Case Report: Use of a Patient-Driven, Opioid-Free Surgical Pathway for Left Total Knee Arthroplasty in a Patient Refusing Opioids

Overprescription of opioids after surgery contributes to persistent postoperative opioid use, with 11% of total knee arthroplasty (TKA) patients continuing opioid use beyond 3 months. In response to the growing demand for opioid-free surgery, we developed a patient-driven, opioid-free surgical pathway (PDOFSP). This team-based pathway enhances communication, education, and multimodal pain management, including nerve blocks and complementary techniques tailored to the patient's preferences. This case report describes a 69-year-old patient who underwent opioid-free TKA due to drug allergies and personal preferences. The program was individualized to the patient's choices and enabled the patient to achieve her goal.