Use of opioids before ACL reconstruction linked with increased postoperative use
Patients who filled opioid prescriptions prior to ACL reconstruction had a five- to seven-fold increased risk of filling opioid prescriptions postoperatively, according to results.
Between 2007 and 2014, investigators identified 4,946 patients who underwent ACL reconstruction. Christopher A. Anthony, MD, and colleagues considered patients preoperative opioid users if they filled at least one opioid prescription in the 3 months preceding ACL reconstruction. Researchers performed a subgroup analysis and defined chronic opioid users as patients who had filled an opioid prescription 1 month to 3 months before ACL reconstruction and acute opioid users as patients who had filled an opioid prescription less than 1 month before ACL reconstruction.
In the 3 months before ACL reconstruction, results showed nearly 35% of patients were filling opioid pain prescriptions. Researchers noted 7.24%, 4.97% and 4.71% of patients were still filling opioid prescriptions 3 months, 9 months and 12 months after their procedure, respectively.
Compared with nonusers, patients who filled prescriptions preoperatively were 5.35-times more likely to be filling opioid prescriptions at 3 months postoperatively, according to results. Researchers found patients were at a 10.50-times increased risk of filling opioid prescriptions at 5 months postoperatively if they filled prescriptions chronically before surgery.
Patients who underwent ACL reconstruction with microfracture had a 1.96, 2.38 and 1.51 increased risk of filling opioid prescriptions at 5 months postoperatively compared with patients undergoing ACL reconstruction alone, ACL reconstruction with meniscus repair and ACL reconstruction with meniscectomy, respectively. At all time points, researchers found an increased risk of filling opioid prescriptions after ACL reconstruction among patients younger than 25 years of age.
“Surgeons and health care systems should be aware 35% of patients are filling opioid prescriptions in the 3 months prior to [ACL reconstruction] ACLR,” Anthony told Healio.com/Orthopedics. “Filling of preoperative opioid prescriptions is a strong predictor of postoperative opioid demand with a five- to seven-fold increased risk after ACLR. Patients less than 25 years of age and those undergoing ACLR with microfracture were at an elevated risk of filling opioid prescriptions postoperatively.” – by Casey Tingle
Disclosures: Anthony reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.