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    Patients Taking Opioids before ACL Surgery More Likely to Be on Pain Medications Longer

    More than 130,000 anterior cruciate ligament (ACL) surgeries take place each year, with most patients stopping pain medication within 3 months postoperatively.

    However, research presented at the American Orthopaedic Society for Sports Medicine’s Annual Meeting today in Toronto, Ontario, Canada reports that patients who filled opioid prescriptions prior to surgery were 10 times more likely to be filling opioid prescriptions 5 months after the procedure.

    “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 counseling regimen than previously identified,” said Chris A. Anthony, MD, lead study author from the University of Iowa Hospitals and Clinics, in Iowa City.

    From the Humana Inc. database, Dr. Anthony and his colleagues used CPT code 29888 to identify 4,946 arthroscopic ACL reconstructions that were performed between 2007-2017. Patients were further categorized according to the type of procedure:

    • ACL reconstruction only
    • ACL reconstruction with meniscus repair
    • ACL reconstruction with menisectomy
    • ACL reconstruction with microfracture

    The researchers evaluated the effect of preoperative opioid demand on postoperative demand by comparing patients who did and did not fill opioid prescriptions pre-and post-surgery. Patients were considered preoperative opioid users if they had filled a prescription in the 3 months preceding surgery.

    They found the following:

    • Nearly 35% of patients (1,716/4,946) filled an opioid prescription in the 3 months before surgery
    • Nearly 7% patients were still filling opioid prescriptions 3 months after surgery
    • Nearly 5% were still filling prescriptions at 12 months after surgery.
    • Patients younger than 25 years old were 4 times more likely to be filling opioid prescriptions at 9 months after surgery than patients in other age groups
    • Patients who underwent ACL reconstruction with microfracture were more likely to be filling an opioid prescription 5 months after surgery than patients in the other procedure groups

    “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,” Dr. Anthony said.

    Source

    Anthony C, Westermann RW, Bedard N, Glass N, Bollier M, Hettrich CM, Wolf BR. Opioid Demand after Anterior Cruciate Ligament Reconstruction (paper 171). Presented at the Annual Meeting of the American Orthopaedic Society for Sports Medicine, July 20-23, 2017, Toronto, Ontario, Canada. All abstracts from the meeting can be found here.