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

Abstract

Background: The healthcare system is plagued finding the balance between opioid use and abuse. Orthopaedicsurgeons are expected to curtail the number of opioids prescribed in order to lower opioid abuse. We sought toprospectively evaluate opioid consumption following a wide range of sports orthopaedic surgical procedures todetermine utilization patterns.Methods: All patients receiving procedures within a one-year period were consented and then called daily for oneweek followed by weekly for up to two months or until the patients no longer were taking their opioid medication. Westudied the number of opioids patient's took postoperatively and also collected information in regards to the patientand the surgical procedure.Results: Included were 223 patients with a mean age of 32.9 years (range, 11 to 82). Surgeons prescribed amean total of 59.5 pills, and patients reported consuming a mean total of 20.9 pills, resulting in a utilization rateof 40%. 94.4% of patients received no education on how to properly dispose of unused opioids. The mean SANEscore was 53.9. The mean Pain Catastrophizing Scale score was 15.1. The mean Opioid Risk Tool was 3.3. Theprocedures 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% shoulderORIF.Conclusion: Over-prescribing opioids after sports orthopaedic surgeries is widespread. In this study, we foundthat patients are being prescribed 2.48 times greater opioid medications than needed following sports orthopaedicsurgical procedures. We recommend surgeons take care when prescribing postoperative pain control and considercustomizing 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 painmanagement for patients likely to require prolonged opioid usag e. Level of evidence: II