Risk Factors for Post ACL Reconstruction Pain
Conditions
Brief summary
In 2006, approximately 130,000 arthroscopic anterior cruciate ligament reconstructions were performed in the United States, and the number is increasing each year. Despite being a minimally invasive procedure, pain is the most common postoperative problem after arthroscopic anterior cruciate ligament reconstruction associated with cost, postoperative opioid consumption, opioid-related side effects, quality of life, patient satisfaction, and delayed discharge. Over two-thirds of the patient receiving arthroscopic anterior cruciate ligament surgery have moderate to severe pain.
Detailed description
At present, multimodal analgesia is a successful mainstay treatment for arthroscopic anterior cruciate ligament surgery which range from opioid, paracetamol, non-steroidal anti-inflammatory agents (NSAIDs), local anesthetic agents, ketamine, corticosteroid, and cold compression therapy. Previous study showed femoral nerve block reduces pain score but also increases incidence of falling. Afterward, a study on adductor canal block showed equivalent postoperative analgesia while preserving quadriceps strength. Furthermore, a few studies were conducted to determine risk factors for postoperative pain after arthroscopic anterior cruciate ligament surgery, but results are contradictory. Previous research found risk factors for postoperative pain after arthroscopic anterior cruciate ligament surgery are female, young age, smoker, preoperative visual analog scale score ≥3, tourniquet time \> 50 minutes, and cartilage injury. In addition, evidence showed higher preoperative visual analog scale, and previous opioid use are associated with greater amount of opioid consumption. In contrary, some evidence showed no effect of age, sex, body mass index (BMI), tourniquet time, type of anesthesia on post postoperative pain after arthroscopic anterior cruciate ligament surgery.
Interventions
OTHERNo intervention
No intervention This study is a retrospective descriptive study.
Sponsors
Prince of Songkla University
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Patients undergoing primary unilateral arthroscopic anterior cruciate ligament reconstruction with or without unilateral cartilage/meniscus injury with or without other ligaments injury (posterior cruciate ligament/medial collateral ligament/lateral collateral ligament) Age ≥ 15 years
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| To find risk factors for moderate to severe postoperative pain after arthroscopic anterior cruciate ligament reconstruction in the first 72 hours. | Three days | To find risk factors for moderate to severe postoperative pain after arthroscopic anterior cruciate ligament reconstruction in the first 72 hours |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| To find incidence of moderate to severe pain after arthroscopic anterior cruciate ligament reconstruction in the first 72 hours | Three days | To find incidence of moderate to severe pain after arthroscopic anterior cruciate ligament reconstruction in the first 72 hours |
| To find analgesic requirement after arthroscopic anterior cruciate ligament reconstruction for 1 year | One year after discharge | To find analgesic requirement after arthroscopic anterior cruciate ligament reconstruction for 1 year |
Outcome results
None listed