Ditch opioids before knee surgery to depend less on painkillers later

Patients, who take opioids prior to Anterior Cruciate Ligament (ACL) surgery, are 10 times more likely to be on pain medications longer, a recent study has found.

"With the ever-increasing opioid epidemic our nation is facing, understanding the risk factors for postoperative narcotic use could aid surgeons and healthcare systems in identifying patients who could benefit from a different pain management and counselling regimen than previously identified," said lead researcher Chris A. Anthony from the University of Iowa Hospitals and Clinics.

The team identified 4,946 arthroscopic ACLRs and evaluated the effect of preoperative opioid demand on postoperative demand by comparing those who did and did not fill prescriptions pre-and post-surgery.

Patients were considered preoperative opioid users if they had filled a prescription in the three months preceeding surgery. Individuals were also categorized by those who underwent only ACLR, those who underwent ACLR with meniscus repair, those who underwent ACLR with menisectomy and those with ACLR and microfracture.

Majority of the patients don't require pain medication after three months post-operatively, but according to their analysis, nearly seven percent of patients were still filling opioid prescriptions, three months following surgery with almost five percent still filling prescriptions at 12 months. Nearly 35 percent of patients were filling opioid prescriptions in the three months prior to surgery. Those younger than 25 years were four times as likely to be filling opioid prescriptions at nine months following surgery.

"We hope that our research will help contribute additional information to the baseline opioid medication demand data and continue to increase our knowledge of how to better cope with addiction and pain management following surgery," said Anthony.

The study was presented at the American Orthopaedic Society for Sports Medicine's Annual Meeting today in Toronto, Ontario, Canada.