{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T23:19:12Z","timestamp":1783466352234,"version":"3.55.0"},"reference-count":31,"publisher":"Georg Thieme Verlag KG","issue":"09","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Knee Surg"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>The ongoing opioid epidemic has prompted a reexamination of perioperative pain management, especially in total knee arthroplasty (TKA)\u2014a procedure known for its high amount of postoperative pain and historical reliance on opioids. Among strategies for opioid-na\u00efve patients, three broad approaches have emerged: Quantity limitation, dynamic reassessment-based prescribing, and tiered, multimodal pain regimens. While limiting prescription size and scheduling timely follow-ups remain important tools, perhaps an important approach to consider is a tiered, multimodal pain management regimen. This strategy begins with baseline administration of non-opioid agents such as acetaminophen, non-steroidal anti-inflammatory drugs (NSAIDs), and gabapentinoids, escalating only as needed to tramadol and, if necessary, stronger opioids. Preoperative cryoneurolysis, intraoperative regional nerve blocks, and long-acting local anesthetics further enhance this regimen's ability to minimize opioid exposure. These clinical gains are now reinforced by the Non-Opioids Prevent Addiction in the Nation (NOPAIN) Act, which provides separate Medicare reimbursement for select non-opioid pain treatments beginning in 2025, helping to eliminate financial barriers to adoption of these measures. In addition, real-world data\u2014including results from the Innovations in Genicular Outcomes Research (iGOR) registry\u2014have demonstrated the effectiveness of these techniques in reducing opioid use and improving functional and quality-of-life outcomes following TKA. Together, this convergence of clinical strategy, supportive policy, and data infrastructure provides a scalable and sustainable framework for advancing opioid stewardship in orthopaedic surgery without compromising patient comfort or recovery.<\/jats:p>","DOI":"10.1055\/a-2778-8820","type":"journal-article","created":{"date-parts":[[2025,12,26]],"date-time":"2025-12-26T23:54:37Z","timestamp":1766793277000},"page":"470-476","source":"Crossref","is-referenced-by-count":1,"title":["Strategies for Opioid Minimization Following Total Knee Arthroplasty: A Comprehensive Review"],"prefix":"10.1055","volume":"39","author":[{"given":"Vinod","family":"Dasa","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Louisiana State University Health Services Center, New Orleans, Louisiana, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5831-055X","authenticated-orcid":false,"given":"Mitchell K.","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Rothman Orthopaedic Institute, Philadelphia, Pennsylvania, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer H.","family":"Lin","sequence":"additional","affiliation":[{"name":"HEOR & RWE, Pacira BioSciences, Inc., Tampa, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew I.","family":"Spitzer","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Cedars-Sinai Medical Center, Los Angeles, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adam","family":"Rivadeneyra","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Orthopaedic Specialty Institute, Orange, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Rogenmoser","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Mid State Orthopaedic and Sports Medicine Center, Alexandria, Louisiana, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew L.","family":"Concoff","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, Exagen Inc., Vista, California, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"DiGiorgi","sequence":"additional","affiliation":[{"name":"HEOR & RWE, Pacira BioSciences, Inc., Tampa, Florida, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Urban","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery, OrthoNebraska, Omaha, Nebraska, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giles R.","family":"Scuderi","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Lenox Hill Hospital, Northwell Orthopedics, New York, New York, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William M.","family":"Mihalko","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Campbell Clinic Orthopaedics, Memphis, Tennessee, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael A.","family":"Mont","sequence":"additional","affiliation":[{"name":"Sinai Hospital of Baltimore, Baltimore, Maryland, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"194","published-online":{"date-parts":[[2026,1,20]]},"reference":[{"issue":"20","key":"ref1","doi-asserted-by":"crossref","first-page":"e1302","DOI":"10.5435\/JAAOS-D-21-01158","article-title":"The opioid epidemic in America: 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