Opioid Sparing Joint Replacement Surgery with AVATAR

May 21, 2020

The opioid epidemic has made headlines around the country over the past several years with addiction affecting all segments of society across economic, social, and ethnic divides. No one is immune to the potential adverse impact of opioid use and sadly, many cases of addiction are fueled by prescription use for treatment of postoperative pain. Not only do opioids care the risk of dependence and abuse, but they are also associated with other negative side effects including nausea, constipation, somnolence, hallucinations and many others. Recognizing the potential perils of opioid use after orthopaedic surgery, there has been a growing focus on methods to effectively manage postoperative pain in an opioid-sparing fashion. Our AVATAR approach has been refined with this goal in mind to allow patients a successful recovery while minimizing the use of prescription narcotics both in terms of the dosage of medication needed and the duration of therapy.

We achieve this in several ways.

  1. We use the best anesthetic and surgical techniques that are tissue sparing and reduce the surgical stress response. This includes the use of regional nerve blocks in knee and shoulder replacement which have proven to reduce postoperative pain.
  2. We use pre-emptive analgesia. This means that patients are given several non-narcotic medications like Celebrex, Gabapentin and intravenous Tylenol immediately prior to surgery. This reduces both intraoperative and postoperative pain.
  3. We use a long-acting local anesthetic injected around the surgical field during the procedures. This provides immediate postoperative pain relief that can last for several days after surgery.
  4. We use multi-modal analgesia. This means that patients are given a combination of non-opioid medications which act synergistically to reduce pain. When taken together, their impact is much more effective than any single medication taken alone. And when taken on a well-structured schedule, these medication programs can provide substantial comfort while minimizing the need for narcotic pain medications.

In addition to these measures, patient education is paramount. We cannot make surgery entirely pain free but by setting realistic expectations and engaging patients in their own recovery, we can manage this process in a manner that makes the experience much more pleasant than in years past. We believe our AVATAR program leads to superior results because our value proposition is a commitment to outcomes through education and navigation. This means we try to effectively help patients through a successful recovery as a team effort. Because our practice focuses so heavily on joint replacement, we can devote more resources to each patient to provide this crucial navigation step. Our mission is your outcome.