Patients who received preoperative counseling before ACL reconstruction used significantly fewer opioids after surgery without reporting more pain, according to a July 23 news release from the Baltimore-based University of Maryland School of Medicine.
The randomized clinical trial, published in The Journal of Bone and Joint Surgery, followed 121 patients ages 14 to 64 who underwent ACL surgery at the University of Maryland Rehabilitation & Orthopaedic Institute between May 2021 and November 2022. Patients counseled to take opioids only as a “last resort” used a median of 15 milligrams of oxycodone within three months, compared to 53 milligrams in the standard-care group. Both groups reported similar pain scores, sleep quality and satisfaction levels.
The study found fewer medication-related side effects in the counseling group and no clinical benefit from higher opioid use. Researchers said the findings support a shift away from advising patients to “stay ahead of the pain” and recommend applying this strategy to other surgeries.
