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Background: Despite the ongoing opioid epidemic, most patients are still prescribed a significant number of opioid medications for pain management after arthroscopic surgery. There is a need for consensus among orthopaedic surgeons and solutions to aid providers in analgesic strategies that reduce the use of opioid pain medications., Purpose: This position statement was developed with a comprehensive systematic review and meta-analysis of exclusively randomized controlled trials (RCTs) to synthesize the best available evidence for managing acute postoperative pain after arthroscopic surgery., Study Design: Position statement., Methods: The Embase, MEDLINE, PubMed, Scopus, and Web of Science databases were searched from inception until August 10, 2022. Keywords included arthroscopy , opioids , analgesia , and pain , and associated variations. We included exclusively RCTs on adult patients to gather the best available evidence for managing acute postoperative pain after arthroscopic surgery. Patient characteristics, pain, and opioid data were extracted, data were analyzed, and trial bias was evaluated., Results: A total of 21 RCTs were identified related to the prescription of opioid-sparing pain medication after arthroscopic surgery. The following recommendations regarding noninvasive, postoperative pain management strategies were made: (1) multimodal oral nonopioid analgesic regimens-including at least 1 of acetaminophen-a nonsteroidal anti-inflammatory drug-can significantly reduce opioid consumption with no change in pain scores; (2) cryotherapy is likely to help with pain management, although the evidence on the optimal method of application (continuous-flow vs ice pack application) is unclear; (3) and (4) limited RCT evidence supports the efficacy of transcutaneous electrical nerve stimulation and relaxation exercises in reducing opioid consumption after arthroscopy; and (5) limited RCT evidence exists against the efficacy of transdermal lidocaine patches in reducing opioid consumption., Conclusion: A range of nonopioid strategies exist that can reduce postarthroscopic procedural opioid consumption with equivalent vocal pain outcomes. Optimal strategies include multimodal analgesia with education and restricted/reduced opioid prescription., Competing Interests: One or more of the authors has declared the following potential conflict of interest or source of funding: O.R.A. has received nonconsulting fees from CONMED. I.W. has received consulting fees from DePuy Mitek, Smith & Nephew, COMED, and Bioventus. J.W. has received research support from Arthrex, CONMED, Linvatec, Ossur, Smith & Nephew, and Zimmer Biomet; and education payments from Arthrex, CONMED, Linvatec, Ossur, Smith & Nephew, and Zimmer Biomet. J.G. has received research support from JRF Ortho, Arthrex, MiMedX, and InGeneron; education payments from Arthrex; and consulting fees from JRF Ortho, Vericel, Arthrex, and Tactile Orthopaedics. M.P. has received consulting fees from Arthrex and CONMED. R.D. has received research support from Smith & Nephew and honoraria from Sanofi. R.M. has received education payments from Arthrex, Gemini Medical, Smith & Nephew, and Linvatec; and consulting fees from Smith & Nephew. M.E.L. has received research support from Arthrex, CONMED, Linvatec, Ossur, Smith & Nephew, and Zimmer Biomet; and education payments from Arthrex, CONMED, Linvatec, Ossur, Smith & Nephew, and Zimmer Biomet. B.M. has received consulting fees from Arthrex and honoraria from Pendopharm. R.K.M has received a grant from Smith & Nephew; consulting fees from Smith & Nephew and Arthrex; nonconsulting fees from Tactile Orthopaedics; royalties from Tactile Orthopaedics; stock from Tactile Orthopaedics; and is on the Board for Tactile Orthopaedics. AOSSM checks author disclosures against the Open Payments Database (OPD). AOSSM has not conducted an independent investigation on the OPD and disclaims any liability or responsibility relating thereto., (© The Author(s) 2023.)

Background: Exercise is widely regarded to improve pain and function in patients with knee osteoarthritis (OA) through building supportive muscle mass, facilitating weight loss, and through the other beneficial effects associated with it., Purpose: To explore literature that presents clinical guidelines for the use of exercise in the treatment of knee OA to inform an evidence-based position statement for the Arthroscopy Association of Canada., Study Design: Position statement., Methods: PubMed, MEDLINE, Embase, and Cochrane databases were searched for guidelines commenting on the role of exercise for knee OA. The search was limited to guidelines published in the last 10 years. Articles were screened for relevance, focusing on recently published research with clinical guidelines. Inclusion criteria involved all articles providing clinical guidelines for exercise and knee OA., Results: Eight guidelines were identified. All eight recommended exercise as an important component of treatment for knee OA, with 6/8 strongly recommending it., Conclusion: Exercise is an effective and important component of the non-pharmacological management of knee OA. The Arthroscopy Association of Canada strongly recommends the use of exercise in the management of knee OA., (© The Author(s) 2021.)