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Editorial Commentary: Scoping Knees With Osteoarthritis and Opioid Dependence? Brace Yourself for Postop Pain.

Arthroscopy 2019 Februrary
Recent data suggest there are 2 factors associated with prolonged opioid use following arthroscopic meniscus surgery: opioid use prior to surgery and the presence of osteoarthritis. With heightened awareness and large-scale efforts to reduce perioperative opioid use, cessation prior to surgical interventions should be given strong consideration because this may result in meaningful reductions in postoperative prescriptions. In addition, counseling patients about opioid-induced hyperalgesia (where opioid medications can make pain worse and not better) in the preoperative period could be used in this population. A multimodal approach to pain control after surgery should be standardized. Finally, we must maximize nonsurgical care in patients with mild osteoarthritis and meniscus tears. Perhaps the quickest way to have a meaningful reduction in postoperative opioid use? Stop scoping knees with osteoarthritis!

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