for those with and without mood disorders. Results: A total of 3,682 patients were analyzed (ACI: 690, OAT: 1,294, OCA: 1,698). A quarter of patients had preMDD (ACI: 25.4%, OAT: 20.6%, OCA: 22.7%). Postoperative opioid use was more prevalent in preMDD patients (OAT: 37.1% vs. 24.1%, P < 0.001; OCA: 30.4% vs. 24.8%, P = 0.032; ACI: 33.7% vs. 26.2%, P = 0.070) (odds ratio [OR] ranged from 1.29 to 1.86). First-year postoperative log-transformed costs were significantly greater for preMDD patients (ACI: $7,733 vs. $5,689*, P = 0.012; OAT: $5,221 vs. $3,823*, P < 0.001; OCA: $6,973 vs. $3,992*, P < 0.001; *medians reported). The estimated adjusted first postoperative year cost increase for preMDD OCA patients was 41.7% (P < 0.001) and 28.0% for OAT patients (P = 0.034). There was no statistical difference for ACI patients (P = 0.654). Conclusion: Cartilage transplantation patients have a high prevalence of preoperative mood disorders. Opioid use and health care costs were significantly greater for patients with preoperative mood disorder diagnoses. Level of Evidence: Level III, retrospective therapeutic study.

Original languageEnglish
Issue number1
StatePublished - Jan 1 2022

Bibliographical note

Funding Information:
This project was not funded. However, the data used for the project was made possible through the University of Kentucky’s Clinical and Translational Science Center, which is supported by the NIH National Center for Advancing Translational Sciences (grant numbers UL1TR001998 and UL1TR000117). The content is solely the authors’ responsibility and does not necessarily represent the official views of the NIH.

Publisher Copyright:
© The Author(s) 2022.


  • autologous chondrocyte implantation
  • osteochondral allograft
  • osteochondral autograft

ASJC Scopus subject areas

  • Medicine (all)


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