{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,16]],"date-time":"2026-05-16T00:43:01Z","timestamp":1778892181266,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"},{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T00:00:00Z","timestamp":1687132800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,5,15]],"date-time":"2023-05-15T00:00:00Z","timestamp":1684108800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["arthroscopysportsmedicineandrehabilitation.org","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Arthroscopy, Sports Medicine, and Rehabil."],"published-print":{"date-parts":[[2023,8]]},"abstract":"<jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To identify the mean morphine milligram equivalent (MME) opioid prescriptions for opioid\u2010na\u00efve patients undergoing isolated anterior cruciate ligament reconstruction (ACLR) between 4 weeks before surgery and the first 90 days after surgery and to describe opioid prescriptions filled per patient and mean MMEs per year within 90 days following ACLR.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Exclusion criteria were patients having concurrent other cruciate or collateral ligament repair or reconstruction, meniscus procedures (repair and debridement), any cartilage procedure, lower\u2010extremity osteotomy, or knee procedures for fracture, infection, or neoplasms; patients with substance use disorder or chronic pain also were excluded. Opioid use between 4 weeks before surgery and the first 90 days after surgery was recorded. Prescribing physician specialty also was tracked. The correlation of patient factors and prescriber specialty of MME were compared using the Student\u2019s\n                      <jats:italic>t<\/jats:italic>\n                      \u2010test. Significance was defined at\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .05.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Opioid\u2010na\u00efve patients undergoing isolated ACLR were included. Isolated arthroscopic ACLRs performed between 2010 and Q3 2020 in opioid\u2010na\u00efve patients were identified within the PearlDiver M91 national database. A total of 37,200 patients were identified. Mean MME per patient was 340.9 \u00b1 198.2, with an average MME per day of 59.9. Factors associated with increased opioid use during the 90 days following ACLR were older age (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) and preoperative diagnosis of depression (\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001). Orthopaedic surgeons were primarily responsible for the number of opioid prescriptions after ACLR (n\u00a0= 29,326, 73.0%) but 27% (n\u00a0= 10,797) of prescriptions came from nonorthopaedic surgeon medical providers who prescribed significantly greater MMEs of opioids than orthopaedic surgeons (456.5 vs 339.2,\n                      <jats:italic>P<\/jats:italic>\n                      &lt; .001) per patient. Lastly, decreasing yearly opioid prescriptions per patient (2.4 to 1.6 prescriptions) and the mean MME per patient (428.4 to 257.1) occurred from 2010 to\u00a02020.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Older age and preoperative diagnosis of depression are associated with greater opioid doses after ACLR. In addition, the vast majority of opioid prescriptions are written by orthopaedic surgeons on the day of ACLR and decreased considerably by four weeks after surgery. Patients receiving opioid prescriptions by nonorthopaedic surgeon medical providers receive significantly greater doses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>Level IV, retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1016\/j.asmr.2023.04.023","type":"journal-article","created":{"date-parts":[[2023,6,19]],"date-time":"2023-06-19T17:05:57Z","timestamp":1687194357000},"update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":6,"title":["Factors Associated With Increased Opioid Prescriptions Following Anterior Cruciate Ligament Reconstruction in Opioid\u2010Na\u00efve Patients"],"prefix":"10.1002","volume":"5","author":[{"given":"Sercan","family":"Yalcin","sequence":"first","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Yale School of Medicine New Haven Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter Y.","family":"Joo","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Yale School of Medicine New Haven Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William","family":"McLaughlin","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Yale School of Medicine New Haven Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jay","family":"Moran","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Yale School of Medicine New Haven Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dennis","family":"Caruana","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Yale School of Medicine New Haven Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Flores","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Yale School of Medicine New Haven Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan","family":"Grauer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Yale School of Medicine New Haven Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Medvecky","sequence":"additional","affiliation":[{"name":"Department of Orthopaedics and Rehabilitation Yale School of Medicine New Haven Connecticut U.S.A."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2023,6,19]]},"reference":[{"key":"e_1_2_2_2_2","volume-title":"Wide\u2010ranging online data for epidemiologic research (WONDER)","author":"Centers for Disease Control 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