Feb. 17, 2022 — Nick Dawson, a 42-year old Montana-based ski instructor, knows a thing or two about ACL repairs. He has torn his anterior cruciate ligament four times and had surgery for the injury three times.
A common but painful surgery, doctors often prescribe a hefty course of overdose in 2019, while 10.1 million people misused the drugs.
“Opioids are pretty standard post-surgery here in the United States,” says Okoroha. “We have the perception that there should be no pain following surgery.”
This approach and belief date back to the mid-1990s, when OxyContin appeared on the market as a “gentler” class of opioids, marketed as less addictive. Insurance companies and doctors bought in, and by 2017, the U.S. had a public health crisis with opioid addiction. Now doctors are looking for ways to break the cycle.
Even before this round of orthopedic research, as a surgeon himself, Okoroha began looking into ways to stop the use of opioids in joint replacement procedures. Finding success there — patients found the protocol as effective or more so than opioids — Okoroha decided to move on to other areas of orthopedic procedures to see if he could produce the same results.
Comparing Protocols
Breaking their research into two studies, the Mayo team first investigated the alternative medication protocol with 62 ACL repair patients, dividing them into two groups: one using the standard opioid plan of hydrocodone and acetaminophen. With the second group, the researchers used nerve blockers, rotator cuff study, patients receiving the experimental protocol fared slightly better.
Okoroha says more research into the new pain treatment plans in other orthopedic surgeries will follow.
In the meantime, “it’s up to providers to see if their patients can manage without opioids,” he says. “If we can combine the evidence with adoption, we can eventually change the standard practice.”