Purpose
To develop a standardized opioid prescribing schedule (SOPS) following anterior cruciate
ligament reconstruction (ACLR) and rotator cuff repair (RCR) and evaluate postoperative
opioid consumption alongside Patient-Reported Outcome Measurement Information System
(PROMIS) pain interference scores.
Methods
A prospective observational study was performed on all patients undergoing primary
ACLR and RCR from March 2019 to October 2021. Patients taking opioids preoperatively
and revision ACLR and RCR were excluded. PROMIS 6B questionnaires were administered
before and after implantation of the SOPS initiated on December 15, 2019. Opioid consumption
was determined by email surveys. Hypothesis testing was performed with Mann–Whitney
U test.
Results
A total of 599 patients met inclusion criteria with 188 patients (71 ACLR and 117
RCR) completing surveys. Before the initiation of SOPS, the average number of oxycodone
5-mg tablets prescribed for ACLR was 44.6 (95% confidence interval [CI] 42.4-46.9)
and for RCR was 44.7 (95% CI 42.7-46.8). The average usage was 23.1 (95% CI 16.9-29.2)
and 22.1 (95% CI 16.2-28.0), respectively. Following SOPS of 30 tablets of oxycodone
5 mg for ACLR and 40 tablets for RCR, the average number of tablets prescribed significantly
decreased for both procedures (P < .01 for ACLR and RCR), and the average consumption decreased to 20.5 (95% CI 16.6-24.4)
and 18.6 (95% CI 14.6-22.5), respectively. PROMIS 6B responses did not demonstrate
statistically significant changes following SOPS.
Conclusions
The results of the present study demonstrate that the implementation of a SOPS reduced
postoperative opioid prescribing amounts and consumption without significant impacting
PROMIS pain interference scores for ACLR and RCR, supporting the possibility to decrease
and standardize opioid prescribing following common sports medicine procedures.
Level of Evidence
III: Retrospective, comparative, therapeutic study.
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Article info
Publication history
Published online: August 12, 2022
Accepted:
June 16,
2022
Received in revised form:
June 6,
2022
Received:
January 20,
2022
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article. Full ICMJE author disclosure forms are available for this article online, as supplementary material.
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© 2022 The Authors. Published by Elsevier Inc. on behalf of the Arthroscopy Association of North America.
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