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Background and purpose: We aimed to examine the association between socioeconomic status (SES) markers and opioid use after primary total hip arthroplasty (THA) due to osteoarthritis, and whether sex, age, or comorbidities modify any association. Methods: Using Danish databases, we included 80,038 patients undergoing primary THA (2001–2018). We calculated prevalences and prevalence ratios (PRs with 95% confidence intervals [CIs]) of immediate post-THA opioid use (≥ 1 prescription within 1 month) and continued opioid use (≥ 1 prescription in 1–12 months) among immediate opioid users. Exposures were individual-based education, cohabitation, and wealth. Results: The prevalence of immediate opioid use was ~45% in preoperative non-users and ~60% in preoperative users (≥ 1 opioid 0–6 months before THA). Among non-users, the prevalences and PRs of continued opioid use were: 28% for low vs. 21% for high education (PR 1.28, CI 1.20–1.37), 27% for living alone vs. 23% for cohabiting (PR 1.09, CI 1.04–1.15), and 30% for low vs. 20% for high wealth (PR 1.43, CI 1.35–1.51). Among users, prevalences were 67% for low vs. 55% for high education (1.22, CI 1.17–1.27), 68% for living alone vs. 60% for cohabiting (PR 1.10, CI 1.07–1.12), and 73% for low wealth vs. 54% for high wealth (PR 1.32, CI 1.28–1.36). Based on testing for interaction, sex, age, and comorbidity did not statistically significant modify the associations. Nevertheless, associations were stronger in younger patients for all SES markers (mainly for non-users). Conclusion: Markers of low SES were associated with a higher prevalence of continued post-THA opioid use. Age modified the magnitude of the associations, but it was not statistically significant.

Background and purpose: We aimed to examine the temporal trends in periprosthetic joint infection (PJI) revision incidence after knee arthroplasty (KA) from 1997 through 2019. Patients and methods: 115,120 primary KA cases from the Danish Knee Arthroplasty Register were followed until the first PJI revision. We computed cumulative incidences and adjusted hazard ratios (aHRs) of PJI revision by calendar periods and several patient- and surgical-related risk factors. Results were analyzed from 0–3 months and from 3–12 months after KA. Results: The overall 1-year PJI revision incidence was 0.7%, increasing from 0.5% to 0.7% (1997 through 2019). The incidence of PJI revision within 3 months increased from 0.1% to 0.5% (1997 through 2019). The adjusted hazard ratio (aHR) within 1 year of primary KA was 5.1 comparing 2017–2019 with 2001–2004. The PJI revision incidence from 3–12 months of KA decreased from 0.4% to 0.2%, with an aHR of 0.5 for 2017–2019 vs. 2001–2004. Male sex, age 75–84 (vs. 65–74), and extreme obesity (vs. normal weight) were positively associated with the risk of PJI revision within 3 months, whereas only male sex was associated from 3–12 months. Partial knee arthroplasty (PKA) vs. total KA was associated with a lower risk of PJI revision both within 3 months and 3–12 months of KA. Conclusion: We observed an increase in PJI revision within 3 months of KA, and a decrease in PJI revision incidence from 3–12 months from 1997 through 2019. The reasons for this observed time-trend are thought to be multifactorial. PKA was associated with a lower risk of PJI revision.