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Evaluation of Pain After Arthroscopically Assisted Anterior Cruciate Ligament Reconstruction

Orthopaedic Associates, Portland, Maine

Craig M. Curry, MD

Maine Medical Center, Portland, Maine

Linda M. Ruterbories, RN

Orthopaedic Associates, Portland, Maine

F. Lincoln Avery, MD

Orthopaedic Associates, Portland, Maine

Philip S. Anson, MD

Orthopaedic Associates, Portland, Maine

Pain after arthroscopically assisted anterior cruciate reconstruction was examined during the first 5 postop erative days to evaluate its intensity and duration. One hundred consecutive patients who underwent arthro scopically assisted anterior cruciate ligament recon struction using a bone-patellar tendon-bone autograft were examined. During surgery, ketorolac (60 mg) was given intravenously and 0.25% bupivicaine (1 ml/kg total) was injected into the joint space and the graft donor site. After surgery, all patients received sched uled doses of oral acetaminophen (650 mg) and ke torolac (10 mg) four times a day, and they were al lowed to take oral oxycodone (5 to 10 mg) every 2 hours as needed. Pain scores at rest and with activity reached a maximum on the 2nd postoperative morn ing. Oxycodone consumption also peaked on the 2nd postoperative day. Eighty-nine (89%) patients reported overall pain as mild or moderate, and 95 patients (95%) reported either excellent or good overall relief of pain. The 5-day cumulative mean of visual analog scale pain scores for attempting straight leg raises was significantly higher for patients unable to successfully perform that activity than for patients who were able to perform it. The association between elevated pain scores and diminished ability to perform straight leg raises suggests that pain may inhibit function and therefore early rehabilitation.

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