A Prospective Assessment of Opioid Utilization Post- Operatively in Orthopaedic Sports Medicine Surgeries

Document Type : RESEARCH PAPER

Authors

Department of Orthopaedic Surgery, St. Louis University, St. Louis, MO, USA

Abstract

Background: The healthcare system is plagued finding the balance between opioid use and abuse. Orthopaedic
surgeons are expected to curtail the number of opioids prescribed in order to lower opioid abuse. We sought to
prospectively evaluate opioid consumption following a wide range of sports orthopaedic surgical procedures to
determine utilization patterns.
Methods: All patients receiving procedures within a one-year period were consented and then called daily for one
week followed by weekly for up to two months or until the patients no longer were taking their opioid medication. We
studied the number of opioids patient’s took postoperatively and also collected information in regards to the patient
and the surgical procedure.
Results: Included were 223 patients with a mean age of 32.9 years (range, 11 to 82). Surgeons prescribed a
mean total of 59.5 pills, and patients reported consuming a mean total of 20.9 pills, resulting in a utilization rate
of 40%. 94.4% of patients received no education on how to properly dispose of unused opioids. The mean SANE
score was 53.9. The mean Pain Catastrophizing Scale score was 15.1. The mean Opioid Risk Tool was 3.3. The
procedures were broken down into: 47.5% ligamentous knee repair, 18.4% shoulder arthroscopy/other shoulder,
7.6% meniscus, 7.6% shoulder arthroplasty, 5.4% distal biceps, 4.0% lower leg (ankle/foot/tibia) and 4.0% shoulder
ORIF.
Conclusion: Over-prescribing opioids after sports orthopaedic surgeries is widespread. In this study, we found
that patients are being prescribed 2.48 times greater opioid medications than needed following sports orthopaedic
surgical procedures. We recommend surgeons take care when prescribing postoperative pain control and consider
customizing their opioid prescriptions on the basis of prior opioid usage, anatomic location and procedure type.
We also recommend educating the patients on proper disposal of excess opioids and consider involving pain
management for patients likely to require prolonged opioid usag e.
Level of evidence: II

Keywords

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The Archives of Bone and Joint Surgery
Volume 9, Issue 5
September and October 2021
Pages 503-511

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History

  • Receive Date: 14 June 2020
  • Revise Date: 08 December 2020
  • Accept Date: 19 December 2020

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