Perioperative Pain and Swelling Control in Anterior Cruciate Ligament Reconstruction

Anterior cruciate ligament reconstruction (ACLR) remains one of the most common sports medicine procedures performed in the young, athletic patient population. Over the past 2 decades, advances in surgical technique as well as improvements in perioperative pain control modalities have enabled the vast majority of patients undergoing ACLR to have the procedure performed in the outpatient setting. Multimodal pain control is paramount to the success of outpatient ACLR and incorporates various combinations of general-epidural-regional anesthetics, perioperative peri-incisional local anesthetics, oral analgesics, electrostimulation, compressive cryotherapy, and early physical therapy. This article provides a concise summary of evidence-based guidelines for perioperative pain and swelling management following ACLR, with an emphasis on oral agents and postoperative modalities.