Opioid consumption after knee arthroscopy

Robert D. Wojahn, Ljiljana Bogunovic, Robert H. Brophy, Rick W. Wright, Matthew J. Matava, John R. Green, Corinne A. Zalomek, Amanda K. Haas, Wendy L. Holloway, Elizabeth A. Garofoli, Matthew V. Smith

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

Background: The opioid epidemic in the United States has placed increased pressure on physicians to engage in responsible opioid prescribing practices. However, surgeons currently have little information to guide their postoperative prescription decision-making. The purpose of this study was to assess opioid consumption after knee arthroscopy and identify preoperative factors that may predict higher opioid usage. Methods: A prospective observational study of 221 patients was conducted in patients undergoing outpatient knee arthroscopy for meniscal repair, partial meniscectomy, debridement, chondroplasty, or loose body removal. Participants recorded their daily opioid consumption in a postoperative pain diary. Total opioid consumption was calculated from counts of remaining pills at the 2-week and 6-week postoperative office visits. Variables, including age, sex, body mass index, smoking status, alcohol consumption, preoperative pain severity and duration, preoperative opioid usage, Patient-Reported Outcomes Measurement Information System (PROMIS) scores, and the Connor-Davidson Resilience Scale, were evaluated for an association with opioid consumption. Results: Total opioid consumption ranged from 0 to 188 pills, with a median of 7 pills (hydrocodone 5-mg equivalents). Forty-six percent of patients took ≤5 pills, 59% took ≤10 pills, and 81% took ≤20 pills. Fifty-six percent of patients had discontinued opioid usage by the third postoperative day. Eighty-eight percent of patients had surplus opioid medication at the time of the final follow-up. Patients undergoing meniscal repair, smokers, and those taking preoperative opioids were significantly more likely to take ≥20 pills (p < 0.05). Conclusions: The median number of pills taken after knee arthroscopy is 7, with the majority of patients consuming ≤20 pills. Meniscal repair, smoking, and preoperative opioid usage were associated with higher postoperative opioid consumption. Level of Evidence: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.

Original languageEnglish (US)
Pages (from-to)1629-1636
Number of pages8
JournalJournal of Bone and Joint Surgery - American Volume
Volume100
Issue number19
DOIs
StatePublished - 2018
Externally publishedYes

Bibliographical note

Funding Information:
Disclosure: There was no source of external funding for this study. Study data were collected and managed using REDCap electronic data capture tools hosted at Washington University in St. Louis School of Medicine. The WUSM REDCap installation is supported by Clinical and Translational Science Award Grant UL1 TR000448 and Siteman Comprehensive Cancer Center and NCI Cancer Center Support Grant P30 CA091842. On the Disclosure of Potential Conflicts of Interest forms, which are provided with the online version of the article, one or more of the authors checked “yes” to indicate that the author had a relevant financial relationship in the biomedical arena outside the submitted work (http://links.lww.com/JBJS/E859).

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