Patients’ Comfort with Opioid Use and Disposal Post-Operatively After Outpatient Anterior Cruciate Ligament Reconstruction: A Gender-Based Analysis

Abstract

BACKGROUND: Despite legislative efforts to curb inappropriate prescribing, opioid-related adverse events and deaths persist. Prior research has demonstrated that pain perception and response to analgesic medications may vary between genders, underlining the importance of a gender-based analysis in postoperative opioid management. Furthermore, orthopedic surgery remains a significant contributor to opioid prescriptions, however, little is known about patient-specific perspectives regarding opioid usage after knee surgery. This study aimed to assess patients' comfort with postoperative opioid use and explore pre-existing knowledge of opioid disposal, with a specific focus on analyzing differences between genders.

METHODS: All patients scheduled for outpatient anterior cruciate ligament (ACL) reconstruction by the senior author between August 2018 and July 2019 were identified and enrolled in the study. At ten days postoperatively a 7-question, multiple choice paper survey created by the authors was administered in person to each patient. The survey inquired about their use of the medications, any concerns, alternative pain control modalities, and their method of disposal of any remaining prescription pain medication. Patient survey responses were collected, and descriptive and inferential statistics of responses were performed for the overall cohort and per gender.

RESULTS: A total of 47 patients (15 males and 32 females) were included in the final study cohort with a 100% response rate. 100% of respondents reported having remaining medication 10 days after surgery. There were no significant differences in responses based on gender. The primary concern with opioid use was addiction risk (43%) while the second most common response was that they had no concerns (28%). Females reported an increased frequency of concern about disposal methods. 72% of patients discontinued medication due to no longer being in pain. Females more frequently discontinued use because they were no longer in pain while males more frequently discontinued due to other concerns. Various disposal methods were used with 40% of males and 13% of females keeping medications in the house most commonly “just in case” they needed it.

CONCLUSION: Both males and females exhibited similar concerns and preferences regarding postoperative pain management, with observed but non-significant differences in medication use and disposal practices. These findings emphasize the value of gender-aware education in opioid misuse prevention efforts.