Effect of postoperative NSAID use on opioid consumption after rotator cuff repair

Document Type

Article

Publication Date

8-1-2025

Publication Title

J Orthop

Abstract

BACKGROUND: Opioid consumption following rotator cuff repair (RCR) remains a significant concern in post-surgical pain management. The use of nonsteroidal anti-inflammatory drugs (NSAIDs) has been proposed as a multimodal analgesic approach to reduce opioid use and improve recovery. However, the impact of NSAIDs on opioid consumption and clinical outcomes following RCR remains unclear, with conflicting findings from previous studies. The purpose of this study is to compare opioid consumption in patients prescribed a short course of NSAIDs after RCR versus those who were not prescribed NSAIDs.

METHODS: A retrospective cohort study was conducted including 125 patients who underwent primary arthroscopic RCR between 2012 and 2022. Patients were categorized into two groups based on the surgeon's practice change in May 2017: those who were not prescribed NSAIDs post-surgery and those who were prescribed NSAIDs for six weeks post-surgery. Data on opioid prescription, the need for opioid and NSAID refills, postoperative complications, and patient-reported outcomes (PROs) were collected and analyzed.

RESULTS: No significant differences were observed between the two groups regarding demographic characteristics or preoperative MRI findings. The NSAID group demonstrated a significant reduction in opioid prescription compared to the non-NSAID group, receiving less morphine milligram equivalents (MME) on the day of surgery (306.7 ± 30.2 vs. 1007.4 ± 302.1, p < 0.001). Furthermore, patients in the NSAID group required fewer opioid refills (21.6 % vs. 37.5 %), though this difference did not reach statistical significance (p = 0.085). Both groups showed similar functional outcomes, with no significant differences in postoperative complications or clinical rotator cuff healing failures.

CONCLUSION: This study demonstrates that a short course of NSAIDs following rotator cuff repair reduces opioid consumption without negatively affecting functional outcomes or tendon healing. These findings support the potential role of NSAIDs in reducing opioid reliance post-surgery and advocate for their inclusion in multimodal pain management protocols for RCR.

PubMed ID

40510511

Volume

66

First Page

173

Last Page

178

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