A comparison of pain scores and medication use in patients undergoing single-bundle or double-bundle anterior cruciate ligament reconstruction.

The anterior cruciate ligament (ACL) is the most commonly injured knee ligament, with approximately 200 000 ruptures annually in the United States.1 Two common surgical approaches to treat the ACL-deficient knee are the single-bundle (SB) and anatomic double-bundle (DB) reconstruction methods. To our knowledge, no studies have been published to date comparing pain and medication use for the SB and DB ACL reconstruction (ACLR) procedures or comparing pain scores in the acute postoperative period for spinal versus general anesthesia approaches for these procedures. No gold standard exists for the management of postoperative pain following ACLR.2 Postoperative pain is often overlooked even though prevention and effective relief of acute pain can improve clinical outcomes, avoid clinical complications, save health care resources and improve quality of life.3 Managing postoperative pain is also important because research has shown that early control of pain can assist with managing its evolution and development.4 Previous studies have analyzed the effects of pain and rehabilitation for SB ACLR surgery and reported that postoperative patients who were unable to perform straight leg raises had significantly higher pain scores than patients who were able to perform straight leg raises.5 These findings suggest that pain may inhibit function, limit early rehabilitation and delay recovery in the long-term.5 The purpose of this quality assurance study was to compare postoperative pain scores and medication use between patients undergoing SB or DB ACLR and to determine if there was a difference in pain scores between patients receiving spinal anesthesia and those receiving general anesthesia for either SB or DB ACLR.