You can find our disclosures on the Academy website. Okay, so during the 21st century, opioid medication prescription and consumption has increased, which has led to an increase in opioid abuse, dependence, and fatal overdoses. Overprescribing is a known cause contributing to the opioid epidemic. For many surgeries, the ideal amount of opioid medication to appropriately treat post-operative pain is unknown. Recently, a group of experts recommend the prescription of 0 to 20 oxycodone 5-milligram tablets for ACL reconstruction. The AOS recommends no more than 20 5-milligram oxycodone tablets for moderate procedures including shoulder arthroscopy. One study in the pediatric population identified a median of 20 oxycodone tablets, again, 5-milligrams, were consumed following ACL reconstruction. So the primary purpose of our study was to determine if the number of opioid doses prescribed affects patients' short-term post-operative pain in the first 14 days. Our secondary aims were to determine if the number of opioid doses prescribed affected patients' opioid consumption, refill rate, and pain management satisfaction. We hypothesized that there would be no significant difference in post-operative pain or pain management between groups. We also hypothesized that patients receiving a prescription for less opioid medications would take less opioid medications. This was a prospective randomized study. So we prescribed patients either 15, 25, or 35 oxycodone 5-milligram tablets. We did not let the patients know that they were in different studies. We told them that we were just observing opioid consumption, so they were blinded. Patients in all three groups were asked to complete pain and medication use logs twice a day for the first 14 days post-operatively, opioid medication satisfaction survey at two weeks, and IKDC functional questionnaires before surgery and then up to six months post-operatively. We excluded patients for concomitant procedures other than meniscectomy or meniscal repair. If they were undergoing a revision reconstruction, if they reported a history of chronic preoperative opioid use, had a history of substance abuse, were pregnant, or had workers' compensation claims at the time of their surgery. You can see here that in terms of demographics with age at surgery, BMI, and sex, the three groups were similar. As far as the overall total opioid count in each group, the median was between 8 and 9. In terms of satisfaction with post-operative pain relief, patients reported similar satisfaction with pain relief, with the majority being satisfied to extremely satisfied. In terms of prescription quality, patients also reported being relatively equivalent satisfaction statistically, and most of them were satisfied to extremely satisfied. Interestingly, despite this equivalence in satisfaction on the prescription quantity, when they were asked if they received too few, the right amount, or too many, patients in the group that received 15 tablets reported a greater proportion of having too few tablets. In terms of functional outcomes, the three groups were similar at both pre-op and then weeks, two weeks, six weeks, three months, and six months. So the strengths of this study is that this is the first randomized study to analyze prescribing patterns and patient outcomes. For the purposes of this particularly abstract, we did not analyze the effect of concomitant meniscal procedures. We also did not analyze the effect of alcohol use disorder or psychiatric disorders such as depression. Graft choice, again, for the purposes of this abstract, was not directly analyzed as well. So overall, we concluded that there were no significant differences in pain scores and opioid consumption over 14 days. Also the functional outcome scores and six-week satisfaction metrics were similar. So given these results, giving lower quantities of opioid medication appears to be as effective in appropriately controlling post-operative pain as higher quantities and may help to limit the amount of opioids prescribed and possible diversion of unused prescription opioid medication. Thank you.

opioid abuse

overprescribing

opioid medications

post-operative pain

opioid consumption