Penn Highlands Healthcare Clinicians Pioneer Opioid-Free ACL Surgery Protocol for Young Athletes
DuBois, Pennsylvania, Sept. 18, 2025 (GLOBE NEWSWIRE) -- In a bold move to combat the opioid crisis and advance surgical recovery, the Orthopedics and Sports Medicine team at Penn Highlands Healthcare has developed a pioneering approach to ACL surgery that substantially reduces —or even eliminates — opioid use, without compromising pain control or patient outcomes.
The multidisciplinary Penn Highlands Healthcare team — led by Matthew A. Varacallo, MD, MBA, FAAOS, a board-certified and fellowship-trained sports medicine and orthopedic surgeon who serves as Director of Orthopedic Robotic Surgery for Penn Highlands Healthcare; along with Samantha L. Morgan, DAT, ATC, LAT, PES, Orthopedic Navigator for Penn Highlands Healthcare; and Christopher P. Varacallo, DO, CAQSM, FAAFP, a sports-fellowship trained and board-certified orthopedic physician for Penn Highlands Healthcare, — designed and implemented a first-of-its-kind opioid avoidance protocol (OAP) for adolescent and young adult patients undergoing anterior cruciate ligament reconstruction (ACLR). Their findings will be presented at the Eastern Orthopaedic Association’s Annual Meeting in October 2025.
“This is a potential blueprint for the future of orthopedic surgery,” said Dr. Matthew Varacallo.
“We’ve proven that you can significantly reduce — or even eliminate — opioid use in surgical patients, starting with one of the most common procedures in sports medicine. ACL reconstruction patients are often young and opioid-naïve, so it’s crucial to explore alternative pain control strategies.”
In the study, 40% of patients who received the OAP were completely opioid-free through postoperative day 60, and overall opioid use was reduced by more than 80% compared to the standard care protocol. Importantly, these patients took fewer narcotic medications without any increase in reported pain or complications.
The protocol included a preoperative cryoneurolysis procedure, which is a "nerve freezing" technique performed seven to 21 days before surgery; a multimodal non-opioid medication regimen consisting of anti-inflammatory drugs and nerve blocks administered on the day of surgery. To ensure flexibility, patients were allowed to request opioid medications if needed.
“Young athletes may not need to be introduced to opioids postoperatively. This study shows they can recover fully without them,” said Dr. Samantha Morgan.
“We’re in the best position to stop opioid exposure at the source,” added Dr. Christopher Varacallo. “Our protocol is proactive, safe, and tailored to the needs of this patient population.”
The study enrolled patients ages 15 to 24 and was completed in December 2024. It is the first ACL-specific trial to integrate cryoneurolysis into a pain management protocol with 60-day opioid tracking and validated patient-reported outcomes.
The Penn Highlands Orthopedics and Sports Medicine team believes this protocol may serve as a replicable model for other orthopedic procedures including total joint replacements and rotator cuff surgeries.
“We are grateful to all those who contributed to this study,” said Dr. Matthew Varacallo. “Most importantly, we thank the patients and families who participated in this work. We plan to continue building on this research to advance the future of orthopedic care.”
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Corinne G. Laboon Penn Highlands Healthcare 724-258-1339 claboon@monvalleyhospital.com
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