Opioid use following partial meniscectomy with needle arthroscopy compared to standard knee arthroscopy: Results from a randomized multicenter trial.

Abstract

To evaluate opioid use following partial meniscectomy performed with needle arthroscopy compared to standard arthroscopy. A prospective, multicenter randomized trial was performed between January and August 2023. Patients undergoing isolated partial meniscectomy were randomized to receive either needle (NA, n = 41) or standard arthroscopic (SA, n = 40) treatment. Those receiving meniscus repair or concurrent ligament, or cartilage procedures were excluded. The primary outcome was opioid consumption within 24 h post-operatively. Secondary outcomes were patient reported outcomes (PROs), including Knee Injury and Osteoarthritis Outcome (KOOS) pain and International Knee Documentation Committee (IKDC) scores measured at 2, 6, and 12-weeks postoperatively. Univariate analysis was used to compare results. Eighty-nine patients were enrolled. One patient withdrew on the day of surgery. Eight patients (NA, n = 2; SA, N = 6) were excluded due to insufficient records regarding opioid consumption. There were 41 patients in the NA group and 40 patients in the SA group (NA 26 males, 63 % vs. SA 19 males, 48 %, p = 0.15). Mean age ± SD (NA 48.5 ± 10.7 vs SA 48.2 ± 9.9 years, p = 0.87) and body mass index (NA 30.8 ± 4.9 vs. SA 32.6 ± 6.6 m/kg², p = 0.64) were not significantly different. Pre-operative Outerbridge scores were similar (NA 2.8 ± 1.1 vs. SA 2.5 ± 1.2, p = 0.38). The NA group consumed significantly fewer opioid pills within 24 h (NA 1.3 ± 1.7 vs. SA 2.7 ± 2.1, p < 0.01). In addition, patients reported significant differences in KOOS pain and IKDC scores at 2 weeks [KOOS pain: NA 62.9 ± 21.2 vs. 50.2 ± 20.1, p = 0.007 and IKDC: NA 56.7 ± 18.7 vs. SA 41 ± 17.2, p < 0.001] and 6 weeks post-operatively [KOOS pain: NA 72.6 ± 20.5 vs. 63.5 ± 18.3, p = 0.050 and IKDC: NA 67.5 ± 23.9 vs. 54.8 ± 18.1, p = 0.015]. At 12 weeks, differences in PROs were not maintained. In the immediate post-operative period, opioid use was significantly reduced after partial meniscectomy performed with needle arthroscopy compared with standard arthroscopy. Level I.